Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2011
Very high serum ferritin levels are associated with increased mortality and critical care in pediatric patients.
To determine whether an elevated serum ferritin level is independently associated with mortality and receipt of critical care in pediatric patients. ⋯ In this pediatric population, with serum ferritin levels of >3000 ng/mL, there was increased risk for both receipt of critical care and subsequent death.
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Pediatr Crit Care Me · Nov 2011
Incidence and risk factors associated with venous thrombotic events in pediatric intensive care unit patients.
To evaluate the incidence and risk factors associated with venous thromboembolism (VTE) in children admitted to pediatric intensive care units (PICUs). ⋯ Children admitted to the PICU have an increased risk of VTE. The presence of a CVC is the strongest risk factor for VTE in this PICU population. Children with VTE were younger, sicker, stayed longer in PICU, and had a higher mortality rate.
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Pediatr Crit Care Me · Nov 2011
Diagnostic efficacy of activated partial thromboplastin time waveform and procalcitonin analysis in pediatric meningococcal sepsis.
A biphasic activated partial thromboplastin time waveform predicts sepsis and disseminated intravascular coagulation in adults. This has not been previously investigated in children. Our aim is to ascertain whether there are changes in the activated partial thromboplastin time waveform in children with meningococcal disease and to compare its diagnostic use with procalcitonin. ⋯ The activated partial thromboplastin time waveform is abnormal in children with meningococcal disease and may be a useful adjunct in the diagnosis and management of sepsis in children.
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Pediatr Crit Care Me · Nov 2011
Inhaled nitric oxide improves systemic microcirculation in infants with hypoxemic respiratory failure.
To investigate the effect of inhaled nitric oxide on the systemic microcirculation. We hypothesized that inhaled nitric oxide improves the systemic microcirculation. Inhaled nitric oxide improves outcome in infants with persistent pulmonary hypertension of the newborn diagnosed by improving pulmonary blood flow and oxygenation. It reduces pulmonary vascular resistance without decline in systemic blood pressure. Inhaled nitric oxide is also utilized in the treatment of acute hypoxemic respiratory failure in children and adults. It is thought to improve regional ventilation perfusion by regional selective pulmonary vasodilation. ⋯ Inhaled nitric oxide improves the systemic microcirculation in children with hypoxemic respiratory failure.
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Pediatr Crit Care Me · Nov 2011
Pediatric intensive care unit family conferences: one mode of communication for discussing end-of-life care decisions.
To examine clinicians' and parents' reflections on pediatric intensive care unit family conferences in the context of discussion about end-of-life care decision making. ⋯ Pediatric intensive care unit clinicians in this study perceive family conferences as having an important role in end-of-life care decision making. The paucity of data from parents, an important finding itself, limits our ability to comment on parents' perceptions of family conferences. Prospective research of pediatric intensive care unit family conferences, with specific attention to parents' experiences and to all aspects of family conferences, including pre- and postconference events, should seek to understand the role and impact of this mode of communication on end-of-life care decision making and to determine the need for improvement to family conferences.