Pediatrics
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Comparative Study Clinical Trial
Overestimating neurodevelopment using the Bayley-III after early complex cardiac surgery.
The newest measure of neurodevelopmental outcomes, the Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III), gives higher-than-expected scores for preterm infants; results after cardiac surgery are unknown. ⋯ Researchers should be careful attributing higher Bayley-III scores to changes in acute care. At-risk children who previously qualified for early developmental intervention may no longer do so. School-age longitudinal studies are needed to determine the accuracy of early developmental estimates using the Bayley-III.
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Randomized Controlled Trial Comparative Study
Comparison of umbilical venous and intraosseous access during simulated neonatal resuscitation.
Emergent umbilical venous catheter (UVC) placement for persistent bradycardia in the delivery room is a rare occurrence that requires significant skill and involves space constraints. Placement of an intraosseous needle (ION) in neonates has been well described. The ION is already used in the pediatric population and is placed at an anatomic location distant from where chest compressions are performed. In this study we compared time to placement, errors in placement, and perceived ease of use for UVCs and IONs in a simulated delivery room. ⋯ In a simulated delivery room setting, ION placement can be performed more quickly than UVC insertion without any difference in technical error rate or perceived ease of use. ION insertion should be considered when rapid intravenous access is required in the neonate at the time of birth, especially by health care professionals who do not routinely place UVCs.
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Randomized Controlled Trial Comparative Study
Randomized clinical trial of rapid versus 24-hour rehydration for children with acute gastroenteritis.
To compare the efficacy of 2 nasogastric rehydration regimens for children with acute viral gastroenteritis. ⋯ Primary treatment failure and clinical outcomes were similar for RNR and SNR. Although RNR generally reduced the need for hospitalization, discharge home from the ED failed for approximately one-fourth of the patients.
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Randomized Controlled Trial
Effect on behavior problems of teen online problem-solving for adolescent traumatic brain injury.
To report the results of a randomized clinical trial of teen online problem-solving (TOPS) meant to improve behavioral outcomes of adolescents with traumatic brain injury (TBI). ⋯ Our findings suggest that TOPS contributes to improvements in parent-teen conflict generally and parent and self-reported teen behavior problems for certain subsets of participants.
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We assessed out-of-hospital cardiac arrests (OHCAs) for various pediatric age groups. ⋯ Survival and favorable neurologic outcome at 1 month were more common after pediatric OHCAs than adult OHCAs.