Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2013
Point prevalence survey of antimicrobial utilization in the cardiac and pediatric critical care unit.
To determine the rate of documented infections and prevalence of antimicrobial use among pediatric patients admitted to the PICU. To assess the appropriateness of antimicrobial prescribing according to clinical and microbiological findings, Infectious Disease Consult recommendations, and formulary guidelines. ⋯ There was a high prevalence of antimicrobial use in CCCU-PICU patients. Because a significant proportion of antimicrobial use was deemed inappropriate, interventions are required to optimize antimicrobial use in critically ill children.
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Pediatr Crit Care Me · Jul 2013
ReviewMechanisms of acute respiratory distress syndrome in children and adults: a review and suggestions for future research.
To provide a current overview of the epidemiology and pathophysiology of acute respiratory distress syndrome in adults and children, and to identify research questions that will address the differences between adults and children with acute respiratory distress syndrome. ⋯ There are significant obstacles to performing research on children with acute respiratory distress syndrome. However, epidemiologic, clinical, and animal studies suggest age-dependent differences in the pathophysiology of acute respiratory distress syndrome. In order to reduce the prevalence and improve the outcome of patients with acute respiratory distress syndrome, translational studies of inflammatory, apoptotic, alveolar fluid clearance, and repair mechanisms are needed. Understanding the differences in pathophysiologic mechanisms in acute respiratory distress syndrome between children and adults should facilitate identification of novel therapeutic interventions to prevent or modulate lung injury and improve lung repair.
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Pediatr Crit Care Me · Jul 2013
Clinical TrialSildenafil exposure and hemodynamic effect after stage II single-ventricle surgery.
To determine sildenafil exposure and hemodynamic effect in children after stage II single-ventricle surgery. ⋯ Sildenafil demonstrated nonlinear exposure with high interindividual variability but was well tolerated and effectively lowered pulmonary vascular resistance index in all subjects. Sildenafil did not acutely improve myocardial performance or increase cardiac index.
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Pediatr Crit Care Me · Jul 2013
Multicenter StudyUnscheduled readmissions to the PICU: epidemiology, risk factors, and variation among centers.
To determine the rate of, and potential risk factors for, unscheduled PICU readmission and assess for variability among PICUs within the United States. ⋯ The rate of unscheduled PICU readmission was low but associated with worse outcomes. Patient and admission/discharge characteristics associated with increased risk of readmissions could be used to target high-risk populations or modifiable factors to improve outcome. Variation of risk among centers suggests room for improvement.