Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2005
ReviewReducing the global burden of sepsis in infants and children: a clinical practice research agenda.
Sepsis remains a predominant cause of mortality and morbidity in children in the developing and industrialized world. This review discusses a clinical practice research agenda to reduce this global burden. ⋯ The global burden of sepsis can be reduced by 1) prevention with improved heterologous or specific vaccines and vitamin or mineral supplement programs; 2) early recognition and treatment with appropriate antibiotics, intravenous fluid resuscitation, and inotropic support in organized healthcare-delivery systems; and 3) development of new diagnostics and therapeutics that reduce systemic thrombosis, improve immune function, and kill resistant organisms.
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Pediatr Crit Care Me · May 2005
Comparative StudyExtracellular hsp70 levels in children with septic shock.
To determine whether hsp70 is elevated in the plasma of children with septic shock. ⋯ Extracellular hsp70 levels are significantly elevated in children with septic shock compared with controls. Given the newly described cell signaling properties of hsp70, these data suggest that extracellular hsp70 may play a role in the host response during septic shock.
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Pediatr Crit Care Me · May 2005
ReviewPhysicians' ability to diagnose sepsis in newborns and critically ill children.
To elucidate physicians' ability to correctly diagnose infection in critically ill children in three different situations: 1) post hoc adjudication (e.g., ward rounds, outcome determination in surveillance studies or controlled trials), 2) when decisions must be made (e.g., sepsis workup in suspected infection), c) and applying suggested adult consensus conference definitions in children. ⋯ Misclassification is a serious threat in post hoc adjudication of episodes or when consensus definitions rely on the application of criteria with imperfect sensitivity (e.g., the positivity of blood cultures in premature infants or children). This underscores the need to use probability-based categorizations such as probable and possible infection.
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Pediatr Crit Care Me · May 2005
A critical appraisal of a systematic review: Sokol J, Jacob SE, Bohn D: Inhaled nitric oxide for acute hypoxemic respiratory failure in children and adults. Cochrane Database Syst Rev 2003 (1): CD002787.
To review the findings and discuss the implications of the use of inhaled nitric oxide for acute hypoxemic respiratory failure in patients beyond the neonatal period. ⋯ There is insufficient evidence to determine whether inhaled nitric oxide is beneficial or harmful for acute hypoxemic respiratory failure in children and adults. While awaiting further studies to prove its benefit, inhaled nitric oxide should not either be recommended as a standard management or excluded for the treatment of acute hypoxemic respiratory failure.
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Pediatr Crit Care Me · May 2005
Reproducibility of cerebral oxygenation measurement in neonates and infants in the clinical setting using the NIRO 300 oximeter.
To study reproducibility of cerebral tissue oxygenation index (cTOI) values in neonates and infants in a clinical setting using the NIRO 300 oximeter (Hamamatsu Photonics, Hamamatsu City, Japan). ⋯ The present study shows that cTOI measurements using the NIRO 300 oximeter at the lateral forehead of neonates and infants are not well reproducible under clinical conditions. This raises the question whether generally valid normal values can be defined with the used approach and makes it difficult to determine a normal range of cerebral oxygenation.