Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2014
Implementation of an Extracorporeal Cardiopulmonary Resuscitation Simulation Program Reduces Extracorporeal Cardiopulmonary Resuscitation Times in Real Patients.
To determine if development of an extracorporeal cardiopulmonary resuscitation simulation program reduced extracorporeal cardiopulmonary resuscitation times in real patients ⋯ There are no standard guidelines of how a team should coordinate the efforts of nursing, physicians, extracorporeal membrane oxygenation specialists, surgeons, respiratory therapists, patient care technicians, and unit clerks to emergently execute this complex procedure. Because time is of the essence, it is essential to develop a highly functioning and well-coordinated team with a standardized method of the procedure, its documentation, and communication. Simulation accomplished this for our program. Following these simulation exercises, not only was there a subjectively observed improved coordination and smoother deployment of extracorporeal membrane oxygenation in real-life extracorporeal cardiopulmonary resuscitation, but we have also demonstrated a significantly faster deployment of extracorporeal membrane oxygenation as compared with the presimulation era.
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Pediatr Crit Care Me · Nov 2014
Clinical TrialIncrease in oxygen consumption after albuterol inhalation in ventilated infants and children.
To determine if inhaled albuterol (salbutamol) increases oxygen consumption (V'O2) in children and, if so, the duration of this effect. ⋯ There is a large increase in V'O2 after albuterol inhalation. This effect lasts up to 3 hours.
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Pediatr Crit Care Me · Nov 2014
Prevalence and Outcome of Diastolic Dysfunction in Children With Fluid Refractory Septic Shock-A Prospective Observational Study.
Our primary objective was to determine the prevalence and outcome of diastolic dysfunction in children with fluid refractory septic shock. The secondary objective was to determine possible early predictors of diastolic dysfunction. ⋯ Diastolic dysfunction is common in children with fluid refractory septic shock, and immediate outcomes may be poorer in such patients. Increased central venous pressure after initial fluid resuscitation may be an early indicator of diastolic dysfunction and warrant urgent bedside echocardiography to guide further management.
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Pediatr Crit Care Me · Nov 2014
An Epidemiological Survey of Pediatric Sepsis in Regional Hospitals in China.
To determine the prevalence, treatment, and outcomes of sepsis at regional hospitals in Huai'an, Jiangsu, China. ⋯ We first report the prevalence and outcome of pediatric sepsis based on a regional hospital network in China. The diverse treatment approaches and practice at low-level clinics suggest the need for clinical implementation of internationally recognized strategy to improve the care standard in resource-limited regional hospitals.
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Pediatr Crit Care Me · Nov 2014
RBC Transfusion in Pediatric Patients Supported With Extracorporeal Membrane Oxygenation: Is There an Impact on Tissue Oxygenation?
To examine first the RBC transfusion practice in pediatric patients supported with extracorporeal membrane oxygenation and second the relationship between transfusion of RBCs and changes in mixed venous saturation (SvO2) and cerebral regional tissue oxygenation, as measured by near-infrared spectroscopy in patients supported with extracorporeal membrane oxygenation. ⋯ Patients supported with extracorporeal membrane oxygenation were exposed to large RBC transfusion volumes for treatment of mild anemia resulting from blood loss, particularly phlebotomy. In the majority of events, RBC transfusion did not significantly alter global tissue oxygenation, as assessed by changes in SvO2 and cerebral near-infrared spectroscopy. Most transfusions were administered at a time at which the patient did not appear to be oxygen delivery dependent according to global measures of tissue oxygenation.