Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2010
Number of sites of perinatal Candida colonization and neutropenia are associated with nosocomial candidemia in the neonatal intensive care unit patient.
To determine the role of perinatally acquired Candida colonization to invasive Candida infection (candidemia) and to assess risk factors associated with Candida colonization and candidemia in neonatal intensive care unit patients. ⋯ Maternal vaginal candidiasis and vaginal birth are risk factors for neonatal colonization. When controlling for illness severity, the number of sites colonized with Candida at birth contributes to neonatal nosocomial candidemia. Early neutropenia increases the risk further. These findings offer opportunities for prevention of Candida infection in neonatal intensive care unit patients.
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Pediatr Crit Care Me · Mar 2010
Case ReportsNeurological sequelae of 2009 influenza A (H1N1) in children: a case series observed during a pandemic.
To outline a series of cases demonstrating neurologic complications in children with Influenza infection. The ongoing 2009 influenza A (H1N1) presents significant challenges to the field of pediatric critical care and requires increased awareness of new presentations and sequelae of infection. Since World Health Organization declared a H1N1 pandemic, much attention has been focused on its respiratory manifestations of the illness, but limited information regarding neurologic complications has been reported. ⋯ We conclude that 2009 influenza A (H1N1) can cause significant acute and residual neurologic sequelae. Clinicians should consider Influenza within a comprehensive differential diagnosis in children with unexplained mental status changes during periods of pandemic influenza.
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Pediatr Crit Care Me · Mar 2010
Neurally adjusted ventilatory assist in children: an observational study.
To assess patient safety and to evaluate operator acceptance to the technology of neurally adjusted ventilatory assist. ⋯ We feel that neurally adjusted ventilatory assist would be safe and potentially efficacious to ventilate infants and children. It has the potential for improved patient-ventilator synchrony, decreasing airway pressures, and it might lead to earlier extubation.
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Pediatr Crit Care Me · Mar 2010
Case ReportsThe critically ill child with novel H1N1 influenza A: a case series.
To describe the presentation, course, and outcome of critically ill children with novel H1N1 influenza disease. ⋯ Underlying chronic illness (especially respiratory illness) seems associated with critical novel H1N1 influenza disease in children. Respiratory manifestations are highly variable among patients and within a single patient involving both bronchoconstriction and alveolar disease. Therapies must be individualized and rapidly adjusted. The duration of critical illness was not different between early and late treatment groups. Whether this is reflective of sample size or indicative of the importance of therapeutic intervention at any time early during infection in critically ill patients is unclear. Bacterial superinfection was more common than previously reported for seasonal influenza A. Moderate novel H1N1 influenza disease, including respiratory failure and hypotension, had 100% survival in our series.