Pediatr Crit Care Me
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Pediatr Crit Care Me · Nov 2007
Randomized Controlled TrialFusidic acid and heparin lock solution for the prevention of catheter-related bloodstream infections in critically ill neonates: a retrospective study and a prospective, randomized trial.
Catheter-related bloodstream infections (CRBSIs) are one of the main morbidities in critically ill neonates. The objective of the present study was to assess the efficacy of a fusidic acid-heparin lock in the prevention of CRBSIs. ⋯ Fusidic acid-heparin lock solution reduced the incidence of CRBSIs in our neonatal intensive care unit. However, we recommend basing antibiotic lock on local CRBSI epidemiology. With regard to fusidic acid, further and broader studies could be useful to confirm our results.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled TrialEffect of inhaled corticosteroid on pulmonary injury and inflammatory mediator production after cardiopulmonary bypass in children.
To determine whether inhaled steroid administration after cardiopulmonary bypass will attenuate pulmonary inflammation and improve lung compliance and oxygenation. ⋯ Cardiopulmonary bypass is associated with a pulmonary inflammatory response. Inhaled corticosteroid did not affect the pulmonary inflammatory response as measured by interleukin-6 and interleukin-8 concentrations in the lung lavage after cardiopulmonary bypass. Pulmonary mechanics and oxygenation were not improved by the use of inhaled corticosteroid.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled TrialProbiotic administration and the incidence of nosocomial infection in pediatric intensive care: a randomized placebo-controlled trial.
To evaluate the efficacy of probiotics in reducing the rates of nosocomial infection in pediatric intensive care. ⋯ The results of this preliminary investigation were unexpected but important in view of the increased use of probiotic preparations in medically fragile pediatric patients. In this randomized, placebo-controlled trial, L. rhamnosus strain GG was not shown to be effective in reducing the incidence of nosocomial infections. In fact, a statistically nonsignificant trend toward an increase in infection was seen (four vs. 11). Further studies with a larger patient population are needed to establish both safety and efficacy of probiotics in pediatric critical care.
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Pediatr Crit Care Me · Sep 2007
Randomized Controlled Trial Comparative StudySelective medicated (normal saline and exogenous surfactant) bronchoalveolar lavage in severe aspiration syndrome in children.
To study the ability of volume-controlled ventilation and medicated (normal saline plus surfactant) bronchoalveolar lavage in aspiration to reduce the duration of intubation and improve gas exchange. ⋯ Even though this was an unblinded small clinical trial and low tidal volume strategy was not employed at an early stage after lung injury, there is some evidence that bronchoalveolar lavage with normal saline and surfactant may have clinical value in treating severe aspiration syndrome in children. More clinical studies are warranted to overcome study limitations and potential bias.
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Pediatr Crit Care Me · Jan 2007
Randomized Controlled Trial Multicenter Study Comparative StudyPilot study to determine the hemodynamic safety and feasibility of magnesium sulfate infusion in children with severe traumatic brain injury.
Magnesium sulfate is neuroprotective in preclinical models, but there are limited safety data regarding its clinical use for pediatric traumatic brain injury. We conducted a pilot study in children with severe traumatic brain injury to a) examine if magnesium sulfate decreases mean arterial pressure, decreases cerebral perfusion pressure, increases intracranial pressure, or adversely effects cardiac conduction; and b) determine the feasibility of a multiple-center trial of magnesium sulfate. ⋯ In children with severe traumatic brain injury, magnesium sulfate administration did not decrease mean arterial pressure or cerebral perfusion pressure or adversely effect cardiac conduction. Our data suggest that enrollment of brain-injured children in a therapeutic trial remains challenging. These results provide information important for clinical trials of magnesium sulfate in children with severe traumatic brain injury.