Pediatr Crit Care Me
-
Pediatr Crit Care Me · Mar 2015
Clinical TrialLow Predictability of Three Different Noninvasive Methods to Determine Fluid Responsiveness in Critically Ill Children.
To predict fluid responsiveness by noninvasive methods in a pediatric critical care population. ⋯ Dynamic preload variables such as stroke volume variation or respiratory variations in vena cava inferior diameter may not be useful for predicting fluid responsiveness in certain pediatric patient populations. Esophageal Doppler peak velocity was predictive of fluid responsiveness where a target value of more than 135,5 cm/s may be a signal to terminate further fluid challenges. This target value may be different in different age groups, as esophageal Doppler peak velocity varies with age.
-
Pediatr Crit Care Me · Mar 2015
Standardizing Postoperative PICU Handovers Improves Handover Metrics and Patient Outcomes.
To improve handover communication and patient outcomes for postoperative admissions to a multidisciplinary PICU. ⋯ Postoperative communication and patient outcomes can be improved and sustained over time with implementation of a standardized handover protocol.
-
Pediatr Crit Care Me · Mar 2015
Hemorrhagic Complications in Pediatric Cardiac Patients on Extracorporeal Membrane Oxygenation: An Analysis of the Extracorporeal Life Support Organization Registry.
To determine the prevalence of and risk factors for hemorrhagic complications in children with cardiac disease requiring extracorporeal membrane oxygenation. ⋯ In this large, multicenter analysis, hemorrhagic complications occurred in nearly half of children with heart disease on extracorporeal membrane oxygenation and were associated with a significant mortality risk. Several factors were associated with hemorrhagic complications in cardiac surgical patients including pre-extracorporeal membrane oxygenation mediastinal exploration, greater surgical complexity, early postoperative cannulation, and longer bypass times. Whether these risks can be mitigated by modifying or delaying systemic anticoagulation requires further investigation.
-
Pediatr Crit Care Me · Mar 2015
Fluid Overload at 48 Hours Is Associated With Respiratory Morbidity but Not Mortality in a General PICU: Retrospective Cohort Study.
Recent evidence suggests that fluid overload may be deleterious to critically ill children. The purpose of this study was to investigate the association of early fluid overload with respiratory morbidity and mortality in patients admitted to a general PICU. ⋯ Fluid overload at 48 hours was associated with oxygenation index at 48 hours and invasive ventilation days in survivors in a general PICU population. There was no association of fluid overload at 48 hours with mortality.
-
Pediatr Crit Care Me · Mar 2015
A Multicentered Prospective Analysis of Diagnosis, Risk Factors, and Outcomes Associated With Pediatric Ventilator-Associated Pneumonia.
To assess risk factors and outcomes associated with pediatric ventilator-associated pneumonia. ⋯ Pediatric ventilator-associated pneumonia is common in mechanically ventilated pediatric patients. These patients have longer length of stay, longer duration of mechanical ventilation, and increased risk for mortality.