Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2016
Randomized Controlled Trial Comparative StudyA Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.
To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications. ⋯ Central venous catheterization through the internal jugular vein and subclavian vein was not significantly different in terms of success at the first attempt. Although the types of mechanical complications were different, the overall rate was similar between internal jugular vein and subclavian vein access. The risk of infectious complications was significantly higher with internal jugular vein access.
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Pediatr Crit Care Me · Sep 2016
ReviewOptimizing Team Dynamics: An Assessment of Physician Trainees and Advanced Practice Providers Collaborative Practice.
The presence of advanced practice providers has become increasingly common in many ICUs. The ideal staffing model for units that contain both advanced practice providers and physician trainees has not been described. The objectives of this study were to evaluate ICU staffing models that include physician trainees and advanced practice providers and their effects on patient outcomes, resident and fellow education, and training experience. A second aim was to assess strategies to promote collaboration between team members. ⋯ Several articles were identified describing the utilization of advanced practice providers in the ICU and the impact of models of care on patient outcomes. Limited data exist describing the impact of advanced practice providers on resident and fellow education and training experience. In addition, there are minimal data describing methods to enhance collaboration between providers. Future research should focus on determining the optimal ICU team structure to improve patient outcomes, education of trainees, and job satisfaction of team members and methods to promote collaboration between advanced practice providers and physicians in training.
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Pediatr Crit Care Me · Sep 2016
Comparative Study Clinical TrialCircuit Lifetime With Citrate Versus Heparin in Pediatric Continuous Venovenous Hemodialysis.
To determine if there is a difference between regional citrate and global heparinized anticoagulation on circuit lifetimes during continuous venovenous hemodialysis in children. ⋯ We showed in our study that citrate provided significantly longer circuit lifetimes than heparin for continuous venovenous hemodialysis in children. Citrate was superior to heparin for the transfusion requirements. Citrate was feasible and safe in children and infants.
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Pediatr Crit Care Me · Sep 2016
Admission Plasma Troponin I Is Associated With Mortality in Pediatric Intensive Care.
Assessment of whether admission plasma troponin I level is associated with mortality or requirement for vasoactive drugs in pediatric intensive care. ⋯ Detectable plasma troponin I at admission to PICU is independently associated with death. The utility of troponin I as a stratification biomarker requires further evaluation.