Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2013
Comparative StudyExtracorporeal Membrane Oxygenation Versus Counterpulsatile, Pulsatile, and Continuous Left Ventricular Unloading for Pediatric Mechanical Circulatory Support.
Despite progress with adult ventricular assist devices, limited options exist to support pediatric patients with life-threatening heart disease. Extracorporeal membrane oxygenation remains the clinical standard. To characterize (patho)physiologic responses to different modes of mechanical unloading of the failing pediatric heart, extracorporeal membrane oxygenation was compared to intra-aortic balloon pump, pulsatile-flow ventricular assist device, or continuous-flow ventricular assist device support in a pediatric heart failure model. ⋯ Each type of pediatric ventricular assist device provided hemodynamic support by unloading the heart with a different mechanism that created a unique profile of physiological changes. These data contribute novel, clinically relevant insight into pediatric mechanical circulatory support and establish an important resource for pediatric device development and patient selection.
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Pediatr Crit Care Me · Nov 2013
Observational StudySimulation training for pediatric residents on central venous catheter placement: a pilot study*.
To assess the effect of simulation training on pediatric residents' acquisition and retention of central venous catheter insertion skills. A secondary objective was to assess the effect of simulation training on self-confidence to perform the procedure. ⋯ Simulation training improved pediatric residents' central venous catheter insertion procedural skills. Decay in skills was found at 3-month follow-up. This suggests that simulation training for this procedure should occur in close temporal proximity to times when these skills would most likely be used clinically and that frequent refresher training might be beneficial to prevent skills decay.
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Pediatr Crit Care Me · Nov 2013
Survival of Newborn Infants With Severe Respiratory Failure Before and After Establishing an Extracorporeal Membrane Oxygenation Program.
Severe hypoxic respiratory failure is a leading cause of neonatal mortality in Chile. Extracorporeal membrane oxygenation improves survival in neonates with hypoxic respiratory failure. ⋯ The establishment of an extracorporeal membrane oxygenation program was associated with a significant increase in the survival of newborns more than or equal to 35 weeks old with severe hypoxic respiratory failure.