Pediatr Crit Care Me
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Pediatr Crit Care Me · Feb 2014
Observational StudyImpact of the Shift to Neonatal Noninvasive Ventilation in Poland: A Population Study.
This study was undertaken to document the real impact of a directed shift in the standard of neonatal practice to a pervasive use of noninvasive respiratory support. ⋯ We believe that the adoption of an approach emphasizing noninvasive ventilation in Poland resulted in decreased mortality without an increase in significant pulmonary or retinal morbidity.
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To report our experience with the use of IV enoxaparin in neonatal and pediatric patients in the ICU. ⋯ The pharmacodynamics of a 30-minute IV enoxaparin infusion was found to produce therapeutic 4 hour anti-Factor Xa levels similar to subcutaneous doses. Although this was a small study, there were no adverse events, suggesting the safety profile of IV enoxaparin may be similar to subcutaneous dosing with the added benefit of less pain associated with IV dosing. These findings suggest that IV enoxaparin may be a viable option for anticoagulating critically ill children and its use warrants further study.
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Pediatr Crit Care Me · Feb 2014
Is Propofol a Friend or a Foe of the Pediatric Intensivist? Description of Propofol Use in a PICU.
The primary objective is to describe the practice patterns of nonprocedural propofol use in a single-center referral PICU. The secondary objective is to describe the rate of concordance of propofol use with the PICU local practice of a maximum mean rate of 4 mg/kg/hr and a maximum duration of 24 hours and to assess for signs and symptoms of propofol infusion syndrome. ⋯ The use of propofol infusions was in concordance with PICU local practice, and propofol infusion syndrome did not developed in patients. In agreement with previous recommendations, propofol infusions in the PICU appear to be safe when limiting doses to 4 mg/kg/hr and for less than 24 hours; however, appropriate monitoring of adverse effects is still warranted due to absence of robust evidence.
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Pediatr Crit Care Me · Feb 2014
Ultrasound-Guided Left Brachiocephalic Vein Cannulation in Children With Underlying Bleeding Disorders: A Retrospective Analysis.
To evaluate the safety and effectiveness of ultrasound-guided left brachiocephalic vein cannulation in infants and children with underlying bleeding conditions. ⋯ Data reported in this retrospective study confirm the safety and effectiveness of ultrasound-guided left brachiocephalic vein catheterization in infants and children with underlying bleeding disorders.
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Pediatr Crit Care Me · Feb 2014
Effectiveness of a Clinical Pathway With Methadone Treatment Protocol for Treatment of Neonatal Abstinence Syndrome Following In Utero Drug Exposure to Substances of Abuse.
To evaluate the effectiveness of methadone for the treatment of neonatal abstinence syndrome when used according to a preexisting clinical pathway. ⋯ Clinical pathway for treating neonatal abstinence syndrome was closely followed at the initial diagnosis. The doses of methadone used in the first 24-48 hours of this study were insufficient for adequate symptom control. Despite a formal treatment protocol, there was substantial variability in total methadone exposure, length of treatment, and length of stay, suggesting other contributory factors for the observed variability.