Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2011
Changes in lung volume during spells in children with Tetralogy of Fallot under general anesthesia.
To describe the changes in end-expiratory lung volume and ventilation inhomogeneities during spells in three children with Tetralogy of Fallot. ⋯ These data show the deleterious effect of a spell on respiratory function, which may worsen hypoxemia. The loss in lung volume can have a deleterious additive effect in the presence of a spell, particularly because of the slow improvement after treatment.
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Pediatr Crit Care Me · Jan 2011
Rotating inotrope therapy in a pediatric population with decompensated heart failure.
To describe the clinical course of a group of patients who received a rotating inotrope regimen, including levosimendan, for decompensated congestive heart failure. ⋯ Rotating inotropes were safe and seemed to be effective in this heterogeneous population of infants and children with decompensated heart failure. This therapeutic regimen warrants prospective comparative analysis.
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Pediatr Crit Care Me · Jan 2011
Variation in duration of respiratory support among Australian and New Zealand pediatric intensive care units.
To test if there was significant variation of mean adjusted duration of respiratory support (RS) at the site level among Australian and New Zealand pediatric intensive care units (PICUs) and to determine whether the pattern of variation differed from the site-level pattern of variation in length of stay (LoS). ⋯ There is unit-level variation in LoS and duration of RS, not accounted for by case-mix. Concurrent analysis of unit-level variation in LoS and duration of RS can help to identify differences in discharge practice and provide direction for improvements in clinical or administrative efficiency.
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To argue that pediatric intensive care physicians have difficulties in responding to parental questions about prognostic certainty, and that this constitutes a failure in their professional responsibility to parents. ⋯ These difficulties arise from three sources: 1) the structure and organization of contemporary intensive care, 2) the neglect of prognostication, and 3) the failure to distinguish scientific certainty from practical certainty. It is proposed that an understanding of these issues will enable physicians to respond to the parental question "How certain are you, doctor?" with more authenticity and sincerity.