Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2011
Brain-systemic temperature gradient is temperature-dependent in children with severe traumatic brain injury.
To understand the gradient between rectal and brain temperature in children after severe traumatic brain injury. We hypothesized that the rectal temperature and brain temperature gradient will be influenced by the child's body surface area and that this relationship will persist over physiologic temperature ranges. ⋯ Brain temperature and rectal temperature are generally well-correlated in children with traumatic brain injury. This relationship is different at the extremes of the physiologic temperature range, with the temperature gradient reversed during brain hypothermia and hyperthermia. Given that studies showing neuroprotection from hypothermia in animal models of brain injury generally target brain temperature, our data suggest the possibility that, if brain temperature were the therapeutic target in clinical trials, this would result in somewhat higher systemic temperature and potentially fewer side effects. This relationship may be exploited in future clinical trials to maintain brain hypothermia (for neurologic protection) at slightly higher systemic temperatures (and potentially fewer systemic side effects).
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Pediatr Crit Care Me · Jul 2011
Comparative Study Clinical TrialEvaluation of a new pediatric continuous oximetry catheter.
To evaluate the accuracy of central venous oxygen saturation recordings from a new in-line pediatric oximetry catheter. ⋯ In this limited number of patients, use of the PediaSat venous oximetry catheter was safe and had good agreement with co-oximetry-measured values.
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Pediatr Crit Care Me · Jul 2011
ReviewHemodynamic monitoring by transpulmonary thermodilution and pulse contour analysis in critically ill children.
To summarize the physiologic principles underlying the hemodynamic monitoring using the PiCCO device (Pulsion, Munich, Germany) incorporating the transpulmonary thermodilution technique, the pulse contour cardiac output, and estimation of the arterial pressure variation method. Analysis and review of the current literature. ⋯ The PiCCO device may be a useful adjunct for hemodynamic monitoring in critically ill children. Further studies are needed to clarify the reliability and clinical value of pulse contour method and extravascular lung water measurement.
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Pediatr Crit Care Me · Jul 2011
Assessment of the Pediatric Index of Mortality 2 with the Pao₂/Fio₂ ratio derived from the Spo₂/Fio₂ ratio: a prospective pilot study in a French pediatric intensive care unit.
The Pediatric Index of Mortality 2 is a mortality prediction tool used in pediatric intensive care units. Arterial blood gas sampling that is required to calculate the Pao₂/Fio₂ ratio is often unavailable. Several authors have proposed mathematical relations between the Pao₂/Fio₂ and Spo₂/Fio₂ ratios. The main objective of this study was to assess the validity of the Pediatric Index of Mortality 2 score and three modified Pediatric Index of Mortality 2 scores with the Pao2/Fio2 ratio calculated from the Spo₂/Fio₂ ratio. ⋯ This study suggests that the Spo₂/Fio₂ ratio could be used in place of Pao₂/Fio₂ for calculating Pediatric Index of Mortality 2. This must nonetheless be confirmed by a larger prospective multicenter study.
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Pediatr Crit Care Me · Jul 2011
Comparative StudyRole of real-time reverse transcription polymerase chain reaction for detection of respiratory viruses in critically ill children with respiratory disease: Is it time for a change in algorithm?
To identify the respiratory viral pathogens associated with acute lower respiratory tract infection in critically ill pediatric patients by using real-time reverse transcription-polymerase chain reaction, and compare results with those of direct fluorescence antibody assay testing. ⋯ Direct fluorescence antibody assay testing is a suboptimal method for the detection of respiratory viruses in critically ill children with lower respiratory tract infection. Given the importance of a prompt and accurate viral diagnosis for this group of patients, we suggest that real-time reverse transcription-polymerase chain reaction becomes part of the routine diagnostic algorithm in critically ill children when a viral etiology is suspected, even if conventional tests yield a negative result.