Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2013
Randomized Controlled Trial Multicenter StudyTherapeutic hypothermia after pediatric cardiac arrest trials: the vanguard phase experience and implications for other trials.
To determine whether an 18-month vanguard phase, in the Therapeutic Hypothermia after Pediatric Cardiac Arrest trials, confirmed study feasibility and patient safety, a prerequisite to continued funding by the sponsor. ⋯ The Therapeutic Hypothermia after Pediatric Cardiac Arrest vanguard phase proved beneficial for the investigators and funding agency. Because complex multicenter trials are rarely ready to launch when grant funds are received, the vanguard allowed time to refine the protocol and recruitment approaches. Competition for vanguard positions led to expedient Institutional Review Board and subcontract completion. Early success and sustained momentum contributed to recruitment at or above goals. Financial risks to the sponsor were minimized by tying funding for the full trial to achieving prespecified milestones. A vanguard phase may be a desirable strategy for the successful conduct of other complex clinical trials.
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Pediatr Crit Care Me · Jan 2013
Multicenter StudyOpioid analgesia in mechanically ventilated children: results from the multicenter Measuring Opioid Tolerance Induced by Fentanyl study.
To examine the clinical factors associated with increased opioid dose among mechanically ventilated children in the pediatric intensive care unit. ⋯ Mechanically ventilated children require increasing opioid doses, often associated with prolonged opioid exposure or the need for additional sedation. Efforts to reduce prolonged opioid exposure and clinical practice variation may prevent the complications of opioid therapy.
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Pediatr Crit Care Me · Jan 2013
Comparative Study Controlled Clinical TrialThe efficacy of noninvasive hemoglobin measurement by pulse CO-oximetry in neonates.
To evaluate clinical applicability of noninvasive hemoglobin (Hb) measurement with a pulse CO-oximeter in neonates. ⋯ Noninvasive Hb measurements with Pulse CO-Oximetry provide clinically acceptable accuracy, and they were significantly correlated with laboratory Hb measurement in neonates. In terms of the clinical applicability, noninvasive Hb monitoring with a pulse CO-oximeter could be useful in the early detection of Hb changes in neonates.
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Pediatr Crit Care Me · Jan 2013
Sensorineural hearing loss and language development following neonatal extracorporeal membrane oxygenation.
To determine the prevalence of hearing loss in school-age children who have undergone neonatal extracorporeal membrane oxygenation treatment and to identify any effects of hearing loss on speech- and language development [corrected] . ⋯ We found normal language development and intelligence in a cohort of neonatal extracorporeal membrane oxygenation survivors. The prevalence of bilateral sensorineural hearing loss was in accordance with that of a larger series in the United States-which exceeds the prevalence in the normal population.
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Describe the roles and respective responsibilities of PICU healthcare professionals in end-of-life care decisions faced by PICU parents. ⋯ Our results describe a framework for healthcare professionals' roles in parental end-of-life care decision making in the pediatric ICU that includes directive, value-neutral, and organizational roles. More research is needed to validate these roles. Actively ensuring attention to these roles during the decision-making process could improve parents' experiences at the end of a child's life.