The Journal of pediatrics
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The Journal of pediatrics · Feb 2012
Multicenter StudyWidespread use of fresh frozen plasma in US children's hospitals despite limited evidence demonstrating a beneficial effect.
To determine the pattern, prevalence and potential complications of fresh frozen plasma (FFP) use in US pediatric hospitals from 2002-2009. ⋯ FFP is commonly used in children admitted to PHIS hospitals. Despite recent expert recommendations highlighting the lack of efficacy in many clinical scenarios, the rate of FFP use does not appear to be changing. Randomized, controlled studies are needed to determine appropriate indications for FFP use and evaluate for potential complications.
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The Journal of pediatrics · Feb 2012
Multicenter StudyCoagulopathy is prevalent and associated with adverse outcomes in transfused pediatric trauma patients.
To evaluate coagulopathy in pediatric trauma patients on presentation to the emergency department, and to quantify the relationship with mortality. ⋯ Coagulopathy is prevalent in pediatric trauma patients ill enough to require a transfusion and is strongly associated with mortality. Studies are needed to determine whether early coagulation factor replacement and the institution of massive transfusion protocols may improve outcomes in these patients.
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The Journal of pediatrics · Dec 2011
Randomized Controlled Trial Multicenter StudyMortality reduction by heart rate characteristic monitoring in very low birth weight neonates: a randomized trial.
To test the hypothesis that heart rate characteristics (HRC) monitoring improves neonatal outcomes. ⋯ HRC monitoring can reduce the mortality rate in very low birth weight infants.
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The Journal of pediatrics · Aug 2011
Multicenter Study Comparative StudyRacial and ethnic disparities in post-operative mortality following congenital heart surgery.
This study assessed racial/ethnic disparities in post-operative mortality after surgery for congenital heart disease (CHD) and explored whether disparities persist after adjusting for access to care. ⋯ There are notable racial/ethnic disparities in post-operative mortality after CHD surgery that do not appear to be explained by differences in access to care.
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The Journal of pediatrics · Aug 2011
Multicenter Study Comparative StudyWhom are we comforting? An analysis of comfort medications delivered to dying neonates.
To clarify the use of end-of-life comfort medications or neuromuscular blockers (NMBs) in culturally different neonatal intensive care units (NICUs). ⋯ Comfort medications were administered to almost all dying infants in each NICU. Some, but not all, centers were comfortable increasing these medications around or after extubation. In three centers, NMBs were at times present at the time of death. However, only in Holland were NMBs initiated after extubation.