Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2008
WITHDRAWN: Reliability of displayed tidal volume in infants and children during dual controlled ventilation.
Previous studies have shown significant difference between ventilator-measured tidal volume and actual-delivered tidal volume. However, these studies utilized 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. DESIGN:: Clinical study during an 8-month period. SETTING:: Pediatric intensive care unit. PATIENTS:: All patients admitted to the pediatric intensive care unit during the enrollment period who were mechanically ventilated using the Servo i (Maquet, Bridgewater, NJ) were eligible for this study. INTERVENTIONS:: Patients were ventilated utilizing a dual control mode of ventilatory support and either an infant or adult circuit (with and without circuit compensation). MEASUREMENTS AND MAIN ⋯ 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 utilizing circuit compensation in small infants and children.
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Pediatr Crit Care Me · Sep 2008
The endotracheal tube air leak test does not predict extubation outcome in critically ill pediatric patients.
Endotracheal tube air leak pressures are used to predict postextubation upper airway compromise such as stridor, upper airway obstruction, or risk of reintubation. To determine whether the absence of an endotracheal tube air leak (air leak test >/=30 cm H2O) measured during the course of mechanical ventilation predicts extubation failure in infants and children. ⋯ An endotracheal tube air leak pressure >/=30 cm H2O measured in the nonparalyzed patient before extubation or for the duration of mechanical ventilation was common and did not predict an increased risk for extubation failure. Pediatric patients who are clinically identified as candidates for an extubation trial but do not have an endotracheal tube air leak may successfully tolerate removal of the endotracheal tube.
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Pediatr Crit Care Me · Sep 2008
Myocardial transcriptional profiles in a murine model of sepsis: evidence for the importance of age.
Age influences outcome of sepsis and septic shock. The mechanism of this age-dependent vulnerability to sepsis remains largely unknown. Because much of the mortality and morbidity associated with sepsis and septic shock is the result of severe derangements in the cardiovascular system, it is possible that the myocardium responds to injury in a developmentally influenced manner. We hypothesized that analysis of cardiac RNA expression profiles may differentiate between the myocardial response to sepsis in young and old mice. ⋯ This report describes the transcriptional response of the heart to sepsis. In addition, our findings suggest that these differences are in part age-dependent and serve as hypothesis generation.
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Pediatr Crit Care Me · Sep 2008
Implications of thrombocytopenia and platelet course on pediatric intensive care unit outcomes.
Thrombocytopenia has been shown to be an independent predictor of mortality and prolonged hospital length of stay in critically ill adults. Studies are lacking in the pediatric intensive care unit population. We evaluated the relationship between platelet counts at admission, platelet course, and outcomes. ⋯ Thrombocytopenia and falling platelet counts are associated with increased risk of mortality and length of stay in the pediatric intensive care unit.