Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2011
Glial fibrillary acidic protein as a brain injury biomarker in children undergoing extracorporeal membrane oxygenation.
To determine whether, in children, plasma glial fibrillary acidic protein is associated with brain injury during extracorporeal membrane oxygenation and with mortality. ⋯ High glial fibrillary acidic protein during extracorporeal membrane oxygenation is significantly associated with acute brain injury and death. Brain injury biomarkers may aid in outcome prediction and neurologic monitoring of patients on extracorporeal membrane oxygenation to improve outcomes and benchmark new therapies.
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Pediatr Crit Care Me · Sep 2011
Intracranial pressure-monitoring systems in children with traumatic brain injury: combining therapeutic and diagnostic tools.
To compare the correlation of intracranial pressure (ICP) measurement and time to detection of ICP crises (defined as ICP ≥ 20 mm Hg for ≥ 5 mins) between an intraparenchymal (IP) monitor and external ventricular drain (EVD) in children for whom continuous cerebrospinal fluid diversion was used as a therapy for severe traumatic brain injury. ⋯ EVD and IP measurements of ICP were highly correlated, although intermittent EVD ICP measurements may fail to identify ICP events when continuously draining cerebrospinal fluid. In institutions that use continuous cerebrospinal fluid diversion as a therapy, a two-monitor system may be valuable for accomplishing monitoring and therapeutic goals.
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Pediatr Crit Care Me · Sep 2011
U.S. attitudes and perceived practice for noninvasive ventilation in pediatric acute respiratory failure.
Few pediatric studies exist regarding the use of noninvasive positive-pressure ventilation for acute respiratory failure; however, those that do suggest a role. This study seeks to describe attitudes and perceived practices of pediatric intensivists regarding the use of noninvasive positive-pressure ventilation in children with acute respiratory failure. ⋯ Noninvasive positive-pressure ventilation is widely used and most frequently utilized in patients with acute lower airway disease. Factors such as severe defects in oxygenation and ventilation, disease progression, and patient tolerability decreased the likelihood of use. These findings may help direct further studies of noninvasive positive-pressure ventilation in children with acute respiratory failure.
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Pediatr Crit Care Me · Sep 2011
Enteral potassium supplementation in a pediatric cardiac intensive care unit: evaluation of a practice change.
Potassium supplementation is a common practice in critically ill children, especially those with heart disease. Intravenous potassium supplementation is the standard route of administration in most intensive care units. Although the enteral route is safer and thus may be a reasonable alternative, data on the efficacy of enteral potassium administration are lacking. ⋯ The efficacy of enteral potassium is comparable to intravenous potassium for potassium replacement in pediatric patients after congenital heart surgery.