Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2009
Derivation and validation of an equation for adjustment of neuron-specific enolase concentrations in hemolyzed serum.
To derive and validate a formula to allow for adjustment of serum neuron-specific enolase (NSE) concentrations based on the amount of hemolysis in the sample. To compare the accuracy of qualitative and quantitative assessment of hemolysis. ⋯ We retrospectively derived and prospectively validated an equation for adjusting serum NSE concentrations based on the amount of hemolysis in the sample. Use of this formula will allow for accurate measurement of NSE even in hemolyzed sample and may improve its usefulness as a marker of brain injury in children. Qualitative assessment of the degree of hemolysis is not accurate and should not be used.
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Pediatr Crit Care Me · Mar 2009
Simulation at the point of care: reduced-cost, in situ training via a mobile cart.
The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams. ⋯ By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.
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Pediatr Crit Care Me · Mar 2009
Antibiotic-resistant bacteria and infection in children with cerebral palsy requiring mechanical ventilation.
Severe and chronic illness can alter the bacterial flora carried in the oropharynx and gut. There are little data on the bacterial flora of children with chronic neurologic impairment. ⋯ In children with moderate to severe chronic neurologic impairment admitted to PICU, there is a high rate of carriage of abnormal bacteria/potential pathogens, antibiotic-resistant bacteria, and infection.
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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
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.