Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2010
Reducing catheter-associated bloodstream infections in the pediatric intensive care unit: Business case for quality improvement.
To determine whether catheter-associated bloodstream infections were associated with increased lengths of stay in pediatric intensive care units and hospitals and increased healthcare costs in critically ill children. Previous studies have shown that hospital-acquired bloodstream infections are associated with longer stays in pediatric intensive care units, increased hospital costs, and increased hospital mortality. Catheter-associated bloodstream infections comprise the vast majority of hospital-acquired bloodstream infections. ⋯ The potential cost savings from reducing or eliminating catheter-associated bloodstream infections in the pediatric intensive care unit are significant. Elimination of catheter-associated bloodstream infections will directly reduce hospital costs, improve asset utilization, and most importantly, improve clinical care.
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Pediatr Crit Care Me · Sep 2010
Genetic variability in complement activation modulates the systemic inflammatory response syndrome in children.
To determine the impact of genetic variability in complement activation on early development of the systemic inflammatory response syndrome (SIRS) in general pediatric critical care. ⋯ Functional polymorphisms in the complement activation cascade modify the risk for early SIRS/sepsis in general pediatric critical care. The complement factor H Y402H variant allele is protective, whereas the mannose-binding lectin variant polymorphisms increase risk. A genotype that permits vigorous complement activation to an infectious or inflammatory insult may offer protection from development of systemic inflammation.
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Pediatr Crit Care Me · Sep 2010
Three decades of pediatric intensive care: Who was admitted, what happened in intensive care, and what happened afterward.
To describe the characteristics of children admitted to intensive care in 1982, 1995, and 2005-2006, and their long-term outcome. ⋯ Over the last three decades, the length of stay in the pediatric intensive care unit and the severity of illness have not changed, but there has been a substantial reduction in pediatric intensive care unit mortality. However, the proportion of survivors with moderate or severe disability increased significantly. Some children who would have been allowed to die in 1982 and 1995 were kept alive in 2005-2006, but survived with disability. This trend has important implications for our patients and their families, and for the community as a whole.
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Pediatr Crit Care Me · Sep 2010
Correlation of intraocular pressure with intracranial pressure in children with severe head injuries.
To determine whether there was a correlation between tonometric measurements of the intraocular pressure and transducer measurements of the intracranial pressure in the acute setting, and whether intraocular pressure can be used as a surrogate measure of intracranial pressure. Children with traumatic brain injuries commonly develop increased intracranial pressure requiring surgical placement of a pressure transducer to measure the intracranial pressure during the acute recovery period. The increased intracranial pressure may cause engorgement of the orbital compartments via dilation of the episcleral veins and manifest as increased intraocular pressure. ⋯ Tonometry is a useful screening surrogate measure of intracranial pressure in children with traumatic brain injuries, but seems to lack the accuracy necessary for close management of intracranial pressure in the acute posttraumatic period.