Pediatr Crit Care Me
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Ischemia depletes antioxidant reserves and impairs mitochondrial electron transport. Oxygen within blood reperfusing ischemic tissue can form free radicals, worsen oxidative stress, and exacerbate tissue injury (reperfusion injury). One strategy for limiting reperfusion injury is to limit delivery of "luxuriant" oxygen during or after reperfusion. Resuscitation guidelines for children with cardiac arrest recommend early weaning of supplemental oxygen as tolerated. There are currently no studies demonstrating the frequency and outcomes of hyperoxia and hypoxia after pediatric cardiac arrest. ⋯ Hyperoxia occurs commonly within the first 24 hours of management in children resuscitated from cardiac arrest.
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Pediatr Crit Care Me · Mar 2013
Clinical TrialExtracorporeal membrane oxygenation and cerebral blood flow velocity in children.
To determine how extracorporeal membrane oxygenation affects cerebral blood flow velocity and to determine whether specific changes in cerebral blood flow velocity may be associated with neurologic injury. ⋯ In children who did not suffer clinically apparent neurologic injury, cerebral blood flow velocities were lower than normal while on extracorporeal membrane oxygenation support and increased after decannulation. However, children who developed cerebral hemorrhage had higher than normal cerebral blood flow velocities noted for days prior to clinical recognition of bleeding. Cerebral blood flow velocity measurement may represent a portable, noninvasive way to predict cerebral complications of extracorporeal membrane oxygenation and deserves further study.
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Pediatr Crit Care Me · Mar 2013
Safe and effective use of a glycemic control protocol for neonates in a cardiac ICU.
To investigate the safety and efficacy of a hyperglycemia protocol in neonates with critical cardiac illness. Neonates are often regarded as high risk for hypoglycemia while receiving continuous insulin infusions and thus have been excluded from some clinical trials. ⋯ A glycemic control protocol can safely and effectively be applied to neonates with critical cardiac disease. Neonates with critical cardiac illness should be included in clinical trials evaluating the benefits of glycemic control.
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Pediatr Crit Care Me · Mar 2013
Pharmacokinetic characterization of intravenous cyclosporine treatment for cardioprotection during resuscitation of asphyxiated newborn piglets.
Cyclosporine treatment, as a single intravenous bolus, during resuscitation has been shown to attenuate myocardial injury in asphyxiated newborn piglets. However, the pharmacokinetics of cyclosporine treatment for cardioprotection in newborns has not been studied. We aimed to assess the pharmacokinetics of a single intravenous cyclosporine treatment during resuscitation of asphyxiated newborn piglets and compare these parameters with healthy newborn piglets. ⋯ This is the first study to demonstrate the pharmacokinetics of intravenous cyclosporine treatment during resuscitation of asphyxiated newborn piglets, which did not appear to different from that of healthy piglets.
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Pediatr Crit Care Me · Mar 2013
Transfusion of leukocyte-depleted RBCs is independently associated with increased morbidity after pediatric cardiac surgery.
To test the hypothesis that transfusion of leukocyte-depleted RBC preparations within the first 48 hours of PICU stay was independently associated with prolonged duration of mechanical ventilation, irrespective of surgery type and disease severity. ⋯ Transfusion of leukocyte-depleted RBCs within the first 48 hours of PICU stay after cardiac surgery is independently associated with prolonged duration of mechanical ventilation.