Pediatr Crit Care Me
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To describe the use of dexmedetomidine for sedating intubated children in a general medical/surgical pediatric intensive care unit (PICU). ⋯ Our study suggests that many, although not all, mechanically ventilated children may be able to reduce their need for other sedation medications with the use of dexmedetomidine. However, the potential side effects of dexmedetomidine necessitates close hemodynamic monitoring with its use.
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Pediatr Crit Care Me · May 2009
Anti-inflammatory modalities: their current use in pediatric cardiac surgery in the United Kingdom and Ireland.
To determine the use of anti-inflammatory therapies in infants and children undergoing cardiac surgery in the United Kingdom and Ireland. ⋯ Although anti-inflammatory interventions are believed to contribute to improved patient outcome following cardiopulmonary bypass, this survey has shown that there are still widespread variations in practice. Rather than reflecting poor clinical practice, we believe this reflects a lack of good evidence supporting clinical benefit.
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Pediatr Crit Care Me · May 2009
Randomized Controlled TrialEffect of alternative chest compression techniques in infant and child on rescuer performance.
Current chest compression (CC) guidelines for an infant recommend a two-finger (TF) technique with lone rescuer and a two- thumb (TT) technique with two rescuers, and for a child either an one hand (OH) or a two hand (TH) technique with one or two rescuers. The effect of a 30:2 compression:ventilation ratio using these techniques on CC quality and rescuer fatigue is unknown. We hypothesized that during lone rescuer CC, TT technique, in infant and TH in child achieve better compression depth (CD) without additional rescuer fatigue compared with TF and OH, respectively. ⋯ Two-thumb compression provides higher CD and CP compared with TF without any evidence of decay in quality and additional rescuer fatigue over 5 minutes. There was no significant difference in child CC quality or rescuer fatigue between OH and TH. Two-thumb technique is preferred for infant CC and our data support the current guidelines for child CC.
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Pediatr Crit Care Me · May 2009
CommentA critical appraisal of "transfusion strategies for patients in pediatric intensive care units" by Lacroix J, Hebert PC, Hutchison, et al (N Engl J Med 2007; 356:1609-1619).
To review the findings and discuss the implications of transfusion strategies in stable critically ill children. ⋯ Using a restrictive transfusion protocol with a transfusion threshold of 7 g/dL in stable critically ill children is as safe as using a liberal protocol and can decrease the number of patients exposed to RBC transfusions.
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Pediatr Crit Care Me · May 2009
Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team.
To determine the effect of a medical emergency team (MET) on the incidence of unexpected cardiac arrest and death. ⋯ Introduction of a MET was associated with reduction of total hospital death and reduction of preventable cardiac arrest and death with increased survival in wards of a pediatric hospital. MET calling criteria identified some but not all children at risk of unexpected cardiac arrest and death.