Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2008
Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome.
To compare the accuracy of procalcitonin and C-reactive protein as diagnostic markers of bacterial infection in critically ill children at the onset of systemic inflammatory response syndrome (SIRS). ⋯ Procalcitonin is better than C-reactive protein for differentiating bacterial from nonbacterial SIRS in critically ill children, although the accuracy of both tests is moderate. Diagnostic accuracy could be enhanced by combining these tests with bedside clinical judgment.
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Pediatr Crit Care Me · Jul 2008
Serum level of cardiac troponin I in pediatric patients with sepsis or septic shock.
To evaluate serum level of contractile protein troponin I (cTnI) within the 24 hrs of sepsis and septic shock diagnosis in children and to correlate with the outcome (discharge from hospital or death). ⋯ Evaluation of serum levels of cTnI within the first 24 hrs of diagnosis of sepsis or septic shock in children was not better than creatine kinase MB isoenzyme or clinical evaluation, to predict the outcome (death or discharge from hospital) of septic process.
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Pediatr Crit Care Me · Jul 2008
Alterations in glucose homeostasis in the pediatric intensive care unit: Hyperglycemia and glucose variability are associated with increased mortality and morbidity.
Critically ill patients with alterations in glucose equilibrium may experience adverse outcomes. We sought to describe the distribution of blood glucose values in the absence of insulin therapy and to evaluate the association of hyperglycemia, hypoglycemia, and glucose variability with mortality and morbidity of critically ill children. ⋯ We found a relationship between blood glucose level and PICU patient outcomes. The relationship is similar to that found in adults and raises the question whether attention to control of blood glucose will improve outcomes in critically ill children.
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Pediatr Crit Care Me · Jul 2008
CommentStage I palliation for hypoplastic left heart syndrome: Is a right ventricle to pulmonary artery conduit associated with improved outcomes? Critical appraisal of Cua et al: Early postoperative outcomes in a series of infants with hypoplastic left heart syndrome undergoing stage I palliation operation with either modified Blalock-Taussig shunt or right ventricle to pulmonary artery conduit (Pediatr Crit Care Med 2006; 7:238-244).
To review the findings and discuss the implications of studies comparing Norwood procedure with either modified Blalock-Taussig shunt (NW-BT) or right ventricle to pulmonary artery conduit (NW-RVPA) in stage I palliation of hypoplastic left heart syndrome (HLHS). ⋯ NW-RVPA has theoretical advantages over NW-BT and is associated with excellent outcome results. However, available data are insufficient to prove benefit in terms of mortality or morbidity. A multicenter randomized trial is currently being conducted, which should provide more conclusive information.
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Pediatr Crit Care Me · Jul 2008
Pulse oximeter accuracy and precision affected by sensor location in cyanotic children.
Children's digits are often too small for proper attachment of oximeter sensors, necessitating sensor placement on the sole of the foot or palm of the hand. No study has determined what effect these sensor locations have on the accuracy and precision of this technology. The objective of this study was to assess the effect of sensor location on pulse oximeter accuracy (i.e., bias) and precision in critically ill children. ⋯ The Philips M1020A pulse oximeter and Nellcor MAX-N sensors were less accurate and precise when used on the sole of the foot or palm of the hand of a child with an Sao2 <90%.