Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2012
Clinical TrialProspective longitudinal evaluation of lung function during the first year of life after repair of congenital diaphragmatic hernia.
To evaluate lung function and respiratory morbidity prospectively during the first year of life in patients with congenital diaphragmatic hernia and to study the effect of extracorporeal membrane oxygenation therapy. ⋯ Infants with congenital diaphragmatic hernia have decreased expiratory flows and increased functional residual capacity within the first year of life. Extracorporeal membrane oxygenation-treated patients with congenital diaphragmatic hernia may have more respiratory morbidity and concomitant growth impairment. Close follow-up beyond the neonatal period is therefore required.
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Pediatr Crit Care Me · May 2012
Clinical TrialVasopressin rescue for in-pediatric intensive care unit cardiopulmonary arrest refractory to initial epinephrine dosing: a prospective feasibility pilot trial.
To assess the feasibility of a large, randomized controlled trial of combination epinephrine-arginine vasopressin for in-pediatric intensive care unit cardiopulmonary arrest refractory to initial epinephrine dosing. ⋯ These pilot data provide support for a larger randomized controlled trial of arginine vasopressin therapy during cardiopulmonary resuscitation for in-hospital pediatric cardiac arrest.
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Pediatr Crit Care Me · May 2012
Comparative Study2009 pandemic influenza A (H1N1) in critically ill children in Cincinnati, Ohio.
To compare the clinical features, management, and outcome of critically ill children with H1N1 to children with seasonal influenza from the previous three influenza seasons. ⋯ In contrast to other studies, we found that critically ill children with H1N1 had a significantly lower morbidity and mortality compared to children with seasonal influenza.
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Pediatr Crit Care Me · May 2012
Comparative StudyNeurally triggered breaths have reduced response time, work of breathing, and asynchrony compared with pneumatically triggered breaths in a recovering animal model of lung injury.
Our objective was to compare response time, pressure time product as a reflection of work of breathing, and incidence and type of asynchrony in neurally vs. pneumatically triggered breaths in a spontaneously breathing animal model with resolving lung injury. ⋯ Neurally triggered breaths have reduced asynchrony, trigger delay, and pressure time product, which may indicate reduced work of breathing associated with less effort to trigger the ventilator and faster response to effort. Further study is required to demonstrate if these differences will lead to decreased days of ventilation and less use of sedation in patients.
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Pediatr Crit Care Me · May 2012
Two-dimensional speckle tracking imaging detects impaired myocardial performance in children with septic shock, not recognized by conventional echocardiography.
Sepsis is common in children and often results in cardiac dysfunction. Assessment of patients with sepsis-associated myocardial depression using ejection fraction and fractional shortening with conventional echocardiography is load dependent and often reveals cardiac dysfunction only after clinical deterioration has occurred. Speckle tracking imaging is a novel technology that can assess deformation and strain by tracking displacement of acoustic markers in the myocardium. We hypothesize that speckle tracking imaging will detect cardiac impairments during sepsis that are not appreciated by conventional echocardiography. ⋯ Speckle tracking imaging detected a number of significantly impaired measures of ventricular performance in children with sepsis, not appreciated by conventional echocardiography. This technology may improve our understanding and identification of myocardial depression in the critically ill septic child.