Pediatr Crit Care Me
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Pediatr Crit Care Me · Oct 2014
Respiratory Secretion Analyses in the Evaluation of Ventilator-Associated Pneumonia: A Survey of Current Practice in Pediatric Critical Care.
Ventilator-associated pneumonia is among the most common nosocomial infections in the PICU. Respiratory secretion cultures and Gram stains are frequently obtained for diagnosis and to guide therapy, but their specificity is questionable. We conducted a scenario-based survey of pediatric intensivists to assess their antibiotic use in response to hypothetical tracheal aspirate culture and Gram stain results. ⋯ The majority of pediatric intensivists would obtain respiratory secretion cultures and Gram stains in the evaluation of an intubated child with fever and leukocytosis and initiate antibiotics guided by the results. The specificity of respiratory secretion cultures and Gram stains for the diagnosis of ventilator-associated pneumonia requires critical evaluation as this diagnosis is responsible for more than half of antibiotic use in the PICU.
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Pediatr Crit Care Me · Oct 2014
Reducing Blood Testing in Pediatric Patients After Heart Surgery: A Quality Improvement Project.
To safely optimize blood testing and costs for pediatric cardiac surgical patients without adversely impacting patient outcomes. ⋯ Blood testing rates were safely decreased in postoperative pediatric cardiac patients by changing laboratory ordering practices. In addition, packed RBC transfusion was decreased among the most complex patients.