Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2005
ReviewSeverity of illness and organ dysfunction scoring in children.
To describe predictive and descriptive general scores that can be used to estimate the severity of illness in critically ill children. ⋯ Pediatric Risk of Mortality III, Pediatric Index of Mortality 2, and Pediatric Logistic Organ Dysfunction scores are the best available tools to estimate the severity of illness in critically ill children.
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The purpose of this review is to review how pediatric trauma may predispose children to sepsis. ⋯ Patients with multiple traumatic injuries are frequently admitted to the intensive care unit, and because head injury is the most common ailment, unconscious patients with a combination of injuries that include head injury will regularly require mechanical ventilation and central venous access and are at risk for life-threatening nosocomial infections. Outside of pulmonary contusions, organ-specific causes of infection are infrequent.
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To summarize the scope and epidemiology of pediatric sepsis. ⋯ Sepsis is a major health problem among children in both developing and industrialized countries. However, sepsis is both preventable and treatable. Improved prevention and treatment of sepsis could have a substantial effect on survival and quality of life of all children, both those who are otherwise healthy and those who are chronically ill. The variations in the epidemiology of pediatric sepsis underscore the need for a multidisciplinary approach and consistently applied definitions.
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Pediatr Crit Care Me · May 2005
A critical appraisal of a systematic review: Sokol J, Jacob SE, Bohn D: Inhaled nitric oxide for acute hypoxemic respiratory failure in children and adults. Cochrane Database Syst Rev 2003 (1): CD002787.
To review the findings and discuss the implications of the use of inhaled nitric oxide for acute hypoxemic respiratory failure in patients beyond the neonatal period. ⋯ There is insufficient evidence to determine whether inhaled nitric oxide is beneficial or harmful for acute hypoxemic respiratory failure in children and adults. While awaiting further studies to prove its benefit, inhaled nitric oxide should not either be recommended as a standard management or excluded for the treatment of acute hypoxemic respiratory failure.
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To define urinary tract infections in critically ill children in the intensive care unit setting for the purpose of surveillance of infection, enrollment of children in sepsis trials, and for trials of therapy and prevention. ⋯ Definitions for definite, probable, and possible urinary tract infection were achieved by consensus that can be used for surveillance and enrolment in sepsis trials. Future research should determine the utility of these definitions in the critically ill child and adapt them accordingly.