Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2011
Comparative StudyIn vitro performance comparison of the Sensormedics 3100A and B high-frequency oscillatory ventilators.
The Sensormedics 3100A and 3100B are widely used to provide high-frequency oscillatory ventilation in clinical practice. Infants and children <35 kg are typically oscillated with the 3100A and >35 kg with the 3100B. This study compares the effect of ventilator and patient parameters on delivered tidal volume during high-frequency oscillatory ventilation of a test lung with these devices. ⋯ Multiple variables contribute to the delivered tidal volume during high-frequency oscillatory ventilation, including ventilator model selection and endotracheal tube size. It is possible that real-time, clinical monitoring of delivered tidal volume during high-frequency oscillatory ventilation would allow better titration and maximize performance of these ventilators in caring for critically ill patients.
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To describe a unique experience providing critical care to infants and children in Haiti 3 months after a major earthquake. ⋯ Pediatric critical care can be implemented in low-income countries but requires significant resource use and careful patient selection. Consideration should be paid to the costs of delivering critical care in developing countries, which can inadvertently appropriate resources that have a larger impact on pediatric public health.
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Pediatr Crit Care Me · Jul 2011
CommentA critical appraisal of Vlasselaers D, Milants I, Desmet L, et al: intensive insulin therapy for patients in paediatric intensive care: a prospective, randomised controlled study. Lancet 2009; 373:547-556.
To review findings and discuss implications of strict glycemic control in children. ⋯ This was a well-designed single-center trial that serves as proof of concept. The effects of intensive insulin therapy on mortality require further investigation, and its practice may need refinement to reduce the risk of hypoglycemia. In the meantime, targeting age-adjusted fasting glucose ranges cannot be routinely recommended in critically ill children.