Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2012
Hepatoadrenal syndrome in pediatric patients with end-stage liver disease.
Adrenal insufficiency in patients with liver failure, referred to as hepatoadrenal syndrome, is well characterized in adult patients but has not yet been described in children. We present 22 pediatric subjects with end-stage liver disease and adrenal insufficiency, diagnosed using the cosyntropin stimulation test. ⋯ Children with end-stage liver disease are at risk for hepatoadrenal syndrome and should have their cortisol levels monitored since clinical manifestations may not be diagnostic.
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Pediatr Crit Care Me · May 2012
Early initiation of arginine vasopressin infusion in neonates after complex cardiac surgery.
To describe our experience with low-dose arginine vasopressin infusions (0.0003 U/kg/min) initiated in the operating room after the Norwood procedure or arterial switch operation. ⋯ Low-dose arginine vasopressin infusion initiated in the operating room after complex neonatal cardiac surgery was associated with decreased fluid resuscitation and catecholamine requirements in the first 24 postoperative hours.
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Pediatr Crit Care Me · May 2012
Use of propofol in pediatric intensive care units: a national survey in Germany.
Propofol is not licensed for sedation in pediatric intensive care medicine mainly due to the risk of propofol infusion syndrome. Nevertheless, it is applied by many pediatric intensive care units. The aim of this national survey was to asses the current use of propofol in pediatric intensive care units in Germany. ⋯ This study shows that propofol is used off-license by many pediatric intensive care units in Ge. The majority of users has adopted tightly controlled regimens for propofol sedation, and limits the dose to ≤3-4 mg/kg/hr and the maximum application time to 24-48 hrs.
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Pediatr Crit Care Me · May 2012
A qualitative study of expert and team cognition on complex patients in the pediatric intensive care unit.
To understand expert and team cognition of complex patients in the pediatric intensive care unit through the use of cognitive task analysis. ⋯ An inadequately developed or inadequately shared mental model is a substantial cognitive limitation for expert and team cognition in the complex environment of the pediatric intensive care unit. Providers utilize techniques that may avoid or decrease the variable interpretations of patient condition that would otherwise impair mental model formation and sharing. Future studies should be designed to enhance mental model formation and communication in the pediatric intensive care unit and other environments that deal with complex patients.
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Pediatr Crit Care Me · May 2012
Transition from neonatal intensive care unit to special care nurseries: experiences of parents and nurses.
To explore parents' and nurses' experiences with the transition of infants from the neonatal intensive care unit to a special care nursery. ⋯ Both parents and nurses considered present transitional arrangements to be inadequate. Nurses should provide more effective discharge planning and transitional care. A positive labeling of the transition as a first step to home discharge for the newborn seems appropriate. Parents need to be better-informed and should be involved in the planning process.