Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2009
ReviewUltrasound examination of the lungs in the intensive care unit.
Lung ultrasound is increasingly used in the critically ill adult. It allows prompt management based upon reproducible data and generates fewer computed tomography (CT) examinations, therefore decreasing irradiation, delays, cost, and discomfort to the patient. The aim of this article is to describe the value of ultrasound for lung imaging in the critically ill and state our experience in neonates. ⋯ The standardized signs assessed in the adult are also found in the critically ill neonate, meaning a potential use in this field. Awaiting confirmatory CT studies, lung ultrasound can be taken into consideration as a possible bedside tool for completing bedside radiography.
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Pediatr Crit Care Me · Nov 2009
Reliability of displayed tidal volume in infants and children during dual-controlled ventilation.
Previous studies have shown a significant difference between ventilator-measured tidal volume and actual-delivered tidal volume. However, these studies used external methods for measurement of compression volume. Our objective was to determine whether tidal volume could be accurately measured at the expiratory valve of a conventional ventilator using internal computer software to compensate for circuit compliance with a dual control mode of ventilation. ⋯ There is an underestimation of delivered tidal volume when compensating for circuit volume loss measured at the ventilator. There is no improvement in measured tidal volume using circuit compensation in small infants and children.
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Pediatr Crit Care Me · Nov 2009
Multicenter StudyLonger-term psychiatric adjustment of children and parents after meningococcal disease.
To ascertain whether increases in psychological symptoms in children and parents after meningococcal disease are sustained over time, and to examine the psychosocial and illness associations of 12-mo psychological outcome. ⋯ Admission to the hospital with meningococcal disease is followed by an increase in psychological symptoms in children at home, some of which are persistent and impairing, and by continuing posttraumatic stress symptoms in a proportion of children and parents. Psychosocial (pre- and postmorbid) factors predict problems at 12-mo follow-up.
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Pediatr Crit Care Me · Nov 2009
Comparative StudyLung contusion in children--early computed tomography versus radiography.
To investigate, in children, the correlation between the extent of lung contusion as detected on early radiologic examination (chest radiograph [CXR] and/or thoracic computed tomography [TCT]) and subsequent clinical outcome measures. ⋯ The severity of lung contusion determined by CXR, but not TCT, correlates with impairment of oxygenation, CO2 exchange, and duration of ventilatory support.
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To evaluate the intraoperative and postoperative care of children following thoracoabdominal resection of neuroblastoma. ⋯ Patients who received pressors had longer operative times and received less intraoperative fluid. Subsequently, they required more postoperative fluid, which is likely the result of hemodynamic instability leading to longer MVD and LOS-P. A prospective study evaluating operative fluid management and optimal time for initiation of pressors, in addition to the role of catecholamines and cytokines in this unique postoperative patient population is indicated.