Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2010
ReviewDevelopmental neurotoxicity of sedatives and anesthetics: a concern for neonatal and pediatric critical care medicine?
To evaluate the currently available evidence for the deleterious effects of sedatives and anesthetics on developing brain structure and neurocognitive function. ⋯ Neuronal cell death after neonatal exposure to sedatives and anesthetics has been clearly demonstrated in developing animal models. Although the relevance for human medicine remains speculative, the phenomenon's serious implications for public health necessitate further preclinical and clinical studies. Intensivists using sedatives and anesthetics in neonates and infants need to stay informed about this rapidly emerging field of research.
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Pediatr Crit Care Me · Mar 2010
Intrahospital transport of children on extracorporeal membrane oxygenation: indications, process, interventions, and effectiveness.
To evaluate indications, process, interventions, and effectiveness of patients undergoing intrahospital transport. Critically ill patients supported with extracorporeal membrane oxygenation are transported within the hospital to the radiology suite, cardiac catheterization suite, operating room, and from one intensive care unit to another. No studies to date have systematically evaluated intrahospital transport for patients on extracorporeal membrane oxygenation. ⋯ Although transporting patients on extracorporeal membrane oxygenation is labor intensive and requires extensive logistic support, it can be carried out safely in experienced hands and it can result in important therapeutic and diagnostic yields. To our knowledge, this is the first study designed to evaluate safety and efficacy of intrahospital transport for patients receiving extracorporeal membrane oxygenation support.
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Pediatr Crit Care Me · Mar 2010
Educational preparation and postgraduate training curriculum for pediatric critical care nurse practitioners.
Nurse practitioners (NPs) in pediatric intensive care units have increased dramatically over recent years. Although state regulations are changing pediatric nurse practitioner certification, licensure and credentialing requirements, available acute care, and critical care educational programs are limited. Thus, entry-level practitioners continue to have varied clinical experience and educational preparation. ⋯ The orientation curriculum presented here may serve as a resource for NPs and collaborating physicians who are developing a training program for entry-level practitioners.
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Pediatr Crit Care Me · Mar 2010
Risk factors for healthcare-associated infection in a pediatric intensive care unit.
Identify risk factors for first-onset healthcare-associated infection (HAI) in a pediatric intensive care unit (PICU). ⋯ Efforts toward a reduction in the exposure to extrinsic risk factors should be made, as each of these factors separately explains 30% of the risk of HAI. Interventions directed at processes related to the use of a ventilator and limitations on its duration of use should be a priority in HAI control strategies, as each day of ventilator use increases the risk of HAI.
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Pediatr Crit Care Me · Mar 2010
Vasoactive-inotropic score as a predictor of morbidity and mortality in infants after cardiopulmonary bypass.
Inotrope score has been proposed as a marker of illness severity after pediatric cardiac surgery despite a lack of data to support its use as such. The goal of this study was to determine the association between inotropic/vasoactive support and clinical outcome in infants after cardiac surgery. ⋯ The amount of cardiovascular support in the first 48 hrs after congenital heart surgery with cardiopulmonary bypass predicts eventual morbidity and mortality in young infants. The degree of support is best characterized by a maximum vasoactive-inotropic score obtained during this period. The usefulness of vasoactive-inotropic score as an independent predictor of clinical outcome in infants after cardiac surgery may have important implications for future cardiothoracic intensive care unit research.