Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2007
ReviewIs hyperglycemia really harmful? A critical appraisal of "Persistent hyperglycemia in critically ill children" by Faustino and Apkon (J Pediatr 2005; 146:30-34).
To review the findings and to discuss the implications of hyperglycemia in critically ill children. ⋯ This study adds to the growing body of knowledge that associates the timing, intensity, duration, and variability of glycemia with outcomes in critically ill children. However, its limitations restrict drawing causal relationships and prevents insights regarding therapy.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled Trial Comparative StudySelective medicated (normal saline and exogenous surfactant) bronchoalveolar lavage in severe aspiration syndrome in children.
To study the ability of volume-controlled ventilation and medicated (normal saline plus surfactant) bronchoalveolar lavage in aspiration to reduce the duration of intubation and improve gas exchange. ⋯ Even though this was an unblinded small clinical trial and low tidal volume strategy was not employed at an early stage after lung injury, there is some evidence that bronchoalveolar lavage with normal saline and surfactant may have clinical value in treating severe aspiration syndrome in children. More clinical studies are warranted to overcome study limitations and potential bias.
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Pediatr Crit Care Me · Sep 2007
Comparative Study Clinical TrialPharmacokinetics of dexmedetomidine in postsurgical pediatric intensive care unit patients: preliminary study.
To characterize the pharmacokinetics of dexmedetomidine and monitor any dexmedetomidine-related adverse events in postoperative pediatric patients requiring short-term mechanical ventilation, analgesia, and sedation in the pediatric intensive care unit (PICU). ⋯ Dexmedetomidine, administered as a continuous infusion, produces consistent, predictable concentrations in children and infants. Further evaluations of the safety, efficacy, and pharmacodynamics of dexmedetomidine are warranted.
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Pediatr Crit Care Me · Sep 2007
Clinical TrialWeaning children from mechanical ventilation with a computer-driven system (closed-loop protocol): a pilot study.
To evaluate the applicability, tolerance, and efficacy of a closed-loop protocol to wean children from mechanical ventilation. ⋯ A closed-loop protocol was successfully used to wean children from mechanical ventilation. Further studies are required to assess the impact of this novel therapeutic strategy on the length of mechanical ventilation.
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Pediatr Crit Care Me · Sep 2007
Using pediatric advanced life support in pediatric residency training: does the curriculum need resuscitation?
The Pediatric Advanced Life Support (PALS) course is used throughout North American pediatric residency programs to provide a core pediatric resuscitation curriculum. Despite this widespread use, its effectiveness has not been formally assessed in pediatric residents. This study aimed to evaluate the PALS curriculum's effectiveness in providing pediatric residents with knowledge, skill and confidence in pediatric resuscitation. ⋯ PALS is successful in providing basic resuscitation knowledge to pediatric residents, but knowledge of critical algorithm details is not sustained. The course does not provide for the expected level of competency in relevant technical skills. Residents do not achieve the confidence to feel well prepared to provide comprehensive care to pediatric patients in cardiopulmonary arrest. These findings support the hypothesis that the PALS course alone is insufficient to provide pediatric residents with competency in cardiopulmonary resuscitation.