Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2008
Serial blood lactate levels as a predictor of mortality in children after cardiopulmonary bypass surgery.
To assess the role of serial lactate levels in determining outcome after cardiopulmonary bypass surgery in children. ⋯ Lactime was a useful predictor of mortality in children undergoing repair or palliation of congenital cardiac defects under cardiopulmonary bypass. Initial and peak lactate levels had a poor positive predictive value for mortality. Lactime also was associated with the number of ventilator days and hospital days in those who survived.
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Pediatr Crit Care Me · May 2008
Worsening renal function in children hospitalized with decompensated heart failure: evidence for a pediatric cardiorenal syndrome?
The purpose of this study was to determine the incidence of renal insufficiency in children hospitalized with acute decompensated heart failure and whether worsening renal function is associated with adverse cardiovascular outcome. ⋯ These data suggest that an important cardiorenal interaction occurs in children hospitalized for acute decompensated heart failure. Renal function commonly worsens in such patients and is associated with prolonged hospitalization and in-hospital death or the need for mechanical circulatory assistance.
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Pediatr Crit Care Me · May 2008
Cerebrospinal fluid values in very low birth weight infants with suspected sepsis at different ages.
Lumbar puncture can be an essential part of the septic work-up in premature infants who are at risk for sepsis and meningitis. Cerebrospinal fluid (CSF) values for cell counts, protein concentrations, and glucose concentrations in children and full-term infants are well established. CSF values in premature infants, however, have not been well studied. We sought to determine CSF values in very low birth weight premature infants at different ages (birth, postmenstrual age, and postnatal age). ⋯ In very low birth weight premature infants, CSF WBC count and CSF protein concentrations vary with advancing postnatal and postmenstrual ages.
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Pediatr Crit Care Me · May 2008
A prospective review of adverse events during interhospital transfers of neonates by a dedicated neonatal transfer service.
To categorize and quantify adverse events occurring during emergency interhospital transfers performed by a specialized neonatal retrieval team and to assign levels of associated risk. ⋯ Adverse events commonly occur during neonatal transfers, even if performed by a dedicated transfer service. Early identification of potentially harmful episodes is important. Human error is likely to be a factor in the majority of adverse events; hence, opportunities should be taken to reduce the number of these through education, training, and risk management.
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Pediatr Crit Care Me · May 2008
Comparative StudyTadalafil improves oxygenation in a model of newborn pulmonary hypertension.
Sildenafil, a phosphodiesterase-5 inhibitor, significantly improves oxygenation when used in animal models and patients with pulmonary hypertension. Tadalafil is a new and clinically available phosphodiesterase-5 inhibitor that, aside from causing pulmonary vasodilation, has been shown to increase cardiac output in pulmonary hypertensive adults. Its hemodynamic effects on the newborn, however, have not been tested. The objective was to evaluate the effect of tadalafil on central hemodynamics and arterial oxygenation in a piglet model of acute pulmonary hypertension. ⋯ In a newborn animal model of acute pulmonary hypertension, oral tadalafil administration reduces pulmonary vascular resistance and increases arterial oxygenation by increasing cardiac output and reducing the lung shunt fraction. This previously untested compound deserves additional investigation in laboratory models of persistent pulmonary hypertension of the newborn.