Pediatr Crit Care Me
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Pediatr Crit Care Me · Apr 2016
Multicenter StudyInvasive Mechanical Ventilation and Mortality in Pediatric Hematopoietic Stem Cell Transplantation: A Multicenter Study.
To establish the current respiratory practice patterns in pediatric hematopoietic stem cell transplant patients and investigate their associations with mortality across multiple centers. ⋯ This study suggests that perhaps earlier more aggressive critical care interventions in the pediatric hematopoietic stem cell transplant patient with respiratory failure requiring invasive mechanical ventilation may offer an opportunity to improve outcomes.
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Pediatr Crit Care Me · Feb 2016
Multicenter StudyPediatric Intensive Care in PICUs and Adult ICUs: A 2-Year Cohort Study in Finland.
To investigate the association between the type of ICU and mortality for children treated at PICUs and adult ICUs. ⋯ Pediatric patients treated at PICUs showed lower mortality. Requirement of mechanical ventilation, emergency admission, and readmission less than 48 hours after discharge and cardiovascular, gastrointestinal, acute infections, hematologic/oncologic disease, and nonsurgical trauma were associated with higher risk of mortality.
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Pediatr Crit Care Me · Feb 2016
Multicenter StudyLimiting and Withdrawing Life Support in the PICU: For Whom Are These Options Discussed?
Most deaths in U.S. PICUs occur after a decision has been made to limitation or withdrawal of life support. The objective of this study was to describe the clinical characteristics and outcomes of children whose families discussed limitation or withdrawal of life support with clinicians during their child's PICU stay and to determine the factors associated with limitation or withdrawal of life support discussions. ⋯ Clinical factors reflecting type and severity of illness, sociodemographics, and institutional practices may influence whether limitation or withdrawal of life support is discussed with families of PICU patients. Most children whose families discuss limitation or withdrawal of life support die during their PICU stay; survivors often have substantial disabilities.
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Pediatr Crit Care Me · Jan 2016
Randomized Controlled Trial Multicenter StudyIntraoperative Steroid Use and Outcomes Following the Norwood Procedure: An Analysis of the Pediatric Heart Network's Public Database.
Data supporting the use of perioperative steroids during cardiac surgery are conflicting, and most pediatric studies have been limited by small sample sizes and/or diverse cardiac diagnoses. The objective of this study was to determine if intraoperative steroid administration improved outcomes following the Norwood procedure. ⋯ In the large multicentered Single Ventricle Reconstruction trial, there was widespread use of intraoperative steroids. Intraoperative steroid administration was not associated with an improvement in outcomes and may be associated with a reduction in hospital survival in neonates undergoing the Norwood procedure. This study highlights the need for a randomized control trial.
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Pediatr Crit Care Me · Jan 2016
Randomized Controlled Trial Multicenter StudyPatterns of Sedation Weaning in Critically Ill Children Recovering From Acute Respiratory Failure.
To characterize sedation weaning patterns in typical practice settings among children recovering from critical illness. ⋯ This study characterizes sedative administration practices for pediatric patients prior to and during weaning from sedation after critical illness. It provides a novel methodology for describing weaning in an at-risk pediatric population that may be helpful in future research on weaning strategies to prevent iatrogenic withdrawal syndrome.