Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2011
ReviewThe diagnostic dilemma of ventilator-associated pneumonia in critically ill children.
A review of the existing literature on ventilator-associated pneumonia in children with emphasis on problems in diagnosis. ⋯ Ventilator-associated pneumonia is an important nosocomial infection in the pediatric intensive care unit. Conclusions regarding epidemiology, treatment, and outcomes are greatly hampered by the inadequacies of current diagnostic methods. We recommend a more rigorous approach to diagnosis by using the Centers for Disease Control and Prevention algorithm. Given that ventilator-associated pneumonia is the most common reason for antibiotic use in the pediatric intensive care unit, more systematic studies are sorely needed.
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Pediatr Crit Care Me · May 2011
Perioperative factors associated with prolonged mechanical ventilation after complex congenital heart surgery.
To evaluate perioperative factors associated with prolonged mechanical ventilation in children undergoing complex cardiac surgery for congenital heart disease. ⋯ Younger age, greater severity of illness at postoperative admission, healthcare-associated infections, noninfectious pulmonary complications, and the need for reintervention are associated with prolonged mechanical ventilation after complex cardiac surgery. Future studies and quality improvement initiatives should focus on those risk factors that are modifiable to promote early extubation in children recovering from complex congenital heart surgery.