Intensive care medicine
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Intensive care medicine · Aug 2017
Multicenter Study Comparative Study Observational StudyPeripherally inserted central catheters are associated with lower risk of bloodstream infection compared with central venous catheters in paediatric intensive care patients: a propensity-adjusted analysis.
Central line-associated bloodstream infection (CLABSI) is an important cause of complications in paediatric intensive care units (PICUs). Peripherally inserted central catheters (PICCs) could be an alternative to central venous catheters (CVCs) and the effect of PICCs compared with CVCs on CLABSI prevention is unknown in PICUs. Therefore, we aimed to evaluate whether PICCs were associated with a protective effect for CLABSI when compared to CVCs in critically ill children. ⋯ PICC should be an alternative to CVC in the paediatric intensive care setting for CLABSI prevention.
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Intensive care medicine · Aug 2017
Multicenter StudyPotentially modifiable factors contributing to sepsis-associated encephalopathy.
Identifying modifiable factors for sepsis-associated encephalopathy may help improve patient care and outcomes. ⋯ Acute renal failure and common metabolic disturbances represent potentially modifiable factors contributing to sepsis-associated encephalopathy. However, a true causal relationship has yet to be demonstrated. Our study confirms the prognostic significance of mild alteration of mental status in patients with sepsis.
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Intensive care medicine · Aug 2017
Multicenter StudyPrediction of pediatric sepsis mortality within 1 h of intensive care admission.
The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. ⋯ We observed mortality patterns specific to pediatric sepsis that support the need for specialized definitions of sepsis severity in children. We demonstrated the importance of lactate, cardiovascular, and respiratory derangements at ICU admission for the identification of children with substantially higher risk of sepsis mortality.