Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2014
Higher Doses of Low-Molecular-Weight Heparin (Enoxaparin) Are Needed to Achieve Target Anti-Xa Concentrations in Critically Ill Children.
To demonstrate that low-molecular-weight heparin (enoxaparin) can be used in critically ill pediatric patients to achieve target anti-factor Xa concentrations and determine appropriate dosing corrected for age and illness severity. ⋯ Enoxaparin can be used to reach recommended target range of anti-factor Xa concentrations in the PICU patient. However, younger patients and patients with higher illness severity are less likely to achieve target concentrations using currently recommended dosing and may require higher doses of enoxaparin to reach target anti-factor Xa concentrations. Starting enoxaparin dose at least 1.3 mg/kg dosed every 12 hours for treatment of thromboembolic disease in critically ill patients aged 61 days to 1 year or those requiring inotropic support should be confirmed in prospective study.
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Pediatr Crit Care Me · Sep 2014
Nonrespiratory Pediatric Logistic Organ Dysfunction-2 Score Is a Good Predictor of Mortality in Children With Acute Respiratory Failure.
Multiple organ dysfunction, not respiratory failure, is the major cause of death in children with acute lung injury or acute respiratory distress syndrome. This study was undertaken to estimate the predictive value of death of the nonrespiratory Pediatric Logistic Organ Dysfunction-2 in children with acute respiratory failure. ⋯ Our study demonstrates that the nonrespiratory Pediatric Logistic Organ Dysfunction-2 score of the entire PICU stay is highly predictive of death in children with acute respiratory failure of whom 94.3% were invasively ventilated. The nonrespiratory Pediatric Logistic Organ Dysfunction-2 score could represent the nonrespiratory organ failure definition tool whose development was recommended in the international expert recommendations on pediatric acute respiratory distress syndrome.
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Pediatr Crit Care Me · Sep 2014
Randomized Controlled TrialEffect of Nonnutritive Sucking and Oral Stimulation on Feeding Performance in Preterm Infants: A Randomized Controlled Trial.
To evaluate the effectiveness of nonnutritive sucking (NNS) and oral stimulation (OS), either applied alone or in combination, to reduce the transition time from tube feeding to independent oral feeding. ⋯ The combined NNS + OS intervention reduced the transition time from introduction to independent oral feeding and enhanced the milk transfer rate. The combined intervention seems to have a beneficial effect on oral feeding proficiency in preterm infants.
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Pediatr Crit Care Me · Sep 2014
Biomarkers S100B and Neuron-Specific Enolase Predict Outcome in Hypothermia-Treated Encephalopathic Newborns.
To evaluate if serum S100B protein and neuron-specific enolase measured during therapeutic hypothermia are predictive of neurodevelopmental outcome at 15 months in children with neonatal encephalopathy. ⋯ Serum S100B and neuron-specific enolase levels in babies with neonatal encephalopathy are associated with neurodevelopmental outcome at 15 months. These putative biomarkers of brain injury may help direct care during therapeutic hypothermia.