Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2012
Defining pediatric sepsis by different criteria: discrepancies in populations and implications for clinical practice.
Pediatric patients with sepsis are identified using related but distinct criteria for clinical, research, and administrative purposes. The overlap between these criteria will affect the validity of extrapolating data across settings. We sought to quantify the extent of agreement among different criteria for pediatric severe sepsis/septic shock and to detect systematic differences between these cohorts. ⋯ Although research, clinical, and administrative criteria yielded a similar incidence (5%-6%) for pediatric severe sepsis/septic shock, there was only a moderate level of agreement in the patients identified by different criteria. One third of patients diagnosed clinically with sepsis would not have been included in studies based on consensus guidelines or International Classification of Diseases, Ninth Revision, Clinical Modification codes. Differences in patient selection need to be considered when extrapolating data across settings.
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Pediatr Crit Care Me · Jul 2012
Comparative StudyComparing the clinical severity of the first versus second wave of 2009 Influenza A (H1N1) in a New York City pediatric healthcare facility.
We previously reported the epidemiology of 2009 Influenza A (H1N1) in our pediatric healthcare facility in New York City during the first wave of illness (May-July 2009). We hypothesized that compared with the first wave, the second wave would be characterized by increased severity of illness and mortality. ⋯ At our pediatric healthcare facility in New York City, fewer children were hospitalized with 2009 Influenza A (H1N1) during the second wave, but both waves had a similar spectrum of illness severity and low mortality rate.
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Pediatr Crit Care Me · Jul 2012
Nutritional status and complications in children with diabetic ketoacidosis.
Diabetic ketoacidosis in children continues to be an important cause of morbidity and mortality, especially in developing economies as a result of malnutrition, a high rate of infections, and delay in seeking timely medical care. Malnutrition also increases the risk of diabetic ketoacidosis-related complications. The objective of this study was to assess the nutritional status of patients presenting with diabetic ketoacidosis and correlate it with the incidence of complications at presentation and those encountered during the course of illness. ⋯ The incidence and severity of therapy-related hypokalemia and hypoglycemia were significantly higher in the malnourished as compared to the normally nourished diabetic ketoacidosis. Other diabetic ketoacidosis-related complications and outcome were similar in both the groups.
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Pediatr Crit Care Me · Jul 2012
Accuracy of tidal volume, compliance, and resistance measurements on neonatal ventilator displays: an in vitro assessment.
To determine the accuracy of measures of respiratory mechanics derived from neonatal ventilators using an in vitro passive physical lung model to simulate newborn pulmonary conditions. ⋯ Neonatal ventilator respiratory mechanics measurements and computation methods need further standardization to be useful in clinical settings.
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Pediatr Crit Care Me · Jul 2012
Development of a bedside tool to predict time to death after withdrawal of life-sustaining therapies in infants and children.
To generate a preliminary bedside predictor of rapid time-to-death after withdrawal of support in children to help identify potential candidates for organ donation after circulatory death. ⋯ This tool is a reasonable preliminary predictor for death within 30 or 60 mins after withdrawal of support in terminally ill or injured children and might assist in identifying potential pediatric candidates for donation after circulatory death, although prospective validation is required.