Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2009
Randomized Controlled TrialLow-dose hydrocortisone in pediatric septic shock: an exploratory study in a third world setting.
To study the efficacy of low-dose intravenous hydrocortisone therapy in the management of pediatric septic shock with respect to the time taken for shock reversal and requirement of inotropes. ⋯ Our data, although, inconclusive favor the need for a study with a larger sample size to clearly define role of low-dose hydrocortisone in pediatric septic shock in developing countries, while taking in consideration effect of malnutrition, delayed presentations, and their interactions with the hypothalamic-pituitary-adrenocortical axis.
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Pediatr Crit Care Me · Jan 2009
Health-related quality of life after prolonged pediatric intensive care unit stay.
To investigate the long-term health-related quality of life (HRQOL) outcomes for patients requiring at least 28 days of pediatric intensive care. ⋯ Our results indicate that, while long PICU stay is associated with significant mortality, the long-term HRQOL is normal for the majority of surviving children.
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The extent of neuroendocrine dysfunction (NED) has not been well defined in critically ill children and likely varies significantly from that in adults. We sought to define the prevalence of neuroendocrine dysfunction in a group of children in a multidisciplinary pediatric intensive care unit and determine the relationship of neuroendocrine dysfunction with severity of illness and presence of sepsis. ⋯ NED is common in both septic and nonseptic critically ill children in a single pediatric intensive care unit. Larger scale studies are necessary to determine whether presence of NED, or specific combinations of neurohormonal dysfunction, is important in predicting outcomes or benefit of early hormonal replacement therapies in critically ill children.
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Pediatr Crit Care Me · Jan 2009
Flexible bronchoscopy and bronchoalveolar lavage in pediatric patients with lung disease.
The use of flexible bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in investigating pediatric patient with airway abnormalities and pulmonary infiltrates are indispensable and are now a routine procedure in many centers. Immunocompromised and cancer patients, especially after bone marrow transplantation, and children who have undergone surgery for congenital heart disease (CHD) are at high risk for pulmonary disease. Our aim was to study the diagnostic rate, safety, and clinical yield of FOB in critically ill pediatric patients. ⋯ FOB and BAL have an important role in the evaluation of airway abnormality and pulmonary infiltrate in pediatric patients, in whom rapid and accurate diagnosis is crucial for survival. We suggest that FOB should be considered as an initial diagnostic tool in those critically ill patients.