Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2014
Multicenter StudyParental Perspectives on Suffering and Quality of Life at End-of-Life in Children With Advanced Heart Disease: An Exploratory Study.
To describe parent perspectives regarding the end-of-life experience of children with advanced heart disease. ⋯ According to their parents, many children with advanced heart disease experience suffering in the end-of-life care period. For most, realization that their child has no realistic chance of survival does not occur until late, some not until death is imminent. Once this realization occurs, however, parents perceive peacefulness, a "good death," and excellent quality of care. Strategies for improved communication around symptom management, quality of life, prognosis, and advance care planning are needed for families of children with advanced heart disease.
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Pediatr Crit Care Me · May 2014
The Parent Perspective: "Being a Good Parent" When Making Critical Decisions in the PICU.
To identify factors important to parents making decisions for their critically ill child. ⋯ These findings suggest a range of themes important for parents to "be a good parent" to their child while making critical decisions. Further studies need to explore whether clinician's knowledge of the parent's most valued factor can improve family-centered care.
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Pediatr Crit Care Me · May 2014
Unfractionated Heparin Activity Measured by Anti-Factor Xa Levels Is Associated With the Need for Extracorporeal Membrane Oxygenation Circuit/Membrane Oxygenator Change: A Retrospective Pediatric Study.
Investigate whether anti-Factor Xa levels are associated with the need for change of circuit/membrane oxygenator secondary to thrombus formation in pediatric patients. ⋯ Higher anti-Factor Xa concentrations were associated with freedom from circuit/membrane oxygenator change due to thrombus formation in pediatric patients during extracorporeal membrane oxygenation support. Activated clotting time measurements did not differ significantly between groups with or without circuit/membrane oxygenator change. This is the first study to link anti-Factor Xa concentrations with a clinically relevant measure of thrombosis in pediatric patients during extracorporeal membrane oxygenation support. Further prospective study is warranted.
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Pediatr Crit Care Me · May 2014
Pediatric Liver Lacerations and Intensive Care: Evaluation of ICU Triage Strategies.
To compare PICU admission criteria following blunt traumatic liver laceration based on CT grade and/or physiologic instability with actual practice to improve efficiency of ICU admission. ⋯ Children with isolated abdominal injury and no physiologic instability can generally be treated without ICU admission. Adding grade more than or equal to 4 to usual ICU admission criteria resulted in excessive admission of stable patients.