Pediatr Crit Care Me
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Pediatr Crit Care Me · Sep 2018
Major Adverse Events Following Over-Shunting Are Associated With Worse Outcomes Than Major Adverse Events After a Blocked Systemic-to-Pulmonary Artery Shunt Procedure.
Causes of major adverse event after systemic-to-pulmonary shunt procedure are usually shunt occlusion or over-shunting. Outcomes categorized on the basis of these causes will be helpful both for quality improvement and prognostication. ⋯ Infants who suffer major adverse event due to over-shunting experience considerably poorer outcomes than those who experience events due to shunt block. A mainly hypoxic event with maintenance of systemic perfusion (as often seen in a blocked shunt) is less likely to result in poorer outcomes than those after a hypoxic-ischemic event (commonly seen in over-shunting).
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Pediatr Crit Care Me · Sep 2018
Clinical TrialPulmonary Functions in Children Ventilated for Acute Hypoxemic Respiratory Failure.
To assess pulmonary functions of children who received mechanical ventilation for acute hypoxemic respiratory failure. ⋯ Significant number of children ventilated for acute hypoxemic respiratory failure had subclinical pulmonary function abnormality, without limiting physical activity, which improved over time. Further research on this topic with a larger sample size and patient categorization according to recent pediatric acute respiratory distress syndrome definition is needed.
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Pediatr Crit Care Me · Sep 2018
Observational StudyAn Observational Cohort Feasibility Study to Identify Microvesicle and Micro-RNA Biomarkers of Acute Kidney Injury Following Pediatric Cardiac Surgery.
Micro-RNA, small noncoding RNA fragments involved in gene regulation, and microvesicles, membrane-bound particles less than 1 μm known to regulate cellular processes including responses to injury, may serve as disease-specific biomarkers of acute kidney injury. We evaluated the feasibility of measuring these signals as well as other known acute kidney injury biomarkers in a mixed pediatric cardiac surgery population. ⋯ Microvesicles and micro-RNAs expression patterns in pediatric cardiac surgery patients can be measured in children and potentially serve as tools for stratification of patients at risk of acute kidney injury.
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Pediatr Crit Care Me · Sep 2018
Albumin 5% Versus Crystalloids for Fluid Resuscitation in Children After Cardiac Surgery.
To determine the clinical benefit of using colloids versus crystalloids for volume resuscitation in children admitted after cardiac surgery. ⋯ In our study, the use of albumin 5% for resuscitation after cardiac surgery was not associated with less fluid intake but rather the opposite. Albumin administration did not provide measured clinical benefit while exposing children to side effects and generating higher costs to the healthcare system.
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Pediatr Crit Care Me · Sep 2018
Practice GuidelineRecommendations on RBC Transfusion in Critically Ill Children With Acute Brain Injury From the Pediatric Critical Care Transfusion and Anemia Expertise Initiative.
To present the recommendations and supporting literature for RBC transfusions in critically ill children with acute brain injury developed by the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. ⋯ The Transfusion and Anemia Expertise Initiative Consensus Conference developed pediatric-specific clinical and research recommendations regarding RBC transfusion in the critically ill child with acute brain injury. Although agreement among experts was very strong, the available pediatric evidence was extremely limited with major gaps in the literature.