Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2009
Procalcitonin versus C-reactive protein and immature-to-total neutrophil ratio as markers of infection after cardiopulmonary bypass in children.
To document concentrations of procalcitonin (PCT), C-reactive protein (CRP), and immature-to-total neutrophil ratio (ITR), postcardiopulmonary bypass (CPB), and to test the hypothesis that PCT is a more reliable marker of infection than CRP or ITR in the post-CPB child. ⋯ CRP was a poor marker of sepsis in this study. Children with a PCT <2.2 ng/mL or ITR <0.08 were unlikely to have definite or probable sepsis. However, only a third of children with high values of PCT and ITR had definite or probable sepsis.
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Pediatr Crit Care Me · Mar 2009
Case ReportsMonitoring biochemical parameters as an early sign of propofol infusion syndrome: false feeling of security.
The aim of this report is to describe a fatal case of propofol infusion syndrome (PRIS), despite regular screening for this syndrome and immediate discontinuation of the infusion after the first signs of biochemical derangement. ⋯ This case report demonstrates that frequent monitoring of biochemical parameters, as suggested in literature, cannot always prevent death due to PRIS.
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Pediatr Crit Care Me · Mar 2009
Cost analysis of two approaches to parenteral nutrition in critically ill children.
In pediatric intensive care, two approaches to parenteral nutrition are available: individualized admixtures or commercial standard solutions. Even though individualized admixtures can be tailored to sometimes highly intricate requirements, standard solutions are able to meet the demands of the majority of pediatric patients. To address the growing importance of costs in intensive care, we investigated whether relevant differences between individualized admixtures and standard solutions in terms of costs can be found. ⋯ Parenteral nutrition with standard solutions offers the potential of a relevant cost reduction compared with individualized admixtures in critically ill children.
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Pediatr Crit Care Me · Mar 2009
Dexmedetomidine sedation for pediatric post-Fontan procedure patients.
The hemodynamic, respiratory, and sedative effects of dexmedetomidine (DEX) for pediatric patients post-Fontan surgery. ⋯ The results of this retrospective review of the role of DEX in the management of the post-Fontan surgical pediatric patient indicate some potential advantages.
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Pediatr Crit Care Me · Mar 2009
Hypophosphatemia in critically ill children: prevalence and associated risk factors.
Hypophosphatemia is a disorder with potential complications and is often unrecognized in critically ill patients. ⋯ Hypophosphatemia was common in the first 10 days of ICU hospitalization and was associated with the diagnosis of respiratory disease, use of dopamine, and malnutrition. These factors should be taken into account during clinical follow up of critically ill children, especially when these conditions are found together.