Pediatr Crit Care Me
-
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.
-
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.
-
Pediatr Crit Care Me · Nov 2009
An explorative study on quality of life and psychological and cognitive function in pediatric survivors of septic shock.
To evaluate self-reported health-related quality of life, anxiety, depression, and cognitive function in pediatric septic shock survivors. ⋯ In this group of septic shock survivors, health-related quality of life, anxiety, and depression are equal to or slightly better than the age-related Dutch norm population. Cognitive function is decreased, especially in children admitted at younger ages. Follow-up studies with adequate neuropsychological testing are warranted to evaluate the association between septic shock, cognitive function, and risk factors for cognitive problems.
-
Pediatr Crit Care Me · Nov 2009
VTCO2 and dynamic compliance-guided lung recruitment in surfactant-depleted piglets: a computed tomography study.
Using computed tomography (CT) as reference, our primary objectives were to test if maximal tidal elimination of carbon dioxide (VTCO2) could be used as a marker of "optimal recruitment," indicating maximal available lung tissue for gas exchange and if a decrease in dynamic compliance (Cdyn) indicated the beginning of lung collapse during a downward positive end-expiratory pressure (PEEP) titration. ⋯ The lung recruitment maneuver was effective and lungs optimally recruited at maximal VTCO2. A fall in Cdyn indicated lung collapse during downward PEEP titration as confirmed by CT.
-
Pediatr Crit Care Me · Nov 2009
Performance of a consensus scoring algorithm for assessing pediatric advanced life support competency using a computer screen-based simulator.
To develop a computer screen-based simulator that may be used as a pediatric advanced life support (PALS) cognitive skill assessment tool and to pilot test a consensus-based scoring system for the simulator. ⋯ Personal computer-based simulation can be used to evaluate performance against consensus criteria in a large number of PALS providers. This technology could supplement traditional curricula by facilitating frequent knowledge assessments as part of a PALS competency maintenance regimen.