Pediatrics
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Multicenter Study
Alterations in end-of-life support in the pediatric intensive care unit.
Our purpose was to examine alterations in end-of-life support in a multiinstitutional sample of PICUs. ⋯ Decisions to limit support are common. Black race and an absence of trainees are associated with decreased frequency of limitation decisions.
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Multicenter Study Comparative Study
Multicenter study of repeat epinephrine treatments for food-related anaphylaxis.
We sought to establish the frequency of receiving >1 dose of epinephrine in children who present to the emergency department (ED) with food-related anaphylaxis. ⋯ Among children with food-related anaphylaxis who received epinephrine, 12% received a second dose. Results of this study support the recommendation that children at risk for food-related anaphylaxis carry 2 doses of epinephrine.
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Multicenter Study Comparative Study
Culturally-sensitive information-sharing in pediatric palliative care.
This study aimed to learn about experiences of Mexican American and Chinese American families who require pediatric palliative care. This article describes parents' perceptions of information-sharing by health care providers during their child's hospitalizations and at their child's death. ⋯ Language and cultural differences create barriers to information-sharing by health care providers to parents who are in need of pediatric palliative care. Less than optimal patterns of information-sharing contribute to frustration, anger, and sadness for parents long after their child's death.
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Multicenter Study
Childhood obesity and survival after in-hospital pediatric cardiopulmonary resuscitation.
We hypothesized that childhood obesity would be associated with decreased likelihood of survival to hospital discharge after in-hospital, pediatric cardiopulmonary resuscitation (CPR). ⋯ Childhood obesity is associated with a lower rate of survival to hospital discharge after in-hospital, pediatric CPR.
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Multicenter Study
Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts.
Despite the magnitude of the problem of catheter-associated bloodstream infections (CA-BSIs) in children, relatively little research has been performed to identify effective strategies to reduce these complications. In this study, we aimed to develop and evaluate effective catheter-care practices to reduce pediatric CA-BSIs. ⋯ In contrast with adult ICU care, maximizing insertion-bundle compliance alone cannot help PICUs to eliminate CA-BSIs. The main drivers for additional reductions in pediatric CA-BSI rates are issues that surround daily maintenance care for central lines, as defined in our maintenance bundle. Additional research is needed to define the optimal maintenance bundle that will facilitate elimination of CA-BSIs for children.