Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2009
ReviewUltrasound examination of the lungs in the intensive care unit.
Lung ultrasound is increasingly used in the critically ill adult. It allows prompt management based upon reproducible data and generates fewer computed tomography (CT) examinations, therefore decreasing irradiation, delays, cost, and discomfort to the patient. The aim of this article is to describe the value of ultrasound for lung imaging in the critically ill and state our experience in neonates. ⋯ The standardized signs assessed in the adult are also found in the critically ill neonate, meaning a potential use in this field. Awaiting confirmatory CT studies, lung ultrasound can be taken into consideration as a possible bedside tool for completing bedside radiography.
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Pediatr Crit Care Me · Nov 2009
Comparative StudyLung contusion in children--early computed tomography versus radiography.
To investigate, in children, the correlation between the extent of lung contusion as detected on early radiologic examination (chest radiograph [CXR] and/or thoracic computed tomography [TCT]) and subsequent clinical outcome measures. ⋯ The severity of lung contusion determined by CXR, but not TCT, correlates with impairment of oxygenation, CO2 exchange, and duration of ventilatory support.
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Pediatr Crit Care Me · Nov 2009
Parental anxiety and medical comprehension within 24 hrs of a child's admission to the pediatric intensive care unit*.
Admission of a child to the pediatric intensive care unit (PICU) can create high-parental anxiety. The authors examined the factors that contribute to parental anxiety and the effect of parental anxiety on comprehension of medical information within 24 hrs of a child's admission to the PICU. The physician's recognition of parental anxiety related to their child's hospitalization was also evaluated. ⋯ Parental anxiety is high following a child's admission to the PICU. Physicians failed to recognize high-parental anxiety in nearly one third of the parents. Despite the high anxiety associated with a child's admission to the PICU, parents seem to understand their children's medical issues within the first 24 hrs.
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Pediatr Crit Care Me · Nov 2009
Dexmedetomidine use in a pediatric cardiac intensive care unit: can we use it in infants after cardiac surgery?
To assess clinical response of dexmedetomidine alone or in combination with conventional sedatives/analgesics after cardiac surgery. ⋯ Dexmedetomidine use in infants and neonates after cardiac surgery was well tolerated in both intubated and nonintubated patients. It provides an adequate level of sedation/analgesia either alone or in combination with low-dose conventional agents.
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Pediatr Crit Care Me · Nov 2009
Reliability of displayed tidal volume in infants and children during dual-controlled ventilation.
Previous studies have shown a significant difference between ventilator-measured tidal volume and actual-delivered tidal volume. However, these studies used external methods for measurement of compression volume. Our objective was to determine whether tidal volume could be accurately measured at the expiratory valve of a conventional ventilator using internal computer software to compensate for circuit compliance with a dual control mode of ventilation. ⋯ There is an underestimation of delivered tidal volume when compensating for circuit volume loss measured at the ventilator. There is no improvement in measured tidal volume using circuit compensation in small infants and children.