Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2007
Association of nursing workload and unplanned extubations in a pediatric intensive care unit.
To estimate nursing workload from the patient acuity level (PAL) assigned to patients in a pediatric intensive care unit (PICU) and to determine its influence on unplanned extubations. ⋯ The likelihood of an unplanned extubation increased with higher patient/nurse and patient acuity/nurse ratios. Successful interventions to reduce the frequency of this medical error may need to address both nurse demand methodology and workload.
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Pediatr Crit Care Me · Jul 2007
Going back for more: an evaluation of clinical outcomes and characteristics of readmissions to a pediatric intensive care unit.
To determine mortality, length of stay, and factors associated with readmissions to the pediatric intensive care unit (PICU). ⋯ Patients readmitted to the PICU during the same hospitalization have significantly adverse outcomes. The study highlights important factors associated with PICU readmissions that can be incorporated into efforts to reduce mortality and resource utilization associated with readmission of critically ill children.
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Pediatr Crit Care Me · Jul 2007
Case ReportsSubarachnoid-pleural fistula in an infant treated with mechanical positive-pressure ventilation.
To report a pediatric case of subarachnoid-pleural fistula, its diagnosis, and its treatment. ⋯ We used beta2-transferrin to confirm the diagnosis of clinically suspected subarachnoid-pleural fistula. High-resolution computed tomographic and magnetic resonance cisternography are the best techniques to localize the fistula. The currently recommended treatment is surgery; we suggest that bilevel positive-pressure ventilation, especially with noninvasive techniques, could be a treatment alternative, reducing the flow of cerebral spinal fluid through the fistula and allowing spontaneous closure.