Pediatr Crit Care Me
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Pediatr Crit Care Me · Dec 2018
Multicenter Study Observational StudyPerformance of the Pediatric Index of Mortality 3 Score in PICUs in Argentina: A Prospective, National Multicenter Study.
To assess the performance of the Pediatric Index of Mortality 3 score in a population of children admitted to PICUs in Argentina. ⋯ The Pediatric Index of Mortality 3 score adequately discriminated patients who died from those who survived in our population. However, the observed mortality was higher than predicted by the score. The use of an updated instrument such as Pediatric Index of Mortality 3 will allow an actual comparison between pediatric intensive care provided in the country and care provided internationally. This might also allow future planning of pediatric intensive care services in Argentina.
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Pediatr Crit Care Me · Dec 2018
Multicenter StudyPediatric Ventilator-Associated Events: Analysis of the Pediatric Ventilator-Associated Infection Data.
To compare the prevalence of infection applying the proposed pediatric ventilator-associated events criteria versus clinician-diagnosed ventilator-associated infection to subjects in the pediatric ventilator-associated infection study. ⋯ The ventilator-associated event criteria appear to be insensitive to the clinical diagnosis of ventilator-associated infection. Differentiation between ventilator-associated condition and infection-related ventilator-associated complication was primarily determined by the clinician decision to treat with antibiotics rather than clinical signs and symptoms. The utility of the proposed pediatric ventilator-associated event criteria as a surrogate for ventilator-associated infection criteria is unclear.
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Pediatr Crit Care Me · Dec 2018
Multicenter Study Observational StudyDuration and Time Trends in Hospital Stay for Very Preterm Infants Differ Across European Regions.
To compare duration and changes over time in length of hospital stay for very preterm and extremely preterm infants in 10 European regions. ⋯ A better understanding of the discharge criteria and care practices that contribute to the wide differences in very preterm length of stay across European regions could inform policies to optimize discharge decisions in terms of infant outcomes and health system costs.
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Pediatr Crit Care Me · Dec 2018
Multicenter StudyPICU Autopsies: Rates, Patient Characteristics, and the Role of the Medical Examiner.
Autopsy rates in North American Children's hospitals have not been recently evaluated. Our objectives were 1) to determine the autopsy rates from patients cared for in PICUs during a portion of their hospital stay, 2) to identify patient characteristics associated with autopsies, and 3) to understand the relative role of medical examiner cases. ⋯ In this first multicenter analysis of autopsy rates in children, 36% of deaths had autopsies conducted, of which nearly half were conducted by the medical examiner. Deaths with autopsy are more likely to be previously healthy children that had catastrophic events prior to admission.
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Pediatr Crit Care Me · Dec 2018
External Validation of the "Quick" Pediatric Logistic Organ Dysfunction-2 Score Using a Large North American Cohort of Critically Ill Children With Suspected Infection.
A quick Pediatric Logistic Organ Dysfunction 2 score on day 1, consisting of tachycardia, hypotension, and altered mentation, was shown to predict mortality with an area under the receiver operating characteristic curve of 82% (95% CI, 76-87%) in children admitted to a PICU with suspected infection. We performed an external validation of the quick Pediatric Logistic Organ Dysfunction 2, including its performance in predicting mortality in specific age groups. ⋯ Quick Pediatric Logistic Organ Dysfunction 2 performed markedly worse in our cohort, compared with the original study, and the high rate of false negatives limits its clinical utility in our population. Further work is needed to develop a robust quick pediatric sepsis diagnostic tool for both research and clinical care.