Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2009
Cost analysis of two approaches to parenteral nutrition in critically ill children.
In pediatric intensive care, two approaches to parenteral nutrition are available: individualized admixtures or commercial standard solutions. Even though individualized admixtures can be tailored to sometimes highly intricate requirements, standard solutions are able to meet the demands of the majority of pediatric patients. To address the growing importance of costs in intensive care, we investigated whether relevant differences between individualized admixtures and standard solutions in terms of costs can be found. ⋯ Parenteral nutrition with standard solutions offers the potential of a relevant cost reduction compared with individualized admixtures in critically ill children.
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Pediatr Crit Care Me · Mar 2009
Multicenter StudyA multi-institutional high-fidelity simulation "boot camp" orientation and training program for first year pediatric critical care fellows.
Simulation training has been used to integrate didactic knowledge, technical skills, and crisis resource management for effective orientation and patient safety. We hypothesize multi-institutional simulation-based training for first year pediatric critical care (PCC) fellows is feasible and effective. ⋯ The first PCC orientation training integrated with simulation was effective and logistically feasible. The train to success concept with repetitive practice was highly valued by participants. Continuation and expansion of this novel multi-institutional training is planned.
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Pediatr Crit Care Me · Mar 2009
Multicenter StudyVasopressin for in-hospital pediatric cardiac arrest: results from the American Heart Association National Registry of Cardiopulmonary Resuscitation.
To describe the landscape of vasopressin uses reported to the American Heart Association National Registry of cardiopulmonary resuscitation (CPR) and test the hypothesis that vasopressin use will be associated with improved return of a sustained circulation (ROSC) following in-hospital pediatric cardiac arrest. ⋯ Vasopressin was given infrequently in in-hospital cardiac arrest. It was most likely to be given in an intensive care setting, and in a pediatric hospital. Multivariate analysis shows an association with vasopressin use and worse ROSC.
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Pediatr Crit Care Me · Mar 2009
Derivation and validation of an equation for adjustment of neuron-specific enolase concentrations in hemolyzed serum.
To derive and validate a formula to allow for adjustment of serum neuron-specific enolase (NSE) concentrations based on the amount of hemolysis in the sample. To compare the accuracy of qualitative and quantitative assessment of hemolysis. ⋯ We retrospectively derived and prospectively validated an equation for adjusting serum NSE concentrations based on the amount of hemolysis in the sample. Use of this formula will allow for accurate measurement of NSE even in hemolyzed sample and may improve its usefulness as a marker of brain injury in children. Qualitative assessment of the degree of hemolysis is not accurate and should not be used.
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Pediatr Crit Care Me · Mar 2009
Simulation at the point of care: reduced-cost, in situ training via a mobile cart.
The rapid growth of simulation in health care has challenged traditional paradigms of hospital-based education and training. Simulation addresses patient safety through deliberative practice of high-risk low-frequency events within a safe, structured environment. Despite its inherent appeal, widespread adoption of simulation is prohibited by high cost, limited space, interruptions to clinical duties, and the inability to replicate important nuances of clinical environments. We therefore sought to develop a reduced-cost low-space mobile cart to provide realistic simulation experiences to a range of providers within the clinical environment and to serve as a model for transportable, cost-effective, widespread simulation-based training of bona-fide workplace teams. ⋯ By bringing all pedagogical elements to the actual clinical environment, a mobile cart can provide simulation to hospital teams that might not otherwise benefit from the educational tool. By reducing the setup cost and the need for dedicated space, the mobile approach provides a mechanism to increase the number of institutions capable of harnessing the power of simulation-based education internationally.