Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2020
ReviewMonitoring of Respiratory Muscle Function in Critically Ill Children.
This review discusses the different techniques used at the bedside to assess respiratory muscle function in critically ill children and their clinical applications. ⋯ Physiologic techniques are useful to precisely assess respiratory muscle function and to individualize and optimize the management of mechanical ventilation in children. Among all the available techniques, the measurements of esophageal pressure and electrical activity of the diaphragm appear particularly helpful in the era of individualized ventilatory management.
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Pediatr Crit Care Me · May 2020
ReviewThe Endothelial Glycocalyx: A Fundamental Determinant of Vascular Permeability in Sepsis.
Sepsis is a significant cause of morbidity and mortality. Children with sepsis often have alterations in microcirculation and vascular permeability. Our objective is current evidence regarding the role of the endothelial glycocalyx as a determinant of capillary leakage in these patients. ⋯ The endothelial glycocalyx is a fundamental component of the endothelium and an important determinant of the mechanotransduction and vascular permeability in patients with sepsis. Studies are needed to evaluate the role of the different types of solutions used in fluid bolus, vasoactive support, and other interventions described in pediatric sepsis on microcirculation, particularly on endothelial integrity and the glycocalyx.