Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2013
Comparative Study Clinical TrialCord blood proteins and multichannel-electroencephalography in hypoxic-ischemic encephalopathy.
To explore the association between multiple umbilical cord blood proteins and severity of hypoxic-ischemic encephalopathy as defined by continuous multichannel electroencephalography. ⋯ Cord blood interleukin-6 and interleukin-16 were associated with electrographic grade of hypoxic-ischemic encephalopathy. To predict an abnormal electroencephalography, interleukin-16 and 10-minute Apgar used in combination performed better than current markers.
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Pediatr Crit Care Me · Jul 2013
Observational StudyThe effect of atropine on rhythm and conduction disturbances during 322 critical care intubations.
Our objectives were to describe the prevalence of arrhythmia and conduction abnormalities before critical care intubation and to test the hypothesis that atropine had no effect on their prevalence during intubation. ⋯ Atropine significantly reduced the prevalence of new arrhythmias during intubation particularly for children over 1 month of age, did not convert sinus tachycardia to ventricular tachycardia or fibrillation, and may contribute to the safety of intubation.
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Pediatr Crit Care Me · Jul 2013
Long-term survival outcomes and causes of late death in neonates, infants, and children treated with extracorporeal life support.
Extracorporeal life support is a resource-intense treatment offered to the sickest patients. We aimed to investigate long-term survival rates and late deaths. ⋯ Although the majority of deaths were early, late mortality was observed following extracorporeal life support. Late deaths were more prevalent in children with underlying complex long-term conditions, particularly heart disease and congenital diaphragmatic hernia. Evaluation of longer term survival is an important component of audit for extracorporeal life support outcomes.
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Pediatr Crit Care Me · Jul 2013
Clinical TrialRisk of extracorporeal life support circuit-related hyperkalemia is reduced by prebypass ultrafiltration.
Pediatric patients who receive large volume blood transfusions are at risk for experiencing transfusion-related hyperkalemic cardiac arrest. Prebypass ultrafiltration of blood used to prime cardiopulmonary bypass circuits is commonly used in pediatric cardiac surgery to create a more physiologic and electrolyte balanced priming solution prior to initiation of cardiopulmonary bypass. This study was undertaken to determine the efficacy of prebypass ultrafiltration in normalizing extracorporeal life support circuit priming solution before initiating extracorporeal life support. ⋯ Prebypass ultrafiltration normalizes the electrolyte balance of blood-primed extracorporeal life support circuits. Prebypass ultrafiltration processing may reduce the risk of transfusion-related hyperkalemic cardiac arrest in small children who require venovenous extracorporeal life support.
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Pediatr Crit Care Me · Jul 2013
Observational StudyThe use of near-infrared spectroscopy during an extubation readiness trial as a predictor of extubation outcome.
To determine whether the measurement of cerebral and somatic regional oxygen saturation during an extubation readiness trial predicts extubation failure in postoperative cardiac patients. ⋯ A 12% decline in somatic regional oxygen saturation during an extubation readiness trial is associated with an increased risk of extubation failure following a successful extubation readiness trial. The addition of somatic regional oxygen saturation measurements to an extubation readiness trial may improve our ability to predict extubation outcome.