Pediatr Crit Care Me
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Acute kidney injury is an independent risk factor for morbidity and mortality in critically ill children in the PICU. Neonates are a particularly vulnerable subgroup regarding acute kidney injury. The objectives were to define the prevalence of acute kidney injury to assess independent risk factors, for the development of acute kidney injury, and to determine the impact of acute kidney injury on outcomes in critically ill neonates without history of cardiac surgery. ⋯ Acute kidney injury is common in neonates not requiring cardiac surgery and is associated with increased morbidity and mortality. Age, bacteremia, and maximum sodium concentration are independently associated with the development of acute kidney injury in this population.
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Pediatr Crit Care Me · Apr 2016
Optimizing Virus Identification in Critically Ill Children Suspected of Having an Acute Severe Viral Infection.
Multiplex rapid viral tests and nasopharyngeal flocked swabs are increasingly used for viral testing in PICUs. This study aimed at evaluating how the sampling site and the type of diagnostic test influence test results in children with suspected severe viral infection. ⋯ Standardized specimen collection and sensitive diagnostic testing with a reverse transcription-polymerase chain reaction increased the identification of influenza in critically ill children. For most pathogenic viruses identified, results from nasopharyngeal flocked swabs agreed with those from nasopharyngeal or endotracheal aspirates.
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Pediatr Crit Care Me · Apr 2016
Multicenter StudyInvasive Mechanical Ventilation and Mortality in Pediatric Hematopoietic Stem Cell Transplantation: A Multicenter Study.
To establish the current respiratory practice patterns in pediatric hematopoietic stem cell transplant patients and investigate their associations with mortality across multiple centers. ⋯ This study suggests that perhaps earlier more aggressive critical care interventions in the pediatric hematopoietic stem cell transplant patient with respiratory failure requiring invasive mechanical ventilation may offer an opportunity to improve outcomes.
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Pediatr Crit Care Me · Apr 2016
Hyperoxia Is Associated With Poor Outcomes in Pediatric Cardiac Patients Supported on Venoarterial Extracorporeal Membrane Oxygenation.
Patients who require venoarterial extracorporeal membrane oxygenation because of cardiac failure frequently have supranormal blood oxygen tensions (hyperoxia). Recent studies have suggested worse outcomes in patients with hyperoxia after resuscitation from cardiac or respiratory arrests, presumably because of oxidative stress. There are limited data regarding the effect of hyperoxia on outcomes in pediatric patients on venoarterial extracorporeal membrane oxygenation. ⋯ In infants with congenital heart disease who are placed on venoarterial extracorporeal membrane oxygenation postoperatively, hyperoxia (defined as a mean PaO2 > 193 mm Hg in the first 48 hr of extracorporeal membrane oxygenation) was an independent risk factor for 30-day mortality after surgery. Future studies are needed to delineate the causative or associative role of hyperoxia with outcomes, especially in children with baseline cyanosis who may be more susceptible to the effects of oxidative stress.