Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2012
Comparative StudyEvaluation and comparison of parental needs, stressors, and coping strategies in a pediatric intensive care unit.
To evaluate and compare the needs, stressors, and coping strategies of mothers and fathers in a pediatric intensive care unit, and to advance the development of the COMPASS questionnaire for examining parent experiences. ⋯ Acute parental experiences can be documented using the COMPASS questionnaire. This study highlights the principal needs, stressors, and coping strategies of parents of children in the pediatric intensive care unit. The experiences of mothers and fathers are similar, but we identify some differences in stressors between the sexes.
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Pediatr Crit Care Me · May 2012
Clinical TrialThe role of passive leg raising to predict fluid responsiveness in pediatric intensive care unit patients.
Fluid challenge is often used to predict fluid responsiveness in critically ill patients. Inappropriate fluid expansion can lead to some unwanted side effects; therefore, we need a noninvasive predictive parameter to assess fluid responsiveness. We want to assess the hemodynamic parameter changes after passive leg raising, which can mimic fluid expansion, to predict fluid responsiveness in pediatric intensive care unit patients and to get a cutoff value of cardiac index in predicting fluid responsiveness in pediatric patients. ⋯ The concomitant measurements in cardiac index changes after the passive leg raising maneuver can be helpful in predicting who might have an increase in cardiac index with subsequent fluid resuscitation.
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Pediatr Crit Care Me · May 2012
Coagulopathy and shock on admission is associated with mortality for children with traumatic injuries at combat support hospitals.
In adults, early traumatic coagulopathy and shock are both common and independently associated with mortality. There are little data regarding both the incidence and association of early coagulopathy and shock on outcomes in pediatric patients with traumatic injuries. Our objective was to determine whether coagulopathy and shock on admission are independently associated with mortality in children with traumatic injuries. ⋯ In children with traumatic injuries treated at combat support hospitals, coagulopathy and shock on admission are common and independently associated with a high incidence of inhospital mortality. Future studies are needed to determine whether more rapid and accurate methods of measuring coagulopathy and shock as well as if early goal-directed treatment of these states can improve outcomes in children.
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Pediatr Crit Care Me · May 2012
A qualitative study of expert and team cognition on complex patients in the pediatric intensive care unit.
To understand expert and team cognition of complex patients in the pediatric intensive care unit through the use of cognitive task analysis. ⋯ An inadequately developed or inadequately shared mental model is a substantial cognitive limitation for expert and team cognition in the complex environment of the pediatric intensive care unit. Providers utilize techniques that may avoid or decrease the variable interpretations of patient condition that would otherwise impair mental model formation and sharing. Future studies should be designed to enhance mental model formation and communication in the pediatric intensive care unit and other environments that deal with complex patients.
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Pediatr Crit Care Me · May 2012
Myocardial dysfunction in neonatal sepsis: a tissue Doppler imaging study.
To assess myocardial performance in septic full-term infants and to correlate it with serum cardiac troponin T concentrations. ⋯ Neonatal sepsis is associated with systolic and diastolic myocardial dysfunction. This study provides proof-of-concept data for the use of tissue Doppler imaging in assessment of myocardial dysfunction in septic neonates. Tissue Doppler imaging appears to be more sensitive than conventional echocardiography in the detection of this dysfunction. Serum cardiac troponin T and left ventricular Tei index may have prognostic value in these patients.