Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2008
Randomized Controlled Trial Multicenter StudyPost hoc analysis of calfactant use in immunocompromised children with acute lung injury: Impact and feasibility of further clinical trials.
To assess the impact of calfactant (a modified natural bovine lung surfactant) in immunocompromised children with acute lung injury and to determine the number of patients required for a definitive clinical trial of calfactant in this population. ⋯ These preliminary data suggest a potential benefit of calfactant in this high-risk population. A clinical trial powered to appropriately assess these findings seems warranted and feasible.
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Pediatr Crit Care Me · Sep 2008
ReviewA comprehensive review of pediatric endotracheal suctioning: Effects, indications, and clinical practice.
To provide a comprehensive, evidence-based review of pediatric endotracheal suctioning: effects, indications, and clinical practice. ⋯ Endotracheal suctioning is a procedure used regularly in the pediatric intensive care unit. Despite this, good evidence supporting its practice is limited. Further, controlled clinical studies are needed to develop evidence-based protocols for endotracheal suctioning of infants and children, and to examine the impact of different suctioning techniques on the duration of ventilatory support, incidence of nosocomial infection, and length of pediatric intensive care unit and hospital stay.
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Pediatr Crit Care Me · Sep 2008
Randomized Controlled TrialA prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure.
To compare the benefits of noninvasive ventilation (NIV) plus standard therapy vs. standard therapy alone in children with acute respiratory failure; assess method effectiveness in improving gas exchange and vital signs; and assess method safety. ⋯ NIV improves hypoxemia and the signs and symptoms of acute respiratory failure. NIV seems to afford these patients protection from endotracheal intubation.
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Pediatr Crit Care Me · Sep 2008
Randomized Controlled TrialThe umbilical arterial catheter: a formula for improved positioning in the very low birth weight infant.
: An umbilical arterial catheter is often used to monitor blood pressure and take frequent blood samples in the very low birth weight newborn infant requiring neonatal intensive care. Incorrect placement of the umbilical arterial catheter increases catheter complications, and adjustment of catheter position after radiograph increases infant handling and infection risk. Current methods overestimate insertion length in very low birth weight babies. We suggest a new formula for calculating insertion length that is more appropriate for today's neonatal intensive care population. The Umbilical Arterial Catheter Calculation Study, Australian Perinatal Trials Register PT0398, was set up to investigate this technical change. Our hypothesis was that the new formula would improve the siting of umbilical arterial catheters in very low birth weight infants. ⋯ : The use of the new formula results in better overall placement and in significantly less overinsertion of umbilical artery catheters in very low birth weight infants.
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Pediatr Crit Care Me · Sep 2008
Elevation of brain natriuretic peptide levels in children with septic shock.
1) To compare brain natriuretic peptide levels in pediatric patients with septic shock with both children admitted to the pediatric intensive care unit without infection and with healthy subjects; and 2) to evaluate the correlation between brain natriuretic peptide with severity of illness and with myocardial dysfunction in children with septic shock. ⋯ Brain natriuretic peptide measured early after admission is increased in children with septic shock, especially in those with cold shock. In addition, the level at 12 hrs correlates with both severity of illness and myocardial dysfunction. Brain natriuretic peptide may be useful in assessing myocardial dysfunction from septic shock, particularly in identifying children with cold shock. Further studies are warranted to determine whether this measurement will be helpful in guiding therapy in pediatric septic shock.