Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2009
A tale of two bridges: effect of the bloodless bridge on renal function and blood pressure in neonates managed with venoarterial extracorporeal membrane oxygenation.
To investigate if a change in bridge design of the extracorporeal membrane oxygenation (ECMO) circuit had an impact on renal function and blood pressure in neonates requiring venoarterial ECMO support. ⋯ Patients managed on venoarterial ECMO after the transition to the "bloodless" bridge had less hypertension compared with those managed before the bridge change. This may reflect improved maintenance of renal perfusion associated with transition to an ECMO bridge design that does not require intermittent circulation with associated arterial-venous shunting.
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Pediatr Crit Care Me · Sep 2009
Airway exchange catheters use in the airway management of neonates and infants undergoing surgical treatment of laryngeal stenosis.
Congenital and acquired upper airway obstruction in infants commonly manifests as an acute, potentially life-threatening condition or a slow and gradual deterioration and can be a challenge to the pediatric anesthesiologist. This case series reports the nonconventional use of pediatric airway exchange catheters emergent and short-term airway management and lung ventilation in neonates and infants with severe laryngotracheal stenosis. ⋯ Airway exchange catheters represent a useful additional tool for short-term advanced airway management for both oxygenation and ventilation in neonates and infants presenting with severe laryngotracheal stenosis.
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Pediatr Crit Care Me · Sep 2009
Effect of injury severity on the incidence and utilization-related outcomes of venous thromboembolism in pediatric trauma inpatients.
The objective of this study was to generate national estimates of the effect of injury severity on the occurrence rate and associated resource utilization-related outcomes of venous thromboembolism (VTE) between pediatric and adolescent trauma inpatients in the United States. ⋯ VTE increases both the length of stay and hospitalization costs independent of injury severity, demonstrating the need to consider thromboprophylaxis in the critically injured population. However, the low overall occurrence rate of VTE in young trauma patients, even in the intensive care unit, highlights the need for additional studies of risk factors and the potential risks of prophylactic anticoagulation, so that thromboprophylaxis can be more directly targeted to the children at highest risk.
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Pediatr Crit Care Me · Sep 2009
World Federation of Pediatric Intensive and Critical Care Societies-its global agenda.
The World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS) is an international body that brings together international expertise, experience, and influence to improve the outcomes of children suffering from life-threatening illness and injury. Its mission is educational, scientific, and charitable in nature. WFPICCS is committed to a global environment, in which all children have access to intensive and critical care of the highest standard. ⋯ The challenge is to find the appropriate role that we need to (and can effectively) play in decreasing both unnecessary death and suffering for children. Clearly, we cannot achieve these goals on our own, hence WFPICCS visualizes close cooperation and collaboration with other agencies offering care to critically ill or injured children such as the World Health Organization, World Federation of Societies of Intensive and Critical Care Medicine, International Pediatric Associations, and regional organizations and programs to achieve our objectives. We feel that this document while imperfect is a good starting point and hope that it will stimulate more discussion to guide the agenda of the federation for years to come.