Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2015
Multicenter StudyEffect of Administration of Neuromuscular Blocking Agents in Children With Severe Traumatic Brain Injury on Acute Complication Rates and Outcomes: A Secondary Analysis From a Randomized, Controlled Trial of Therapeutic Hypothermia.
To evaluate the association between neuromuscular blocking agents and outcome, intracranial pressure, and medical complications in children with severe traumatic brain injury. ⋯ Administration of neuromuscular blocking agents was ubiquitous and daily administration of neuromuscular blocking agents was associated with intracranial hypertension but not outcomes-likely indicating that increased injury severity prompted their use. Despite this, neuromuscular blocking agent use was not associated with complications. A different study design-perhaps using randomization or methodologies-of a larger cohort will be required to determine if neuromuscular blocking agent use is helpful after severe traumatic brain injury in children.
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Pediatr Crit Care Me · May 2015
Functional Recovery Following Critical Illness in Children: The "Wee-Cover" Pilot Study.
To determine the feasibility of conducting a longitudinal prospective study to evaluate functional recovery and predictors of impaired functional recovery in critically ill children. ⋯ Longitudinal research is needed to understand how children recover after a critical illness. Our results suggest factors that may influence the recovery trajectory and were used to inform the methodology, outcomes of interest, and appropriate sample size of a larger multicenter study evaluating functional recovery in this population.
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Determine the relationship between the volume of burn admissions and outcomes for children with burns. ⋯ Higher volume pediatric burn centers had lower mortality, particularly at larger burn sizes. The lower mortality of children a high volume centers could reflect greater experience, resource, and specialized expertise in treating pediatric patients.
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Pediatr Crit Care Me · May 2015
Measurement of Salivary Cortisol Level for the Diagnosis of Critical Illness-Related Corticosteroid Insufficiency in Children.
To compare serum total, serum free and salivary cortisol in critically ill children. ⋯ Serum free and salivary cortisol values correlate in critically ill children. Salivary cortisol can be used as a surrogate for serum free cortisol in critically ill pediatric patients. Salivary cortisol is a cost-effective and less invasive measure of bioavailable cortisol and offers an alternate and accurate method for assessing critical illness-related corticosteroid insufficiency in children.
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Pediatr Crit Care Me · May 2015
Routine Medical Emergency Team Assessments of Patients Discharged From the PICU: Description of a Medical Emergency Team Follow-Up Program.
This study describes one follow-up program in the Ontario Rapid-Response System project consisting of routine medical emergency team visits of patients discharged from the PICU consisting of two planned visits within 48 hours following discharge. Study purpose was to describe interventions provided and the patient characteristics associated with medical emergency team utilization. ⋯ Routine medical emergency team visits following PICU discharge reduced the risk of early readmission. Our results suggest that one in seven patients in the follow-up program receive major medical emergency team support. We suggest a follow-up program with at least one routine medical emergency team visit within the first 24 hours of discharge with a second planned visit reserved for complex postsurgical patients.