Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2014
Age-Based Difference in Activation Markers of Coagulation and Fibrinolysis in Extracorporeal Membrane Oxygenation.
Coagulation system activation in extracorporeal membrane oxygenation results in hemostatic derangements. Thrombin generation markers like prothrombin fragment 1+2 and thrombin-antithrombin complex are sensitive markers of hypercoagulability. Plasmin-antiplasmin complex is a sensitive marker for fibrinolysis. D-dimers reflect thrombin generation and fibrinolysis. The aim was to identify the extent of hemostasis activation during extracorporeal membrane oxygenation by measuring thrombin-antithrombin complex, prothrombin fragment 1+2, plasmin-antiplasmin complex, and D-dimer. ⋯ Despite our best efforts at adequate anticoagulation with unfractionated heparin, neonates showed persistent increase in coagulation activation on extracorporeal membrane oxygenation. Fibrinolysis activation may contribute to bleeding in patients older than 30 days. Different anticoagulation protocols should be individualized based on age.
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Pediatr Crit Care Me · Jun 2014
Observational StudyHemodynamic Changes in Preterm Neonates With Septic Shock: A Prospective Observational Study.
We evaluated hemodynamic changes in preterm neonates with septic shock using functional echocardiography and studied the effects of vasoactive drugs on hemodynamic variables. ⋯ We found an elevated left ventricular output but normal ejection fraction in preterm neonates with septic shock. This suggests that septic shock in preterm neonates is predominantly due to vasoregulatory failure. Vasoactive drugs significantly increased right ventricular output, which was predominantly due to increase in heart rate.
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Pediatr Crit Care Me · Jun 2014
Observational StudyPhysiological Effect of High-Flow Nasal Cannula in Infants With Bronchiolitis.
To assess the effect of delivering high-flow nasal cannula flow on end-expiratory lung volume, continuous distending pressure, and regional ventilation distribution in infants less than 12 months old with bronchiolitis. ⋯ In infants with bronchiolitis, high-flow nasal cannula oxygen/air delivered at 8 L/min resulted in increases in end-expiratory lung volume and improved respiratory rate, FIO2, and SpO2.
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Pediatr Crit Care Me · Jun 2014
An Electronic Delphi Study to Establish Pediatric Intensive Care Nursing Research Priorities in 20 European Countries.
To identify and to establish research priorities for pediatric intensive care nursing science across Europe. ⋯ The results of this study inform the European Society of Pediatric and Neonatal Intensive Care's nursing research agenda in the future. The results allow nurse researchers within Europe to encourage collaborative initiatives for nursing research.