Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2017
Pediatric Critical Care Transport as a Conduit to Terminal Extubation at Home: A Case Series.
To present our single-center's experience with three palliative critical care transports home from the PICU for terminal extubation. ⋯ Although a relatively infrequent practice in pediatric critical care, transport home for terminal extubation represents a feasible alternative for families seeking out-of-hospital end-of-life care for their critically ill technology-dependent children. Our single-center experience supports the need for development of formal programs for end-of-life critical care transports to include patient screening tools, palliative care home discharge algorithms, transport protocols, and resource utilization and cost analyses.
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Pediatr Crit Care Me · Jan 2017
Identifying Children at Risk of Malignant Bordetella pertussis Infection.
To identify factors associated with malignant pertussis. ⋯ Clinical predictors of malignant pertussis are identifiable within 48 hours of hospital presentation. Early recognition of children at risk of malignant pertussis may facilitate early referral to a PICU for advanced life support and selection for trials of investigational therapies.
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Pediatr Crit Care Me · Jan 2017
The Impact of Chronic Health Conditions on Length of Stay and Mortality in a General PICU.
Each year approximately 20,000 children are admitted to PICUs across the United Kingdom. It is highlighted in several international studies that 40-70% of children admitted to PICUs have at least one chronic health condition that leads to increased length of stay and higher mortality rates. The prevalence of chronic health conditions in children admitted to U.K. PICUs is unknown. The purpose of this study was to use existing clinical data to explore the prevalence and impact of chronic health conditions on length of stay and mortality in a tertiary U.K. PICU. ⋯ The increasing number of chronic healthcare conditions is associated with length of stay and mortality.
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Pediatr Crit Care Me · Jan 2017
Observational StudyA Novel Electrocardiogram Algorithm Utilizing ST-Segment Instability for Detection of Cardiopulmonary Arrest in Single Ventricle Physiology: A Retrospective Study.
We evaluated ST-segment monitoring to detect clinical decompensation in infants with single ventricle anatomy. We proposed a signal processing algorithm for ST-segment instability and hypothesized that instability is associated with cardiopulmonary arrests. ⋯ In single ventricle patients, increased ST instability and magnitude were associated with rapid response events that required intervention for cardiopulmonary arrest, whereas conventional ST-segment monitoring did not differentiate an arrest from control state.
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Pediatr Crit Care Me · Jan 2017
Evaluating the Performance of the Pediatric Acute Lung Injury Consensus Conference Definition of Acute Respiratory Distress Syndrome.
The Pediatric Acute Lung Injury Consensus Conference has developed a pediatric-specific definition of acute respiratory distress syndrome, which is a significant departure from both the Berlin and American European Consensus Conference definitions. We sought to test the external validity and potential impact of the Pediatric Acute Lung Injury Consensus Conference definition by comparing the number of cases of acute respiratory distress syndrome and mortality rates among children admitted to a multidisciplinary PICU when classified by Pediatric Acute Lung Injury Consensus Conference, Berlin, and American European Consensus Conference criteria. ⋯ Applying the Pediatric Acute Lung Injury Consensus Conference definition of acute respiratory distress syndrome has the potential to significantly increase the number of acute respiratory distress syndrome patients identified, with a lower overall mortality rate. However, severe acute respiratory distress syndrome is associated with extremely high mortality, particularly if present at 24 hours after initial diagnosis.