Pediatr Crit Care Me
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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.
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Pediatr Crit Care Me · Jul 2011
Evaluation of multidisciplinary simulation training on clinical performance and team behavior during tracheal intubation procedures in a pediatric intensive care unit.
Tracheal intubation in the pediatric intensive care unit is often performed in emergency situations with high risks. Simulation has been recognized as an effective methodology to train both technical and teamwork skills. Our objectives were to develop a feasible tool to evaluate team performance during tracheal intubation in the pediatric intensive care unit and to apply the tool in the clinical setting to determine whether multidisciplinary teams with a higher number of simulation-trained providers exhibit more proficient performance. ⋯ It is feasible to rate the technical and behavioral performance of multidisciplinary airway management teams during real intensive care unit intubation events by using our assessment tool. The presence of two or more multidisciplinary simulation-trained providers is associated with improved performance during real events.
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Pediatr Crit Care Me · Jul 2011
ReviewVenous oximetry and the assessment of oxygen transport balance.
To review the principles of venous oximetry; the physiology of oxygen transport balance; clinical studies on venous oximetry; and the assignment of a classification of recommendation and level of evidence. ⋯ One of the tenets of critical care medicine is to provide a timely and accurate assessment of tissue oxygenation. In conjunction with other monitoring modalities, the routine deployment of central venous catheters readily enables the clinician to complete this task.
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Pediatr Crit Care Me · Jul 2011
ReviewEchocardiography as a hemodynamic monitor in critically ill children.
Echocardiography is a widely used modality to assess myocardial structure and function in pediatric intensive care settings. While the use of echocardiography for diagnostic purposes remains important, its use as a hemodynamic monitoring tool has not been well established. ⋯ To date, the literature on echocardiography in pediatric critical care is limited. The purpose of this review is to examine the scientific evidence for the usefulness of echocardiography as a hemodynamic monitoring tool in pediatric critical care.
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Pediatr Crit Care Me · Jul 2011
ReviewThe Collaborative Pediatric Critical Care Research Network Critical Pertussis Study: collaborative research in pediatric critical care medicine.
To provide an updated overview of critical pertussis to the pediatric critical care community and describe a study of critical pertussis recently undertaken. ⋯ Research is urgently needed to provide an evidence base that might optimize management for critical pertussis, a serious, disabling, and too often fatal illness for U.S. children and those in the developing world.