Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2009
Automated measurement of the lower inflection point in a pediatric lung model.
To determine which flow setting most accurately detects the lower inflection point (Pflex) using an automated constant flow method and varying endotracheal tube (ETT) sizes with and without an airleak in a pediatric lung model. ⋯ Estimation of Pflex can be achieved using automated P-V curves with ETTs appropriate for pediatric use, with and without an airleak. ETT size and flow rate affect the accuracy of these measurements when an airleak is present, and use of increased flow rates to create the automated P-V curves can reduce error. These data support the idea that a low-flow technique provides the most accurate determination of Pflex in pediatric patients without a leak around their ETT, whereas increased flows are needed to compensate when an ETT airleak is present.
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Pediatr Crit Care Me · Jul 2009
ReviewPediatric neurointensive care: 2008 update for the Rogers' Textbook of Pediatric Intensive Care.
To review important articles, in the field of pediatric neurointensive care, that were published subsequent to the fourth edition of the Rogers' Textbook of Pediatric Intensive Care. ⋯ Developments in the field and practice of pediatric neurocritical care continue with significant additions to the literature and practice recommendations concerning care following traumatic brain injury, cardiac arrest, status epilepticus, and cerebrovascular events. Importantly, the continued progression in knowledge raises the health services issue of whether, in certain settings of high clinical volume, it is time for specialized pediatric neurointensive care services or units.
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Pediatr Crit Care Me · Jul 2009
Multicenter StudyManagement of severely injured children in road accidents in France: impact of the acute care organization on the outcome.
To examine the impact of acute care management on outcome in children severely injured in road accidents. ⋯ The management in a more aggressive center for children admitted to TRR and monitored for ICP, when indicated, is associated with a better outcome. This could be explained by a more extensive experience in trauma management.
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Pediatr Crit Care Me · Jul 2009
Clinical TrialEnteral feeding algorithm for infants with hypoplastic left heart syndrome poststage I palliation.
Infants with hypoplastic left heart syndrome (HLHS) experience a high incidence of growth failure in the postoperative period following stage I palliation. Because of an increased risk of necrotizing enterocolitis in this population, clinicians may be reluctant to initiate early enteral feedings. Published guidelines for initiating and advancing enteral feedings in this population are limited. ⋯ The use of an enteral feeding algorithm is a safe and effective means of initiating and advancing enteral nutrition in infants with HLHS following stage I palliation.