Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2010
Building trust through communication in the intensive care unit: HICCC.
The goal of this study was to explore the role of communication in building trust between intensivists and parents in the pediatric intensive care unit. ⋯ Communication is vital to building trust in the pediatric intensive care unit. Developed from parents' own observations and perspectives, HICCC is an accessible framework that can help doctors to remember what parents value in communication in the acute care setting. In addition, pediatric intensivists would benefit from targeted cultural competency training to reduce physician bias.
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Pediatr Crit Care Me · May 2010
Case ReportsHome extubation by a pediatric critical care team: providing a compassionate death outside the pediatric intensive care unit.
Our objective is to present a case report of home extubation by a pediatric intensive care team in a terminally ill pediatric patient. Literature relevant to home extubation will be reviewed. The design is a case report. ⋯ Before offering home extubation to families, hospitals should prepare families for the experience and address the availability of staff to comfort parents and provide bereavement support. Medicolegal as well as cost issues for the hospital related to home extubation should be explored before the implementation of a program of this nature. This case illustrates that home extubation is a creative, compassionate, and culturally sensitive alternative to hospital-based end-of-life care involving the pediatric intensivist, transport teams, and primary care physicians.
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Pediatr Crit Care Me · May 2010
Clinical implications of hepatitis A virus ribonucleic acid detection and genotyping in acute liver failure in children in Argentina.
To investigate the detection of hepatitis A virus ribonucleic acid in patients with acute liver failure and to assess if the results have any clinical implications for the evolution of acute liver failure in children. Hepatitis A infection, a vaccine-preventable disease, is an important cause of acute liver failure in children in Argentina. Universal vaccination in 1-yr-old children was implemented in June 2005. ⋯ Hepatitis A virus genotyping studies did not show any particularities, all cases were IA and, thus, apparent associations between genotype and the clinical presentation of acute liver failure could not be found.
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Pediatr Crit Care Me · May 2010
Randomized Controlled TrialHelium/oxygen-driven albuterol nebulization in the management of children with status asthmaticus: a randomized, placebo-controlled trial.
We investigated the effect of heliox-powered albuterol therapy on hospital length of stay and clinical status in children with moderate to severe status asthmaticus. ⋯ Despite the previously demonstrated effects of heliox on improved aerosol particle delivery into the distal airways, heliox-powered nebulized albuterol therapy for children admitted to the hospital with moderate to severe status asthmaticus does not shorten hospital length of stay or hasten rates of clinical improvement when compared with air/oxygen-powered nebulized albuterol.
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Pediatr Crit Care Me · May 2010
Multicenter StudyOutcomes among neonates, infants, and children after extracorporeal cardiopulmonary resuscitation for refractory inhospital pediatric cardiac arrest: a report from the National Registry of Cardiopulmonary Resuscitation.
Describe the use of extracorporeal cardiopulmonary resuscitation as rescue therapy in pediatric patients who experience cardiopulmonary arrest refractory to conventional resuscitation. We report on outcomes and factors associated with survival in children treated with extracorporeal cardiopulmonary resuscitation during cardiopulmonary arrest from the American Heart Association National Registry of CardioPulmonary Resuscitation. ⋯ Forty-four percent of pediatric patients who failed conventional cardiopulmonary resuscitation from in-hospital cardiopulmonary arrest and who were reported to the National Registry of CardioPulmonary Resuscitation database as treated with extracorporeal cardiopulmonary resuscitation survived to hospital discharge. The majority of survivors with recorded neurologic outcomes were favorable. Patients with cardiac illness category were more likely to survive to hospital discharge after treatment with extracorporeal cardiopulmonary resuscitation. Extracorporeal cardiopulmonary resuscitation should be considered for select pediatric patients refractory to conventional in-hospital resuscitation measures.