Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2018
Retrospective Application of New Pediatric Ventilator-Associated Pneumonia Criteria Identifies a High-Risk Population.
To promote standardization, the Centers for Disease Control and Prevention introduced a new ventilator-associated pneumonia classification, which was modified for pediatrics (pediatric ventilator-associated pneumonia according to proposed criteria [PVAP]). We evaluated the frequency of PVAP in a cohort of children diagnosed with ventilator-associated pneumonia according to traditional criteria and compared their strength of association with clinically relevant outcomes. ⋯ Few children with ventilator-associated pneumonia diagnosis met the proposed PVAP criteria. PVAP was associated with increased morbidity and mortality. This work suggests that additional study is required before new definitions for ventilator-associated pneumonia are introduced for children.
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Pediatr Crit Care Me · Jun 2018
Observational StudyAchievement of Therapeutic Vancomycin Exposure With Continuous Infusion in Critically Ill Children.
Describe and assess a continuous infusion dosing scheme of vancomycin therapy in critically ill children. ⋯ The current continuous infusion of vancomycin dosing scheme used in our population was inappropriate and led to underexposure. Using pharmacokinetic approaches such as covariate-adjusted initial dosing and Bayesian estimation of exposure should prove useful for achieving the pharmacokinetic target.
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Pediatr Crit Care Me · Jun 2018
Epidemiology of Pediatric Critical Care Transport in Northern Alberta and the Western Arctic.
Specialized pediatric critical care transport teams are essential to pediatric retrieval systems. This study aims to describe the contemporary transports performed by a Canadian pediatric critical care transport team and to compare the treatment and outcomes of children referred from high-level care (hospitals offering pediatric services where an adult ICU exists) and nonhigh-level care (all other hospitals) hospitals. ⋯ The current transport system has multiple priorities with regard to efficiency and quality. The medical services at referral hospitals may affect the likelihood of PICU admission and subsequent PICU length of stay; however, no negative impact was observed in other outcomes including mortality.
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Pediatr Crit Care Me · Jun 2018
Editorial CommentThe Quest to Optimize Pediatric Interhospital Transport.