Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2009
Adequate agreement between venous oxygen saturation in right atrium and pulmonary artery in critically ill children.
To determine the agreement between venous oxygen saturation in right atrium (Srao2) and pulmonary artery (Svo2) in critically ill pediatric patients. ⋯ The concordance analysis performed allows to conclude that there is an appropriate agreement between Svo2 and Srao2. This finding may become clinically relevant considering the difficulties associated to the use of PAC in children.
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Pediatr Crit Care Me · Jan 2009
Case ReportsNear infrared spectroscopy changes with pericardial tamponade.
Report on the use of near infrared spectroscopy (NIRS) for the recognition of pericardial tamponade after neonatal congenital heart surgery. ⋯ Pericardial tamponade is a well-known complication of open heart surgery in children, and early recognition of this can be difficult. This case report demonstrated cerebral saturation to be decreased as impending pericardial tamponade developed. Along with the commonly used markers of tamponade, near infrared spectroscopy measurement of cerebral saturation may also be of benefit in recognizing this life-threatening condition.
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We explored the hypothesis that marked decline in plasma zinc concentrations among critically ill children is related to shifts in metallothionein expression and inflammation. ⋯ Plasma zinc concentrations are low in critically ill children. Plasma zinc correlated with measures of inflammation (C-reactive protein and interleukin-6) on day 3; low plasma zinc concentrations were associated with the degree of organ failure on day 3. These data serve as the basis for a larger study of shifts in plasma zinc concentrations in critically children to potentially identify patients who might benefit from zinc supplementation.
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Pediatr Crit Care Me · Jan 2009
Feasibility of weaning and direct extubation from open lung high-frequency ventilation in preterm infants.
High-frequency ventilation (HFV) is increasingly used in preterm infants, but data on weaning and extubation are limited. We aimed to establish if weaning the continuous distending pressure (CDP) below 8 cm H2O and the Fio2 below 0.30 is feasible in preterm infants on open lung HFV and if these settings result in successful extubation. ⋯ This study shows that weaning the CDP below 8 cm H2O with an Fio2 below 0.30 is feasible during open lung HFV and extubation at these settings can be successful in preterm infants. In our series, a 90% success rate was observed. The value of this approach should be prospectively compared with conventional weaning and extubation strategies.
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Pediatr Crit Care Me · Jan 2009
Comparative StudyEchocardiography, not chest radiography, for evaluation of cannula placement during pediatric extracorporeal membrane oxygenation.
Optimal cannula position is essential during extracorporeal membrane oxygenation (ECMO). We hypothesize that echocardiography is superior to chest radiography in diagnosing abnormal cannula position during ECMO. ⋯ Echocardiography appears to be superior to chest radiography for assessing ECMO cannula position in our institution. A prospective study, including cost analysis, comparing chest radiography and echocardiography, is needed to definitely determine the preferred diagnostic test or sequence of tests to establish ECMO cannula position.