Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2012
Risk factors for mechanical ventilation in U.S. children hospitalized with seasonal influenza and 2009 pandemic influenza A*.
We tested the hypothesis that the use of mechanical ventilator support in children hospitalized with influenza during the 2009 H1N1 influenza A (H1N1) pandemic was higher than would be expected in children hospitalized for seasonal influenza after adjusting for patient risk. ⋯ Although the number of children with a hospital discharge diagnosis of influenza almost tripled during the 2009 pandemic influenza A period, the risk-adjusted proportion of children receiving mechanical ventilation was lower than we would have predicted in a seasonal influenza cohort. Early hospital use of influenza antiviral medications was associated with a decrease in late-onset mechanical ventilation.
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Pediatr Crit Care Me · Nov 2012
Randomized Controlled TrialEffect of continuous blood purification on concentrations of plasma vasoactive substances and cardiac function in endotoxic shock.
To evaluate the effect of continuous blood purification on cardiac function and plasma vasoactive substances in endotoxic shock in piglets. ⋯ The adverse cardiovascular effects of lipopolysaccharide-induced endotoxin shock can be improved by continuous blood purification. Improvement is correlated with increases in the concentration of plasma vasoactive substances (endothelin and dopamine) and decreases in nitric oxide synthase activity.
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Pediatr Crit Care Me · Nov 2012
Comparative StudyActivated partial thromboplastin time is a better trending tool in pediatric extracorporeal membrane oxygenation.
To determine whether activated partial thromboplastin times are a better heparin management tool than activated clotting times in pediatric extracorporeal membrane oxygenation. ⋯ The activated clotting time is not an accurate monitoring tool for heparin management in pediatricextracorporeal membrane oxygenation. The point-of-care activated partial thromboplastin time correlates well with the clinical laboratory activated partial thromboplastin time but cannot be substituted for the clinical laboratory activated partial thromboplastin time values. Management of pediatric extracorporeal membrane oxygenation patients with the clinical laboratory activated partial thromboplastin time reduced bleeding complications which are associated with increases in mortality.
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Pediatr Crit Care Me · Nov 2012
Cerebral white matter and neurodevelopment of preterm infants after coagulase-negative staphylococcal sepsis.
Coagulase-negative staphylococci are the most common pathogens causing late-onset sepsis in the neonatal intensive care unit. Neonatal sepsis can be associated with cerebral white matter damage in preterm infants. Neurodevelopment has been shown to be correlated with apparent diffusion coefficients, fractional anisotropy, and axial and radial diffusivities of the white matter. ⋯ No association was found between coagulase-negative staphylococcal sepsis in preterm infants and cerebral white matter damage as determined by values of apparent diffusion coefficients, fractional anisotropy, and radial and axial diffusivity at term-equivalent age, and no adverse effect was seen on early neurodevelopmental outcome.
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Pediatr Crit Care Me · Nov 2012
"I was able to still be her mom"--parenting at end of life in the pediatric intensive care unit.
The death of a child in the pediatric intensive care unit is perhaps one of the most devastating and challenging experiences a parent can ever endure. This article examines how parents of children dying in the pediatric intensive care unit understood their role and discusses implications for clinical care and policy. ⋯ Parents' ability to fulfill the essential features of their role as parents of children dying in the pediatric intensive care unit shapes how they perceive the quality of the experience. Pediatric intensive care unit clinical care and policies can and should uphold and protect these features enabling parents to feel that, despite the outcome, they had done their best on behalf of their children.