Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2014
Multicenter StudyAcute Rehabilitation Practices in Critically Ill Children: A Multicenter Study.
To evaluate acute rehabilitation practices in pediatric critical care units across Canada. ⋯ Only half of the children receive rehabilitation while in the pediatric critical care unit, and when it occurs, therapy is primarily focused on respiratory function. Mobilization appears to be reserved for at-risk children who were muscle relaxed and sedated; however, its implementation in these patients is delayed. Future pediatric-specific research is essential to identify patients at risk and to understand treatment priorities and rehabilitation strategies to improve functional recovery in critically ill children.
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Pediatr Crit Care Me · Jul 2014
Randomized Controlled Trial Multicenter StudyContinuous Infusion of Clonidine in Ventilated Newborns and Infants: A Randomized Controlled Trial.
To assess the influence of an infusion of clonidine 1 μg/kg/hr on fentanyl and midazolam requirement in ventilated newborns and infants. ⋯ Clonidine 1 μg/kg/hr in ventilated newborns reduced fentanyl and midazolam demand with deeper levels of analgesia and sedation without substantial side effects. This was not demonstrated in older infants, possibly due to lower clonidine serum levels.
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Pediatr Crit Care Me · Jul 2014
Multicenter StudyVasoactive-Inotropic Score Is Associated With Outcome After Infant Cardiac Surgery: An Analysis From the Pediatric Cardiac Critical Care Consortium and Virtual PICU System Registries.
To empirically derive the optimal measure of pharmacologic cardiovascular support in infants undergoing cardiac surgery with bypass and to assess the association between this score and clinical outcomes in a multi-institutional cohort. ⋯ Maximum vasoactive-inotropic score calculated in the first 24 hours after cardiac ICU admission was strongly and significantly associated with morbidity and mortality in this multi-institutional cohort of infants undergoing cardiac surgery. Maximum vasoactive-inotropic score more than or equal to 20 predicts an increased likelihood of a poor composite clinical outcome. The findings were consistent in stratified analyses by age and surgical complexity.
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Pediatr Crit Care Me · Jul 2014
Multicenter StudyExtracorporeal Membrane Oxygenation-Supported Cardiopulmonary Resuscitation Following Stage 1 Palliation for Hypoplastic Left Heart Syndrome.
To report on survival from a large multicenter cohort of neonates with hypoplastic left heart syndrome requiring extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation after stage 1 palliation operation. ⋯ Mortality for neonates with hypoplastic left heart syndrome supported with extracorporeal membrane oxygenation-assisted cardiopulmonary resuscitation after stage 1 palliation is high. Lower body weight, increased duration of extracorporeal membrane oxygenation support, and renal failure increased mortality.
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Pediatr Crit Care Me · May 2014
Multicenter StudyParental Perspectives on Suffering and Quality of Life at End-of-Life in Children With Advanced Heart Disease: An Exploratory Study.
To describe parent perspectives regarding the end-of-life experience of children with advanced heart disease. ⋯ According to their parents, many children with advanced heart disease experience suffering in the end-of-life care period. For most, realization that their child has no realistic chance of survival does not occur until late, some not until death is imminent. Once this realization occurs, however, parents perceive peacefulness, a "good death," and excellent quality of care. Strategies for improved communication around symptom management, quality of life, prognosis, and advance care planning are needed for families of children with advanced heart disease.