Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2014
Tidal Volume Drives Inflammation During Mechanical Ventilation for Viral Respiratory Infection.
Respiratory syncytial virus lower respiratory tract infection is the most frequent cause of respiratory insufficiency necessitating mechanical ventilation in infants during the winter season. Recently, we presented a new animal model to show that mechanical ventilation aggravates respiratory syncytial virus-induced pulmonary inflammation by distinct mechanisms. We now use this model to study whether low tidal volume mechanical ventilation causes less ventilator-induced lung injury in the presence of respiratory syncytial virus lower respiratory tract infection. ⋯ Low tidal volume mechanical ventilation causes less ventilation-induced cellular and cytokine influx into the bronchoalveolar space during respiratory syncytial virus lower respiratory tract infection.
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Pediatr Crit Care Me · Jan 2014
Comparative StudyCost and Safety of Pediatric Intensive Care Physician-Placed Broviac Catheters.
To compare the cost and safety of placement of Broviac catheters in children by pediatric intensivists in a sedation suite versus placement by pediatric surgeons in the operating room. ⋯ Pediatric critical care physicians can place Broviac catheters as safely as pediatric surgeons and at a lower cost in a defined patient population.
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Pediatr Crit Care Me · Jan 2014
Clinical TrialSildenafil Exposure and Hemodynamic Effect After Fontan Surgery.
Determine sildenafil exposure and hemodynamic effect in children after Fontan single-ventricle surgery. ⋯ After Fontan surgery, sildenafil infusion acutely improves cardiopulmonary hemodynamics, increasing cardiac index. For the range of doses studied, exposure was within the acute safety range reported in adult subjects.
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Pediatr Crit Care Me · Jan 2014
Impact of positive end-expiratory pressure on cardiac index measured by ultrasound cardiac output monitor*.
To evaluate the impact of different levels of positive end-expiratory pressure on cardiac index in children receiving mechanical ventilation. To explore the effect of lung recruitment on the relationship between positive end-expiratory pressure and cardiac output. ⋯ In hemodynamically stable mechanically ventilated children, although there is a statistically significant decrease in cardiac output as positive end-expiratory pressure is increased between 0 and 12 cm H2O, the mean change is less than 10%, and this is likely not clinically significant. In the presence of lung disease, intensive care physicians should feel less reluctant in their use of positive end-expiratory pressure for hemodynamically stable patients.