Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2005
Short-term psychiatric adjustment of children and their parents following meningococcal disease.
To assess short-term changes in child and parent psychiatric status following meningococcal disease. ⋯ Admission of children to pediatric intensive care units for meningococcal disease is associated with an increase in and high levels of psychiatric and posttraumatic stress disorder symptoms in children and parents. Length of admission is associated with psychiatric symptoms in children and posttraumatic stress disorder symptoms in parents. Pediatric follow-up should explore psychiatric as well as physical sequelae in children and parents.
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Pediatr Crit Care Me · Jan 2005
Physician assistants as physician extenders in the pediatric intensive care unit setting-A 5-year experience.
To describe the scope of practice and complementary role of physician assistants as physician extenders in the pediatric intensive care unit. ⋯ Physician assistants play a complementary role as physician extenders in the pediatric intensive care unit, enabling compliance with New York state and Accreditation Council for Graduate Medical Education resident work hour regulations. Physician assistants perform similar tasks and activities as the pediatric intensive care unit residents and integrate well with them in enhancing bedside patient care. Over time, physician assistants provide additional direction to the residents by virtue of their familiarity with unit-specific policies and procedures and repetitive pediatric intensive care unit practice patterns. As multifunctional members of the health care team, they support nursing and respiratory therapy functions and improve the day-to-day functioning of the unit. The physician assistant serves as a key member of the pediatric intensive care unit transport team. Limitations observed include high job turnover rates among the physician assistants and confusion between their role as shift workers or professional employees.
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Pediatr Crit Care Me · Jan 2005
ReviewInternational pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics.
Although general definitions of the sepsis continuum have been published for adults, no such work has been done for the pediatric population. Physiologic and laboratory variables used to define the systemic inflammatory response syndrome (SIRS) and organ dysfunction require modification for the developmental stages of children. An international panel of 20 experts in sepsis and clinical research from five countries (Canada, France, Netherlands, United Kingdom, and United States) was convened to modify the published adult consensus definitions of infection, sepsis, severe sepsis, septic shock, and organ dysfunction for children. ⋯ We modified the adult SIRS criteria for children. In addition, we revised definitions of severe sepsis and septic shock for the pediatric population. Our goal is for these first-generation pediatric definitions and criteria to facilitate the performance of successful clinical studies in children with sepsis.
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Pediatr Crit Care Me · Jan 2005
Comparative StudyPilot study of preoperative heart rate variability and adverse events in children emerging from anesthesia.
To assess correlations between preoperative heart rate variability (a noninvasive measure of autonomic cardiac activity) and adverse respiratory events during anesthesia emergence in children. ⋯ This study provides new information regarding pathophysiology in children with upper respiratory infection. The magnitude of difference demonstrated is insufficient to propose this method as a preoperative screening test.
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Pediatr Crit Care Me · Jan 2005
Early application of generic mortality risk scores in presumed meningococcal disease.
Mortality from meningococcal disease typically occurs within 24 hrs of intensive care unit (ICU) admission. An early, accurate mortality-risk tool may aid in trial design for novel therapies. We assessed the performance of two generic scores that assign mortality risk within 1 hr of ICU admission: the Preintensive Care Pediatric Risk of Mortality (Pre-ICU PRISM) and Pediatric Index of Mortality (PIM). ⋯ Pre-ICU PRISM and PIM both discriminate well but calibrate poorly when applied to a cohort of children with meningococcal sepsis. Both scores provide an effective means of stratification for clinical trial purposes. The main advantage for PIM appears to be ease of data collection.