Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2011
Opportunities for antibiotic reduction in mechanically ventilated children.
To identify opportunities to safely reduce antibiotic use in critically ill children with moderately severe respiratory failure. ⋯ Eleven of 20 mechanically ventilated children treated with antibiotics for presumed infectious pneumonia had undetectable concentrations of bacteria in their lower respiratory tract, and three others had organisms present at low concentrations, suggesting that opportunities exist to reduce antibiotic exposure in this population.
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Pediatr Crit Care Me · May 2011
Handover after pediatric heart surgery: a simple tool improves information exchange.
To improve the quality of handover of complex patients after pediatric cardiac surgery through the use of a simple handover tool. ⋯ Use of a simple tool during handover of pediatric postcardiac surgery patients resulted in a more complete exchange of critical information with no significant prolongation of the handover duration.
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Pediatr Crit Care Me · May 2011
Prospective operationalization and feasibility of a glycemic control protocol in critically ill children.
To evaluate the feasibility and safe operationalization of a pediatric glycemic control protocol in the setting of a general pediatric intensive care unit in a developing country. ⋯ Hyperglycemia is frequent in critically ill children managed in a pediatric intensive care unit in a developing country. Using a glycemic control protocol, one-third of these children required insulin, but attendants should be aware of a significant risk of hypoglycemia in this setting. Based on these data, a trial to detect a 20% relative reduction in mortality (power 90%, p = .05) associated with insulin in a similar population would need to screen >10,000 patients.
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Pediatr Crit Care Me · May 2011
Comparative StudyInfluenza A (pH1N1) infection in children admitted to a pediatric intensive care unit: differences with other respiratory viruses.
To describe the clinical features of patients admitted to the pediatric intensive care unit (PICU) with acute lower respiratory tract infection (LRTI) attributable to influenza A pH1N1 virus and compare them with those admitted with LRTI due to other viral pathogens. ⋯ Patients with influenza A pH1N1 respiratory virus infection presented with more severe illness. Outcomes were similar in both groups.
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Pediatr Crit Care Me · May 2011
Impact of a computerized note template/checklist on documented adherence to institutional criteria for determination of neurologic death in a pediatric intensive care unit.
Variability exists in the documentation of death by neurologic criteria in children. We hypothesized that the use of a note template/checklist, which included directive (educational) prompts based on institutional neurologic determination of death criteria, improved thoroughness of documentation within our institutional guidelines for the neurologic determination of death. ⋯ Use of a note template/checklist to guide and document neurologic determination of death improved adherence to institutional criteria for assessment of cessation of neurologic function.