Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2012
Comparative StudyNeurally triggered breaths have reduced response time, work of breathing, and asynchrony compared with pneumatically triggered breaths in a recovering animal model of lung injury.
Our objective was to compare response time, pressure time product as a reflection of work of breathing, and incidence and type of asynchrony in neurally vs. pneumatically triggered breaths in a spontaneously breathing animal model with resolving lung injury. ⋯ Neurally triggered breaths have reduced asynchrony, trigger delay, and pressure time product, which may indicate reduced work of breathing associated with less effort to trigger the ventilator and faster response to effort. Further study is required to demonstrate if these differences will lead to decreased days of ventilation and less use of sedation in patients.
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Pediatr Crit Care Me · May 2012
Fluid overload is associated with impaired oxygenation and morbidity in critically ill children.
Fluid overload is common in the critically ill and is thought to contribute to oxygenation failure and mortality. Since increasing disease severity often requires more fluid for resuscitation, it is unclear whether fluid overload is a causative factor in morbidity or is simply an indicator of disease severity. ⋯ This is the first study to report that positive fluid balance adversely affected the pediatric intensive care unit course in children who did not receive renal replacement therapy. While timely administration of fluids is lifesaving, positive fluid balance after hemodynamic stabilization may impact organ function and negatively influence important outcomes in critically ill patients.
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Pediatr Crit Care Me · May 2012
Comparative StudyComparative effects of bronchoalveolar lavage with saline, surfactant, or perfluorocarbon in experimental meconium aspiration syndrome.
Today, in meconium aspiration syndrome, treatment focuses on bronchoalveolar lavage, because it removes meconium and proinflammatory factors from airways. This technique might be more effective if different solutions were used such as saline solution, a protein-free surfactant, or a perfluorocarbon, because these would be less inhibited by meconium proteins. ⋯ In lambs with meconium aspiration syndrome, bronchoalveolar lavage with diluted lucinactant is an effective therapy producing significant improvements in gas exchange, pulmonary hypertension, and pulmonary mechanics. In addition, bronchoalveolar lavage with perfluorocarbon appears to confer some advantages over lavage with equal volumes of saline or no lavage.
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Pediatr Crit Care Me · May 2012
Dimension and overlap of femoral and neck blood vessels in neonates.
Neonates frequently require access to their central blood vessels. However, limited data exist relating to the size and the anatomical relation of the femoral and neck vessels for neonates of different postmenstrual ages. ⋯ Central blood vessel size increases with increasing postmenstrual age. Correlation of blood vessel size to anthropometric measurements was better in the premature neonates compared to term neonates. A high degree of overlap exists within the femoral and cervical blood vessels. In the femoral vessels, the degree of overlap did not decrease with external rotation with abduction of the hip at any postmenstrual age.
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Pediatr Crit Care Me · May 2012
Comparative StudyEvaluation and comparison of parental needs, stressors, and coping strategies in a pediatric intensive care unit.
To evaluate and compare the needs, stressors, and coping strategies of mothers and fathers in a pediatric intensive care unit, and to advance the development of the COMPASS questionnaire for examining parent experiences. ⋯ Acute parental experiences can be documented using the COMPASS questionnaire. This study highlights the principal needs, stressors, and coping strategies of parents of children in the pediatric intensive care unit. The experiences of mothers and fathers are similar, but we identify some differences in stressors between the sexes.