Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2013
Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique: a prospective observational study.
To establish the incidence, etiology, risk factors, and outcomes associated with ventilator-associated pneumonia using an invasive sampling technique to avoid contamination. ⋯ Ventilator-associated pneumonia is a frequent nosocomial infection in newborns. Only duration of mechanical ventilation has been identified as an independent risk factor for ventilator-associated pneumonia. The use of a blind invasive sampling technique seems to diminish sample contamination.
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Pediatr Crit Care Me · Jan 2013
Factors associated with health-related quality of life changes in survivors to pediatric intensive care.
To determine predictors of change in the health-related quality of life in survivors to pediatric intensive care, based on preadmission health status, demographic characteristics, and physiological variables. ⋯ The most common variables used to compute probability of death algorithms were not capable of predicting health-related quality of life in survivors to pediatric intensive care. The preadmission health-related quality of life and trauma admissions are important variables to predict change in the health-related quality of life of children surviving to pediatric intensive care.
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Pediatr Crit Care Me · Jan 2013
Clinical TrialDiagnosis of bacterial ventilator-associated pneumonia in children: reproducibility of blind bronchial sampling.
To evaluate the reproducibility of blind bronchial sampling in patients with suspected diagnosis of bacterial ventilator-associated pneumonia. ⋯ Blind bronchial sampling of lower respiratory tract secretions in mechanically ventilated patients generates reproducible results of quantitative and qualitative cultures. We suggest that blind bronchial sampling may provide valuable clue to the bacterial etiology in ventilated child with suspected clinical ventilator-associated pneumonia.
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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.
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Pediatr Crit Care Me · Jan 2013
Factors associated with mortality in pediatric patients requiring extracorporeal life support for severe pneumonia.
In children with respiratory failure secondary to pneumonia, extracorporeal life support can be lifesaving. Our goal was to identify variables associated with mortality in children with pneumonia requiring extracorporeal life support. ⋯ In children with severe pneumonia receiving extracorporeal life support, prognostic factors associated with increased risk of death included extracorporeal life support treatment exceeding 14 days, arterial cannulation, longer duration of mechanical ventilation, and decreased ability to wean ventilator FIO2 over the first 24 hrs on extracorporeal life support. Analysis of the Extracorporeal Life Support Organization registry can identify prognostic variables, which may influence medical decision making, resource utilization, and family counseling.