Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2011
Hospital-acquired viral infection increases mortality in children with severe viral respiratory infection.
To investigate the association of method of acquisition (hospital-acquired vs. community-acquired) and mortality in children with severe viral respiratory infection. ⋯ Our results suggest that in children with severe viral respiratory infection, hospital acquisition of infection is associated with increased mortality even after adjusting for chronic medical conditions that predispose to an increased risk of complications from viral illness.
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Pediatr Crit Care Me · Nov 2011
Vancomycin pharmacokinetic-pharmacodynamic parameters to optimize dosage administration in critically ill children.
Critically ill children may present changes in pharmacokinetic parameters and may not reach effective concentrations of vancomycin with current dosages. The objective of this study is to calculate vancomycin pharmacokinetic parameters in critically ill children and to estimate area under the curve at 24 hrs/minimal inhibitory concentration reached for Staphylococcus aureus. ⋯ Critically ill children show changes in pharmacokinetic parameters. Serum concentration monitorization is necessary for dosage individualization. Most children do not reach an area under the curve at 24 hrs/minimal inhibitory concentration >400 with current dosage.
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Pediatr Crit Care Me · Nov 2011
Informed consent for bedside procedures in the pediatric intensive care unit: a preliminary report.
No uniform guidelines exist regarding informed consent for bedside procedures in the intensive care unit (ICU), and practice varies widely between institutions. Neither guidelines nor data exist to help pediatric ICU (PICU) directors craft procedural consent policies. We conducted an exploratory study to explore the impact on patients, parents, and healthcare providers of a requirement for informed consent for bedside procedures in the PICU and to describe parental and provider beliefs regarding procedural consent. ⋯ Parental consent for invasive bedside procedures in the PICU can be obtained reliably and without posing an undue time burden on healthcare providers. Most parents perceive a real decision making opportunity surrounding invasive procedures, but agree readily to the recommendations of their healthcare providers.
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Pediatr Crit Care Me · Nov 2011
Ethanol lock therapy for catheter-associated blood stream infections in a pediatric intensive care unit.
Ethanol locks are being used to prevent and eradicate central venous catheter infections. This study describes the efficacy of ethanol locks in clearing central venous catheter infections in a pediatric intensive care unit. ⋯ Ethanol locks using 70% ethanol solution with dwell times as short as 4-6 hrs in conjunction with standard antibiotic therapy have 92% effective clearance of catheter-associated bloodstream infection and a 77% catheter salvage rate in our pediatric intensive care unit. The use of 70% ethanol locks appears to be well tolerated and represents a relatively inexpensive pharmacologic intervention that, along with systemic antibiotics, can help treat catheter-associated bloodstream infections and salvage central venous catheters.