Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2013
Quality metrics in neonatal and pediatric critical care transport: a consensus statement.
The transport of neonatal and pediatric patients to tertiary care medical centers for specialized care demands monitoring the quality of care delivered during transport and its impact on patient outcomes. Accurate assessment of quality indicators and patient outcomes requires the use of a standard language permitting comparisons among transport programs. No consensus exists on a set of quality metrics for benchmarking transport teams. The aim of this project was to achieve consensus on appropriate neonatal and pediatric transport quality metrics. ⋯ This project demonstrates that quality metrics can be achieved through consensus building and provides the foundation for benchmarking among neonatal and pediatric transport programs and quality improvement projects.
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Pediatr Crit Care Me · Jun 2013
A survey of stated physician practices and beliefs on the use of steroids in pediatric fluid and/or vasoactive infusion-dependent shock.
Limited evidence exists on the use of corticosteroids in pediatric shock. We sought to determine physicians' practices and beliefs with regard to the management of pediatric shock. ⋯ This survey provides information on the stated beliefs and practices of pediatric critical care physicians with regard to the use of steroids in fluid and/or vasoactive drug-dependent shock. Clinicians feel that the role of steroids in shock still requires clarification and that they would be willing to randomize patients into a trial. This survey may be useful as an initial framework for the development of a future trial on the use of steroids in pediatric shock.
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Pediatr Crit Care Me · Jun 2013
Observational StudyThe impact of postintubation chest radiograph during pediatric and neonatal critical care transport.
Tracheal intubation is necessary in the setting of pediatric/neonatal critical care transport but information regarding usefulness and efficiency of a confirmatory postintubation chest radiograph is limited. We hypothesize that routine postintubation chest radiograph to confirm tracheal tube position is not informative and can be eliminated to improve efficiency without compromising safety in transport. ⋯ Although postintubation chest radiographs may extend the overall on-scene transport times in select patients, our data show that the postintubation chest radiographs remain informative in pediatric/neonatal critical care specialty transport and should be obtained when feasible.
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Pediatr Crit Care Me · Jun 2013
Multidisciplinary quality improvement initiative to reduce ventilator-associated tracheobronchitis in the PICU.
To test the hypothesis that successful implementation of a care bundle designed to prevent nosocomial airway infection will be associated with decreased incidence of ventilator-associated tracheobronchitis. ⋯ Successful implementation of a care bundle to prevent ventilator-associated infection was associated with decreased incidence of ventilator-associated tracheobronchitis. Development of ventilator-associated tracheobronchitis was independently associated with adverse outcomes in our cohort of pediatric ICU patients.
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Pediatr Crit Care Me · Jun 2013
Comparative StudyMobilization of endothelial progenitor cells from bone marrow is impaired in a piglet model of acute respiratory distress syndrome.
To characterize the endothelial progenitor cell mobilization in the models of moderate and severe lung injury, we hypothesized that there were differences in endothelial progenitor cell levels and mobilizing cytokines between moderate and severe lung injury. ⋯ There was a rapid release of endothelial progenitor cells from bone marrow into circulation in moderate acute lung injury, and endothelial progenitor cell mobilization was impaired in acute respiratory distress syndrome.