Pediatrics
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The degree to which clinical prediction rules (CPRs) for children meet published standards is unclear. ⋯ Many CPRs have been derived for children, but few have been validated. Relative to adult CPRs, several quality indicators demonstrated weaknesses. Existing performance standards may prove elusive for CPRs that involve children. CPRs for children that are more assistive and less directive and include patients' values and preferences in decision-making may be helpful.
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To perform a systematic review of the quality of reporting for randomized controlled trials (RCTs) with infants and neonates that were published in high-impact journals and to identify RCT characteristics associated with quality of reporting. ⋯ The quality of reporting of infant and neonatal RCTs is inconsistent, particularly in pediatric journals. Therefore, readers cannot assess accurately the validity of many RCT results. Strict adherence to the Consolidated Standards of Reporting Trials guidelines should lead to improved reporting.
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To perform a systematic review of the quality of reporting for randomized controlled trials (RCTs) with infants and neonates that were published in high-impact journals and to identify RCT characteristics associated with quality of reporting. ⋯ The quality of reporting of infant and neonatal RCTs is inconsistent, particularly in pediatric journals. Therefore, readers cannot assess accurately the validity of many RCT results. Strict adherence to the Consolidated Standards of Reporting Trials guidelines should lead to improved reporting.
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Circulatory shock is an important cause of pediatric morbidity and mortality and requires early recognition and prompt institution of adequate treatment protocols. Unfortunately, the hemodynamic status of the critically ill child is poorly reflected by physical examination, heart rate, blood pressure, or laboratory blood tests. Advanced hemodynamic monitoring consists, among others, of measuring cardiac output, predicting fluid responsiveness, calculating systemic oxygen delivery in relation to oxygen demand, and quantifying (pulmonary) edema. We discuss here the potential value of these hemodynamic monitoring technologies in relation to pediatric physiology.