Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2008
Randomized Controlled TrialUse of methylene blue spectrophotometry to detect subclinical aspiration in enterally fed intubated pediatric patients.
Enteral feeding is widely used in ventilated patients admitted to pediatric intensive care units. Although studies in adult patients have shown that the site of feeding (stomach vs. small intestine) may be associated with aspiration pneumonia, there are no such reports in critically ill pediatric patients. We hypothesized that in intubated pediatric patients, there was no difference in the frequency of aspiration between nasogastric and postpyloric enteral feeding. ⋯ Use of nasogastric feeding shortens the time needed to reach nutritional goals and reduces the number of radiographic studies. Nasogastric feeding demonstrates no increase in aspiration compared with postpyloric feeding in intubated pediatric patients.
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Pediatr Crit Care Me · May 2008
Comparative StudyAssessment of cardiac output in children: a comparison between the pressure recording analytical method and Doppler echocardiography.
To assess cardiac output in pediatric patients with the pressure recording analytical method (PRAM) and the Doppler echocardiography method. PRAM derives cardiac output from beat-by-beat analysis of the arterial pressure profile (systolic and diastolic phase) in the time domain. ⋯ In the range of ages evaluated, PRAM provides reliable estimates of cardiac output when compared with noninvasive techniques.
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Pediatr Crit Care Me · May 2008
Pediatric critical care nurses' perceptions, knowledge, and attitudes regarding organ donation after cardiac death.
Donation after cardiac death (DCD) is being implemented nationwide in the United States to increase the number of organ donors. Pediatric critical care nurses (PCRNs) are key facilitators in the organ donation process. This study assesses their perception, level of knowledge, and understanding of DCD and the effect of an educational intervention. ⋯ PCRNs are generally supportive of organ donation but have a self-perceived and objectively identified knowledge deficit regarding DCD, resulting in their being unprepared to identify potential DCD donors or handle family questions. A simple educational intervention can improve PCRNs' knowledge of the DCD process and their confidence and comfort with this process. As DCD policies are implemented, specific interventions should target these key members of the intensive care unit team.
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To determine whether known serum markers of neurologic injury are increased in children with septic shock. ⋯ Markers of neurologic injuries are increased in children with septic shock. This may indicate subclinical injuries that are either transient or permanent. Studies that correlate the long-term neurologic outcome of children with these markers are needed to identify children at risk for neurologic injuries from septic shock.
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Pediatr Crit Care Me · May 2008
Intensive care experience with sclerotherapy for cervicofacial lymphatic malformations.
To describe a cohort of patients needing intensive care support after sclerotherapy for cervicofacial lymphatic malformations. ⋯ Children with extensive disease and airway involvement need multiple PICU admissions. The potential for life-threatening respiratory embarrassment is unpredictable following sclerotherapy. Consideration should be given to performing further sclerotherapy while the patients are intubated in the PICU. The PICU provides a safe and secure environment for such procedures.