Pediatr Crit Care Me
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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
Aortopexy as treatment for tracheo-bronchomalacia in children: an 18-year single-center experience.
To define the factors influencing the outcome of aortopexy as management of tracheo-bronchomalacia. ⋯ Aortopexy proved to be an effective treatment for most cases of tracheo-bronchomalacia, but major comorbidity was associated with an adverse outcome. Our data suggest that aortopexy should be considered in most cases of severe tracheo-bronchomalacia.
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Pediatr Crit Care Me · Sep 2011
Case ReportsComputed tomography may demonstrate pseudosubarachnoid hemorrhage in diffuse cerebral edema after cardiorespiratory arrest.
To report the cases of two children who died from diffuse cerebral edema after cardiorespiratory arrest and who had radiologic findings of subarachnoid hemorrhage on computed tomography, the presence of which was excluded on subsequent postmortem examination. ⋯ Radiologic mimics of subarachnoid hemorrhage have been reported in the adult literature and are termed pseudosubarachnoid hemorrhage. A diagnosis of pseudosubarachnoid hemorrhage, rather than true subarachnoid hemorrhage, should be considered in the context of diffuse cerebral edema after cardiorespiratory arrest. Interpretation of the radiologic finding of subarachnoid hemorrhage in a child after a prolonged cardiac arrest should be cautious to avoid unnecessary and deleterious management and investigation for aneurysms.
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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
Case ReportsIpsilateral lobar emphysema in an infant with a repaired congenital diaphragmatic hernia.
To report a case of lobar emphysema in an infant who had a congenital diaphragmatic hernia that was surgically repaired at birth. ⋯ Lobar emphysema can be a rare development in patients who had a congenital diaphragmatic hernia at birth. This can result in respiratory failure and needs surgical intervention.