Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2024
Meta AnalysisPerformance of Tools and Measures to Predict Fluid Responsiveness in Pediatric Shock and Critical Illness: A Systematic Review and Meta-Analysis.
In this systematic review and meta-analysis we asked: Do predictors of fluid responsiveness in children perform comparably: 1) in the PICU as in non-PICU settings? 2) in shock states compared with nonshock states? Additionally, 3) is there an association between preload responsiveness and clinical response? ⋯ We suggest three opportunities for further research in fluid responsiveness in children: 1) assessing predictive performance of tools during resuscitation in shock states; 2) separating predictive tool from reference test when using ultrasound techniques; and 3) targeting decreasing time in a shock state, rather than just increase in preload.
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Pediatr Crit Care Me · Jan 2024
Randomized Controlled Trial Multicenter StudySurvival With Favorable Neurologic Outcome and Quality of Cardiopulmonary Resuscitation Following In-Hospital Cardiac Arrest in Children With Cardiac Disease Compared With Noncardiac Disease.
To assess associations between outcome and cardiopulmonary resuscitation (CPR) quality for in-hospital cardiac arrest (IHCA) in children with medical cardiac, surgical cardiac, or noncardiac disease. ⋯ In pediatric IHCA, medical cardiac patients had lower odds of survival with favorable neurologic outcomes compared with noncardiac and surgical cardiac patients. We failed to find differences in CPR quality between medical cardiac and noncardiac patients, but there were lower odds of achieving target CC depth in surgical cardiac compared to noncardiac patients.
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Pediatr Crit Care Me · Jan 2024
Pulmonary Hemorrhage in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Single-Center Retrospective Study.
Pulmonary hemorrhage (PH) is a serious complication posthematopoietic stem cell transplant (HSCT). In view of limited available pediatric data, we performed a retrospective study to describe epidemiology, management, and outcomes of PH post-HSCT in children in our national center. ⋯ PH is a rare but serious complication after HSCT. Corticosteroids were associated with improved survival even in patients with a concomitant infection.
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Pediatr Crit Care Me · Jan 2024
Observational StudyPerfusion Index Variations in Children With Septic Shock: Single-Center Observational Cohort Study in India.
To study in children with septic shock: 1) variation in peripheral perfusion index (PI), which is a derived variable from pulse oximetry; 2) correlation between PI and lactate concentration; and 3) exploratory diagnostic evaluation between mortality and PI. ⋯ We have used pulse oximetry-derived PI in children presenting with septic shock and found that the value is negatively correlated with a rise in serum lactate concentration. However, the utility of using a critical threshold value in PI (≤ 0.6) after 6 hours of treatment to be indicative of later mortality has considerable uncertainty.
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Pediatr Crit Care Me · Jan 2024
ReviewPediatric Death After Withdrawal of Life-Sustaining Therapies: A Scoping Review.
Evaluate literature on the dying process in children after withdrawal of life sustaining measures (WLSM) in the PICU. We focused on the physiology of dying, prediction of time to death, impact of time to death, and uncertainty of the dying process on families, healthcare workers, and organ donation. ⋯ The dying process in children is poorly understood and understudied. This knowledge gap leaves families in a vulnerable position and the clinical team without the necessary tools to support patients, families, or themselves. Improving time to death prediction after WLSM may improve care provision and enable identification of potential organ donors.