Pediatr Crit Care Me
-
Pediatr Crit Care Me · Sep 2013
Multicenter StudyPaediatric Index of Mortality 3: An Updated Model for Predicting Mortality in Pediatric Intensive Care.
To provide an updated version of the Paediatric Index of Mortality 2 for assessing the risk of mortality among children admitted to an ICU. ⋯ Paediatric Index of Mortality 3 provides an international standard based on a large contemporary dataset for the comparison of risk-adjusted mortality among children admitted to intensive care.
-
Pediatr Crit Care Me · Sep 2013
Randomized Controlled TrialOptimizing Patient-Ventilator Synchrony During Invasive Ventilator Assist in Children and Infants Remains a Difficult Task.
To document and compare the prevalence of asynchrony events during invasive-assisted mechanical ventilation in pressure support mode and in neurally adjusted ventilatory assist in children. ⋯ Asynchrony events are frequent during pressure support in children despite adjusting the cycling off criteria. Neurally adjusted ventilatory assist allowed for an almost ten-fold reduction in asynchrony events. Further studies should determine the clinical impact of these findings.
-
Pediatr Crit Care Me · Sep 2013
Randomized Controlled TrialEffect of Mechanical Cleaning of Endotracheal Tubes With Sterile Urethral Catheters to Reduce Biofilm Formation in Ventilator Patients.
To investigate the effectiveness of mechanical cleaning with sterile urethral catheters to prevent formation of biofilms on endotracheal tubes. ⋯ Mechanical cleaning with sterile urethral catheters reduced bacterial colonization, prevented formation of endotracheal tube biofilm, and reduced the occurrence of ventilator-associated pneumonia.
-
In the past decade, guidelines have been developed for the early detection and management of severe sepsis in children and neonates. However, severe sepsis continues to be a significant U.S. healthcare problem, accounting for over 720,000 annual hospitalizations. Large-scale epidemiologic studies of severe sepsis continue to be limited, particularly in children. We present data from 1995, 2000, and 2005 in seven U.S. states, examining how case mix, outcome, and resource use for pediatric severe sepsis have changed over time. ⋯ Between 1995 and 2005, the prevalence of severe sepsis in U.S. children steadily rose, due to a significant increase in the prevalence of severe sepsis in newborns.
-
Pediatr Crit Care Me · Sep 2013
Nonconvulsive Electrographic Seizures Are Common in Children With Abusive Head Trauma.
To determine the prevalence of nonconvulsive seizures in children with abusive head trauma. ⋯ Electrographic seizures and electrographic status epilepticus are common in children with abusive head trauma. Most seizures have no clinical correlate. Further study is needed to determine whether seizure identification and management improves outcome.