Pediatr Crit Care Me
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Pediatr Crit Care Me · Feb 2017
Clinical TrialLong-Term Follow-Up on Health-Related Quality of Life After Mechanical Circulatory Support in Children.
The objective of this study was to evaluate health-related quality of life in long-term survivors of mechanical circulatory support after acute cardiopulmonary failure. ⋯ Long-term survivors' health-related quality of life as reported by their parents is lower than that of healthy children. However, the self-assessed health-related quality of life of the patients older than 12 years in our group is comparable to a healthy control population.
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Pediatr Crit Care Me · Feb 2017
Clinical TrialMannose-Binding Lectin Levels in Critically Ill Children With Severe Infections.
Low mannose-binding lectin levels and haplotypes associated with low mannose-binding lectin production have been associated with infection and severe sepsis. We tested the hypothesis that mannose-binding lectin levels would be associated with severe infection in a large cohort of critically ill children. ⋯ Mannose-binding lectin levels are largely genetically determined. This relationship was preserved in children during critical illness, despite the effect of large-volume fluid administration on mannose-binding lectin levels. Previous literature evaluating an association between mannose-binding lectin levels and severe infection is inconsistent; we found no relationship in our PICU cohort. We found that mannose-binding lectin levels were lower after aggressive fluid resuscitation and suggest that studies of mannose-binding lectin in critically ill patients should assess mannose-binding lectin haplotypes to reflect preillness levels.
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Pediatr Crit Care Me · Feb 2017
Ultrasound-Guided Subclavian Vein Cannulation in Low Birth Weight Neonates.
Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons. The subclavian vein approach is yet relatively undescribed in low birth weight infants (i.e., < 2,500 g), and this study aims to explore the feasibility of this technique in very small infants. ⋯ This large series of subclavian vein catheterizations in small infants demonstrates the feasibility of subclavian vein catheterizations even in very small neonates weighing less than 1,500 g.
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Pediatr Crit Care Me · Feb 2017
Clinical TrialA Systemic Inflammation Mortality Risk Assessment Contingency Table for Severe Sepsis.
We tested the hypothesis that a C-reactive protein and ferritin-based systemic inflammation contingency table can track mortality risk in pediatric severe sepsis. ⋯ A C-reactive protein- and ferritin-based contingency table effectively assessed mortality risk. Reduction in systemic inflammation below a combined threshold C-reactive protein of 4.08 mg/dL and ferritin of 1,980 ng/mL appeared to be a desired response in children with severe sepsis.
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Pediatr Crit Care Me · Feb 2017
Comparative StudyThe Clinical Impact of Heated Humidified High-Flow Nasal Cannula on Pediatric Respiratory Distress.
To assess the impact on a single PICU of introducing high-flow nasal cannula as a management tool for respiratory distress. ⋯ The introduction of high-flow nasal cannula as a therapy for respiratory distress in the PICU was associated with a significant decrease in the PICU intubation rate with no associated change in mortality.