Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2013
Multicenter Study Comparative StudyThe ideal time interval for critical care severity-of-illness assessment.
Determine if the shortest sampling interval for laboratory variables used to estimate baseline severity of illness in pediatric critical care is equivalently sensitive across multiple sites without site-specific bias, while accounting for the vast majority of dysfunction compared with the standard 0- to 12-hour Pediatric Risk of Mortality III score. ⋯ Prognostically important laboratory physiologic data collected within the interval from 2 hours prior to PICU to admission through 4 hours after admission account for the vast majority of dysfunction that these variables would contribute to Pediatric Risk of Mortality III scores. There was no institutional bias associated with this sampling period.
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Pediatr Crit Care Me · Jun 2013
Multicenter Study Comparative StudyUsing administrative data for mortality risk adjustment in pediatric congenital cardiac surgery.
To evaluate the performance of risk-adjustment models from the University HealthSystem Consortium and the Agency for Healthcare Research Quality on an administrative dataset for children undergoing congenital cardiac surgery. ⋯ Administrative data can be used to create risk-adjustment models in the congenital cardiac surgery population. Risk-adjustment models generated from administrative data may represent an attractive addition to clinically derived models in pediatric congenital cardiac surgery patients and should be considered for use either alone or in combination with clinical data in future analyses where mortality is a measure of performance and quality.
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Pediatr Crit Care Me · Jun 2013
Multicenter StudyAre pediatric critical care medicine fellowships teaching and evaluating communication and professionalism?
To describe the teaching and evaluation modalities used by pediatric critical care medicine training programs in the areas of professionalism and communication. ⋯ A wide range of techniques are currently used within pediatric critical care medicine to teach communication and professionalism, but there are a number of required elements that are not specifically taught by fellowship programs. These areas of deficiency represent opportunities for future investigation and improved education in the important competencies of communication and professionalism.
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Pediatr Crit Care Me · May 2013
Multicenter StudyCritical pertussis illness in children: a multicenter prospective cohort study.
Pertussis persists in the United States despite high immunization rates. This report characterizes the presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, and critical care therapies among children requiring admission to the PICU. ⋯ Pulmonary hypertension may be associated with mortality in pertussis critical illness. Elevated WBC is associated with the need for mechanical ventilation, pulmonary hypertension, and mortality risk. Research is indicated to elucidate how pulmonary hypertension, immune responsiveness, and elevated WBC contribute to morbidity and mortality and whether leukoreduction might be efficacious.
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Pediatr Crit Care Me · Mar 2013
Multicenter StudyA multicenter outcomes analysis of children with severe viral respiratory infection due to human metapneumovirus.
To investigate the impact of human metapneumovirus on morbidity and mortality outcomes in children with severe viral respiratory infection. ⋯ Analysis of our results suggests that there is substantial morbidity and mortality associated with severe viral respiratory infection due to human metapneumovirus in children. Female gender, hospital acquisition of human metapneumovirus infection, and presence of chronic medical conditions each independently increases mortality. The burden of illness from human metapneumovirus on the ICU in terms of resource utilization may be considerable.