Pediatr Crit Care Me
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Pediatr Crit Care Me · Apr 2017
Comparative Study Clinical TrialSeizure Detection by Critical Care Providers Using Amplitude-Integrated Electroencephalography and Color Density Spectral Array in Pediatric Cardiac Arrest Patients.
Determine the accuracy and confidence of critical care medicine providers to identify seizures using amplitude-integrated electroencephalography versus amplitude-integrated electroencephalography combined with color density spectral array electroencephalography (aEEG + CDSA). ⋯ Amplitude-integrated electroencephalography and aEEG + CDSA offer reasonable sensitivity and negative predictive value for seizure detection by critical care medicine providers. aEEG + CDSA did not improve seizure detection over amplitude-integrated electroencephalography alone although critical care medicine providers felt more confident using both tools combined. Amplitude-integrated electroencephalography and color density spectral array require further evaluation as a tool for screening for seizures and should only be used in conjunction with professional continuous electroencephalography review.
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Pediatr Crit Care Me · Apr 2017
ReviewSystematic Review of Interventions to Reduce Psychiatric Morbidity in Parents and Children After PICU Admissions.
To describe and evaluate interventions aimed at reducing psychiatric morbidity in parents and children discharged from PICU. ⋯ Intervention studies are few but do lead to reductions in parent and child psychopathology. There is sufficient information to suggest some of these interventions could be supported and further evaluated.
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Pediatr Crit Care Me · Apr 2017
Observational StudyUtility of Assessing Cytokine Levels for the Differential Diagnosis of Pneumonia in a Pediatric Population.
Although pneumonia is easily diagnosed, determining the causative agent is difficult due to low pathogen detection rates. We performed a prospective observational study to evaluate the utility of measuring inflammatory cytokine levels to discriminate between pneumonia caused by typical bacteria, respiratory syncytial virus, or Mycoplasma pneumoniae in a pediatric population. ⋯ These results suggest that interleukin-6 is a good biomarker for identifying bacterial pneumonia and that the interleukin-6/interleukin-10 ratio is an effective biomarker for discriminating Mycoplasma pneumoniae pneumonia from respiratory syncytial virus pneumonia.
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Pediatr Crit Care Me · Apr 2017
Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock.
Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis that these polymorphisms are associated with outcome and corticosteroid responsiveness among children with septic shock. ⋯ Based on these glucocorticoid receptor polymorphisms, we could not detect a beneficial effect of corticosteroids among any genotype group. Among children homozygous for the wild-type allele, corticosteroids were independently associated with increased odds of poor outcome.
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Pediatr Crit Care Me · Apr 2017
Observational StudyMultiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure.
The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for extrapulmonary organ dysfunction and the independent association of multiple organ dysfunction syndrome with outcomes in pediatric acute respiratory failure. ⋯ Extrapulmonary organ dysfunction was common, generally occurred concurrent with respiratory dysfunction (especially in sepsis), and was a major risk factor for mortality in pediatric acute respiratory failure.