Pediatr Crit Care Me
-
Pediatr Crit Care Me · Mar 2011
Multicenter StudyDaily practice of mechanical ventilation in Italian pediatric intensive care units: a prospective survey.
To assess how children requiring endotracheal intubation are mechanically ventilated in Italian pediatric intensive care units (PICUs). ⋯ Mechanical ventilation is frequently used in Italian PICUs with almost one child of two requiring endotracheal intubation. Children treated with MV represent a more severe category of patients than children who are breathing spontaneously. Describing the standard care and how MV is performed in children can be useful for future clinical studies.
-
Pediatr Crit Care Me · Mar 2011
Multicenter StudyPerformance of the Pediatric Index of Mortality 2 for pediatric cardiac surgery patients.
To evaluate the performance of the Pediatric Index of Mortality 2 (PIM-2) for pediatric cardiac surgery patients admitted to the pediatric intensive care unit (PICU). ⋯ The PIM-2 demonstrated poor performance with fair discrimination, poor calibration, and predictive ability for pediatric cardiac surgery population and thus cannot be recommended in its current form as an adequate adjustment tool for quality measurement in this patient group.
-
Pediatr Crit Care Me · Jan 2011
Randomized Controlled Trial Multicenter StudyAdjunctive corticosteroid therapy in pediatric severe sepsis: observations from the RESOLVE study.
To assess whether corticosteroids, used as adjunctive therapy for pediatric severe sepsis, is associated with improved outcomes. ⋯ Children with severe sepsis who received adjunctive corticosteroid therapy exhibited similar illness severity compared with those who did not. No definitive improvement in outcomes can be attributable to adjunctive corticosteroid therapy in the largest pediatric sepsis trial conducted to date.
-
Pediatr Crit Care Me · Jan 2011
Multicenter StudyAcute kidney injury and renal replacement therapy independently predict mortality in neonatal and pediatric noncardiac patients on extracorporeal membrane oxygenation.
To determine the independent impact of acute kidney injury (AKI) and renal replacement therapy (RRT) in infants and children who receive extracorporeal membrane oxygenation. Despite continued expertise/technological advancement, patients who receive extracorporeal membrane oxygenation have high mortality. AKI and RRT portend poor outcomes independent of comorbidities and illness severity in several critically ill populations. ⋯ After adjusting for known predictors of mortality, AKI and RRT independently predict mortality in neonates and children, who receive extracorporeal membrane oxygenation. Ascertainment of AKI risk factors, testing novel therapies, and optimizing the timing/delivery of RRT may positively impact survival.
-
Pediatr Crit Care Me · Nov 2010
Comment Multicenter Study Comparative StudyComparison of the effectiveness and safety of two insulin infusion protocols in the management of hyperglycemia in critically ill children.
To compare the effectiveness and safety of a paper-based and a computerized algorithm used for tight glycemic control. ⋯ YIIP is less effective but is as safe as ePi in achieving tight glycemic control. We are awaiting the results of two multicenter trials designed to determine the survival benefit of tight glycemic control in children. Further studies are needed to determine the clinical significance of the different glucose metrics in critically ill patients.