Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2012
Clinical TrialProspective longitudinal evaluation of lung function during the first year of life after repair of congenital diaphragmatic hernia.
To evaluate lung function and respiratory morbidity prospectively during the first year of life in patients with congenital diaphragmatic hernia and to study the effect of extracorporeal membrane oxygenation therapy. ⋯ Infants with congenital diaphragmatic hernia have decreased expiratory flows and increased functional residual capacity within the first year of life. Extracorporeal membrane oxygenation-treated patients with congenital diaphragmatic hernia may have more respiratory morbidity and concomitant growth impairment. Close follow-up beyond the neonatal period is therefore required.
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Pediatr Crit Care Me · May 2012
Randomized Controlled TrialWashing red blood cells and platelets transfused in cardiac surgery reduces postoperative inflammation and number of transfusions: results of a prospective, randomized, controlled clinical trial.
Children undergoing cardiac surgery with cardiopulmonary bypass are susceptible to additional inflammatory and immunogenic insults from blood transfusions. We hypothesize that washing red blood cells and platelets transfused to these patients will reduce postoperative transfusion-related immune modulation and inflammation. ⋯ Washed blood transfusions in cardiac surgery reduced inflammatory biomarkers, number of transfusions, donor exposures, and were associated with a nonsignificant trend toward reduced mortality. A larger study powered to test for clinical outcomes is needed to determine whether these laboratory findings are clinically significant.
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Pediatr Crit Care Me · May 2012
Myocardial dysfunction in neonatal sepsis: a tissue Doppler imaging study.
To assess myocardial performance in septic full-term infants and to correlate it with serum cardiac troponin T concentrations. ⋯ Neonatal sepsis is associated with systolic and diastolic myocardial dysfunction. This study provides proof-of-concept data for the use of tissue Doppler imaging in assessment of myocardial dysfunction in septic neonates. Tissue Doppler imaging appears to be more sensitive than conventional echocardiography in the detection of this dysfunction. Serum cardiac troponin T and left ventricular Tei index may have prognostic value in these patients.
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Pediatr Crit Care Me · May 2012
Randomized Controlled TrialKetamine as a neuroprotective and anti-inflammatory agent in children undergoing surgery on cardiopulmonary bypass: a pilot randomized, double-blind, placebo-controlled trial.
Infants are potentially more susceptible to cell death mediated via glutamate excitotoxicity attributed to cardiopulmonary bypass. We hypothesized that ketamine, via N-methyl D-aspartate receptor blockade and anti-inflammatory effects, would reduce central nervous system injury during cardiopulmonary bypass. ⋯ We did not find any evidence for neuroprotection or neurotoxicity in our pilot study. A large, adequately powered randomized control trial is needed to discern the central nervous system effect of ketamine on the developing brain. brain.
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Pediatr Crit Care Me · May 2012
Multicenter Study Clinical TrialEchocardiography as a guide for patent ductus arteriosus ibuprofen treatment and efficacy prediction.
To evaluate echocardiography criteria in predicting the response to ibuprofen treatment. ⋯ Echocardiography may be a useful tool to help patent ductus arteriosus management. A combined use of ductal diameter and left-right ductal shunt maximum velocity criteria allows a more accurate prediction of the response of infants with patent ductus arteriosus to ibuprofen treatment.