Pediatr Crit Care Me
-
Pediatr Crit Care Me · Feb 2014
Observational StudyPostoperative Neutrophil Gelatinase-Associated Lipocalin Predicts Acute Kidney Injury After Pediatric Cardiac Surgery.
We investigated the temporal pattern and predictive value of neutrophil gelatinase-associated lipocalin for early identification of acute kidney injury in children undergoing cardiac surgery. ⋯ Urine neutrophil gelatinase-associated lipocalin is a predictive biomarker for acute kidney injury after pediatric cardiac surgery, and it may permit earlier intervention that improves outcome of acute kidney injury. Urine neutrophil gelatinase-associated lipocalin normalized to urine creatinine improves the prediction of acute kidney injury severity but offers no advantage in acute kidney injury diagnosis.
-
Pediatr Crit Care Me · Feb 2014
Observational StudySurvey of In-House Coverage by Pediatric Intensivists: Characterization of 24/7 In-Hospital Pediatric Critical Care Faculty Coverage.
To characterize the current state of 24/7 in-hospital pediatric intensivist coverage in academic PICUs, including perceptions of faculty and trainees regarding the advantages and disadvantages of in-hospital coverage. ⋯ Although concerns exist regarding the effect of 24/7 in-hospital coverage on faculty, the majority of pediatric intensivists and critical care trainees responded that in-hospital coverage by intensivists is good for patient care. The majority of intensivists also state that they would prefer to work at an institution with in-hospital coverage. Further research is needed to objectively delineate the effects of in-hospital coverage on both patients and faculty.
-
Pediatr Crit Care Me · Feb 2014
A Canadian Survey of Perceived Barriers to Initiation and Continuation of Enteral Feeding in PICUs.
Clinicians believe nutrition support is important; however, delivery of enteral nutrition may be delayed or interrupted due to a lack of guidelines or perceived contraindications to administration. The aim of this national survey was to examine the knowledge and perceived barriers among clinicians which prevent enteral nutrition administration to PICU patients. ⋯ Overall, there is high variability among clinicians regarding acceptable procedural and clinical barriers to enteral nutrition administration; this may be improved by a standardized feeding protocol. Therefore, further research must be conducted to provide clinicians with evidence to support their practices for enteral nutrition administration.
-
Pediatr Crit Care Me · Feb 2014
Anti-Factor Xa Assay Is a Superior Correlate of Heparin Dose Than Activated Partial Thromboplastin Time or Activated Clotting Time in Pediatric Extracorporeal Membrane Oxygenation.
To assess the utility of activated clotting time, activated partial thromboplastin time, and anti-Factor Xa assay for the monitoring and dosing of heparin in pediatric patients requiring support with extracorporeal membrane oxygenation. ⋯ The anti-Factor Xa assay correlated better with heparin dosing than activated clotting time or activated partial thromboplastin time. Activated clotting time has a poor correlation to heparin doses commonly associated with extracorporeal membrane oxygenation. In pediatric extracorporeal membrane oxygenation, anti-Factor Xa assay may be a more valuable monitor of heparin administration.
-
Pediatr Crit Care Me · Feb 2014
Parental Symptoms of Posttraumatic Stress After Pediatric Extracorporeal Membrane Oxygenation.
To investigate the prevalence of posttraumatic stress symptoms in parents of children who have been supported on extracorporeal membrane oxygenation and to explore associated factors. ⋯ A substantial number of parents in this population experience posttraumatic stress symptom. Psychological interventions may be targeted toward those whose child has had ongoing illness before extracorporeal membrane oxygenation.