Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2020
Providing Early Attending Physician Expertise via Telemedicine to Improve Rapid Response Team Evaluations.
To evaluate the effect of providing early attending physician involvement via telemedicine to improve the decision process of rapid response teams. ⋯ Early in the study, more rapid ICU attending involvement via telemedicine was associated with rapid response team providers spending less time outside the ICU, and among patients transferred to the ICU, a significant decrease in likelihood of patients requiring vasopressors or intubation within the first 60 minutes of transfer. These findings provide evidence that early ICU attending involvement via telemedicine can improve efficiency of rapid response team evaluations.
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Pediatr Crit Care Me · May 2020
Observational StudyDelirium and Developmental Disability: Improving Specificity of a Pediatric Delirium Screen.
Children with developmental disabilities are at high risk for developing delirium when critically ill. However, existing pediatric delirium screening tools were designed for children with typical development. The objective of this study was to improve the specificity of the Cornell Assessment for Pediatric Delirium, to allow for accurate detection of delirium in developmentally delayed children admitted to the PICU. We hypothesized that the Cornell Assessment for Pediatric Delirium, when combined with fluctuation in level of awareness as measured by the Richmond Agitation-Sedation Scale, would be valid and reliable for the diagnosis of delirium in developmentally delayed children. ⋯ When used in conjunction with Richmond Agitation-Sedation Scale score fluctuation, the Cornell Assessment for Pediatric Delirium is a sensitive and specific tool for the detection of delirium in children with developmental delay. This allows for reliable delirium screening in this hard-to-assess population.
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Pediatr Crit Care Me · May 2020
Multicenter Study Observational StudyDaily Practice of Mechanical Ventilation and Weaning in Turkish PICUs: A Multicenter Prospective Survey.
To investigate conventional mechanical ventilation weaning characteristics of patients requiring conventional mechanical ventilation support for greater than 48 hours within the PICU. ⋯ Pediatric patients requiring conventional mechanical ventilation with a diagnosis of sepsis and high initial peak inspiratory pressures may require longer conventional mechanical ventilation weaning prior to extubation. Causative factors and optimal weaning for this cohort needs further consideration.
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Pediatr Crit Care Me · May 2020
Observational StudyWork of Breathing in Mechanically Ventilated Preterm Neonates.
To compare the imposed work of breathing by means of pressure-time product of the diaphragm in newborn infants receiving different modes of mechanical ventilation. ⋯ In preterm infants, patient-triggered ventilation modalities result in lower work of breathing than intermittent mandatory ventilation, while the assist control mode is also associated with lower pressure-time product of the diaphragm compared with synchronized intermittent mandatory ventilation. The difference in the imposed diaphragmatic workload between these ventilation modalities was inversely related to postmenstrual age, implying that less mature infants benefit more from assist control-based ventilation strategies.
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Pediatr Crit Care Me · May 2020
Observational StudyThe Validity and Reliability of the Japanese Version of the Cornell Assessment of Pediatric Delirium.
To examine validity and reliability of the Japanese version of the Cornell Assessment of Pediatric Delirium. ⋯ The Japanese version of the Cornell Assessment of Pediatric Delirium is a valid and reliable tool for use in Japanese PICUs. This will allow for detection of delirium in real-time and may lead to better identification of the population and risk factors for appropriate management and therapeutic and preventative interventions.