Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2009
Mechanical component failures in 28,171 neonatal and pediatric extracorporeal membrane oxygenation courses from 1987 to 2006.
To provide a descriptive summary of mechanical component failure associated with extracorporeal membrane oxygenation (ECMO), and to examine patient and ECMO variables that may be associated with mechanical component failure and guide further study. We hypothesized that duration of ECMO, era of ECMO, indication for ECMO, age of patient, and center ECMO volume would be associated with mechanical component failure. ⋯ Mechanical component failure over the course of this study was infrequent during neonatal and pediatric ECMO, and declined across eras as experience with the therapy grew. Increasing duration of ECMO was associated with an increasing probability of mechanical component failure. Indication for ECMO and patient age were also statistically associated with mechanical component failure probability, but ECMO center volume was not.
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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
Pediatric organ donation: a national survey examining consent rates and characteristics of donor hospitals.
To characterize the eligible pediatric donor pool in the United States by age, consent rate, location, and cause of donor loss. ⋯ Overall pediatric consent rates were 69.2% but varied by age. Eligible donors were found most often in hospitals with level I trauma programs or PCCM fellowship programs. Few hospitals had >10 eligible donors in a 12-month period. This study is the first to describe in detail the U.S. pediatric donor population.