Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2016
Double-Blind Randomized Clinical Trial Comparing Dopamine and Epinephrine in Pediatric Fluid-Refractory Hypotensive Septic Shock.
We compared efficacy of dopamine and epinephrine as first-line vasoactive therapy in achieving resolution of shock in fluid-refractory hypotensive cold septic shock. ⋯ Epinephrine is more effective than dopamine in achieving resolution of fluid-refractory hypotensive cold shock within the first hour of resuscitation and improving organ functions.
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Pediatr Crit Care Me · Nov 2016
Comparative StudyEnterovirus D68 in Critically Ill Children: A Comparison With Pandemic H1N1 Influenza.
In 2014, the Unites States experienced an outbreak of enterovirus D68 associated with severe respiratory illness. The clinical characteristics associated with severe illness from enterovirus D68 during this outbreak compared with those associated with the 2009 H1N1 influenza virus outbreak are unknown. ⋯ Critically ill children with enterovirus D68 were more likely to present with reactive airway disease exacerbations, whereas children with H1N1 influenza were more likely to present with pneumonia. Compared with the pandemic H1N1 influenza outbreak, the enterovirus D68 outbreak resulted in more children requiring admission to the ICU, but was associated with less severe outcomes.
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Pediatr Crit Care Me · Nov 2016
Hospital Volume and Mortality in Mechanically Ventilated Children: Analysis of a National Inpatient Database in Japan.
To evaluate the relationship between annual hospital volume of mechanical ventilation in children and mortality. ⋯ In mechanically ventilated pediatric patients divided by hospital volume quartiles, all three higher volume groups had lower mortality than the lowest volume group.
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Pediatr Crit Care Me · Nov 2016
Short-Term Health-Related Quality of Life of Critically Ill Children Following Daily Sedation Interruption.
Our earlier pediatric daily sedation interruption trial showed that daily sedation interruption in addition to protocolized sedation in critically ill children does not reduce duration of mechanical ventilation, length of stay, or amounts of sedative drugs administered when compared with protocolized sedation only, but undersedation was more frequent in the daily sedation interruption + protocolized sedation group. We now report the preplanned analysis comparing short-term health-related quality of life and posttraumatic stress symptoms between the two groups. ⋯ Daily sedation interruption in addition to protocolized sedation for critically ill children did not seem to have an effect on short-term health-related quality of life. Also in view of the earlier found absence of effect on clinical outcome, we cannot recommend the use of daily sedation interruption + protocolized sedation.
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Pediatr Crit Care Me · Nov 2016
Association of Extracorporeal Membrane Oxygenation Support Adequacy and Residual Lesions on Outcomes in Neonates Supported After Cardiac Surgery.
There is a paucity of data regarding the impact of extracorporeal membrane oxygenation support, adequacy of surgical repair, and timing of intervention for residual structural lesions in neonates cannulated to extracorporeal membrane oxygenation after cardiac surgery. Our goal was to determine how these factors were associated with survival. ⋯ Our data suggest that clearance of lactate is an important therapeutic target for patients cannulated to extracorporeal membrane oxygenation. In addition, timely identification of residual lesions and expedient interventions on those lesions may improve survival.