Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2014
Editorial CommentTransfusion practices in evolution, not revolution*.
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Pediatr Crit Care Me · Jun 2014
Review Meta AnalysisPerioperative Steroids Administration in Pediatric Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials.
To evaluate the effects of prophylactic perioperative corticosteroid administration, compared with placebo, on postoperative mortality and clinical outcomes (renal dysfunction, duration of mechanical ventilation, and ICU length of stay) in pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. ⋯ Despite a demonstrated attenuation of cardiopulmonary bypass-induced inflammatory response by steroid administration, a systematic review of randomized controlled trials performed so far reveals that steroid administration has potential clinical advantages (lower mortality and significant reduction of renal function deterioration). A larger prospective randomized study is needed to verify clearly the effects of steroid prophylaxis in pediatric patients.
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Pediatr Crit Care Me · Jun 2014
Randomized Controlled Trial Comparative StudyA Comparative Study of Two Remifentanil Doses for Procedural Pain in Ventilated Preterm Infants: A Randomized, Controlled Study.
Remifentanil is an ultrashort-acting synthetic opioid, and the metabolism of which is not influenced by hepatic or renal function. This study aims to compare the efficacy of two remifentanil doses during procedures in ventilated preterm infants. ⋯ For mechanically ventilated preterm infants, the use of remifentanil at 0.25 μg/kg/min as an analgesic for short procedures represents a therapeutic option. Our pilot study suggests the need for larger randomized trials.
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Pediatr Crit Care Me · Jun 2014
ReviewCitrate Anticoagulation During Continuous Renal Replacement Therapy in Pediatric Critical Care.
To provide the pediatric intensivist an in-depth understanding of citrate as regional anticoagulant during continuous renal replacement therapy. ⋯ Continuous renal replacement therapy is the most common modality of renal replacement in the critical care setting. Regional anticoagulation is an ideal option in a critically ill child after recent surgery or with coagulopathy. Therefore, regional citrate anticoagulation in the pediatric critical care population requiring renal replacement therapy is commonly employed. Complications of citrate anticoagulation can be avoided with a greater understanding of the properties and clearance of citrate. Continued reporting of observational data and the development of prospective multicenter trials using citrate anticoagulation are needed to ensure safe and standardized care in the pediatric population.