Pediatr Crit Care Me
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Pediatr Crit Care Me · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyA multicenter randomized controlled trial comparing effectiveness of two nasal continuous positive airway pressure devices in very-low-birth-weight infants.
Many studies suggest nasal continuous positive airway pressure is an effective and relatively complication-free means of respiratory support in premature infants. However, only limited data exist regarding the practical aspects of nasal continuous positive airway pressure delivery, including the best way to provide the positive airway pressure. ⋯ We found fewer severe nasal complications but no statistically significant advantage in treatment success in infants assigned to Infant Flow nasal continuous positive airway pressure compared with those assigned to constant flow nasal continuous positive airway pressure treatment. Significant risk factors of treatment failure include small size, maturity, and severity of respiratory distress syndrome.
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Pediatr Crit Care Me · Mar 2012
ReviewSimulation-based crisis resource management training for pediatric critical care medicine: a review for instructors.
To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. ⋯ Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.
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Pediatr Crit Care Me · Mar 2012
Comparative StudyComparison of seven infant continuous positive airway pressure systems using simulated neonatal breathing.
Continuous positive airway pressure is an established treatment for respiratory distress in neonates. Continuous positive airway pressure has been applied to infants using an array of devices. The aim of this experimental study was to investigate the characteristics of seven continuous positive airway pressure systems using simulated breath profiles from newborns. ⋯ The seven tested continuous positive airway pressure systems showed large variations in pressure stability and imposed work of breathing. They also showed large differences in how well they maintain continuous positive airway pressure when exposed to leak. For most systems, imposed work of breathing increased with increasing continuous positive airway pressure level. The clinical importance of the difference in pressure stability is uncertain. Our results may facilitate the design of clinical studies examining the effect of pressure stability on outcome.