Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2012
"What would you do if this were your child?": practitioners' responses during enacted conversations in the United States.
To explore how practitioners in the United States respond to the question "What would you do if this were your child?" during realistic enactments with professional actors. ⋯ Practitioners demonstrated a wide repertoire of responses that varied in their degree of relational engagement and responsiveness. Future research should explore parents' perspectives and preferences regarding such communication to further refine recommendations and educational experiences.
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Pediatr Crit Care Me · Nov 2012
Cerebral white matter and neurodevelopment of preterm infants after coagulase-negative staphylococcal sepsis.
Coagulase-negative staphylococci are the most common pathogens causing late-onset sepsis in the neonatal intensive care unit. Neonatal sepsis can be associated with cerebral white matter damage in preterm infants. Neurodevelopment has been shown to be correlated with apparent diffusion coefficients, fractional anisotropy, and axial and radial diffusivities of the white matter. ⋯ No association was found between coagulase-negative staphylococcal sepsis in preterm infants and cerebral white matter damage as determined by values of apparent diffusion coefficients, fractional anisotropy, and radial and axial diffusivity at term-equivalent age, and no adverse effect was seen on early neurodevelopmental outcome.
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Pediatr Crit Care Me · Nov 2012
Neonatal incubators: a toxic sound environment for the preterm infant?*.
High sound pressure levels may be harmful to the maturing newborn. Current guidelines suggest that the sound pressure levels within a neonatal intensive care unit should not exceed 45 dB(A). It is likely that environmental noise as well as the noise generated by the incubator fan and respiratory equipment may contribute to the total sound pressure levels. Knowledge of the contribution of each component and source is important to develop effective strategies to reduce noise within the incubator. ⋯ The sound levels, especially at low frequencies, within a modern incubator may reach levels that are likely to be harmful to the developing newborn. Much of the noise is at low frequencies and thus difficult to reduce by conventional means. Therefore, advanced forms of noise control are needed to address this issue.
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Pediatr Crit Care Me · Nov 2012
Randomized Controlled Trial Multicenter StudyBiomarker response to drotrecogin alfa (activated) in children with severe sepsis: results from the RESOLVE clinical trial*.
REsearching severe Sepsis and Organ dysfunction in children: A gLobal perspective (RESOLVE), a phase III trial of drotrecogin alfa (activated) in pediatric severe sepsis, examined biomarker changes in inflammation and coagulation. This report describes biomarker profiles in early severe sepsis and the pharmacodynamic assessment of drotrecogin alfa (activated) in RESOLVE. ⋯ While children in the RESOLVE trial were similar to adults in that they showed a relationship between severity of coagulation and inflammation abnormalities and mortality, their pharmacodynamic response to drotrecogin alfa (activated) differed with respect to changes in protein C activity and systemic inflammation.