Pediatr Crit Care Me
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Pediatr Crit Care Me · Aug 2023
Randomized Controlled TrialThe Effects of Expectation Setting and Bundle Consent on Acute Caregiver Stress in the PICU: A Randomized Controlled Trial.
Having a child admitted to the PICU is a stressful experience for parents and can have long-term negative mental health consequences. The objective was to determine if formalized expectation setting and bundled consent for invasive procedures upon admission impacts the acute stress burden on parents. ⋯ This study did not demonstrate a decrease in stress when bundled consent was obtained. However, this intervention decreased the parents' perceived severity of illness. Further multicenter studies are needed to evaluate the effects of bundled consent on parents.
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Pediatr Crit Care Me · Nov 2023
Critical Care Unit Characteristics and Extracorporeal Cardiopulmonary Resuscitation Survival in the Pediatric Cardiac Population: Retrospective Analysis of the Virtual Pediatric System Database.
Existing literature provides limited data about ICU characteristics and pediatric extracorporeal cardiopulmonary resuscitation (E-CPR) outcomes. We aimed to evaluate the associations between patient and ICU characteristics, and outcomes after E-CPR in the pediatric cardiac population. ⋯ The overall prevalence of E-CPR among critically ill children with cardiac disease observed in the VPS database is low. We failed to identify an association between ICU cohort type and survival. Further investigation into organizational factors is warranted.
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Pediatr Crit Care Me · Jan 2024
Pulmonary Hemorrhage in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Single-Center Retrospective Study.
Pulmonary hemorrhage (PH) is a serious complication posthematopoietic stem cell transplant (HSCT). In view of limited available pediatric data, we performed a retrospective study to describe epidemiology, management, and outcomes of PH post-HSCT in children in our national center. ⋯ PH is a rare but serious complication after HSCT. Corticosteroids were associated with improved survival even in patients with a concomitant infection.
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Pediatr Crit Care Me · Jan 2024
Meta AnalysisPerformance of Tools and Measures to Predict Fluid Responsiveness in Pediatric Shock and Critical Illness: A Systematic Review and Meta-Analysis.
In this systematic review and meta-analysis we asked: Do predictors of fluid responsiveness in children perform comparably: 1) in the PICU as in non-PICU settings? 2) in shock states compared with nonshock states? Additionally, 3) is there an association between preload responsiveness and clinical response? ⋯ We suggest three opportunities for further research in fluid responsiveness in children: 1) assessing predictive performance of tools during resuscitation in shock states; 2) separating predictive tool from reference test when using ultrasound techniques; and 3) targeting decreasing time in a shock state, rather than just increase in preload.
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Pediatr Crit Care Me · Aug 2023
ReviewEnteral Nutrition During Extracorporeal Membrane Oxygenation in the Neonatal and Pediatric Populations: A Literature Review.
The number of infants and children requiring extracorporeal membrane oxygenation (ECMO) is rising. While critically ill, providers may believe that enteral nutrition puts the patient at risk for severe complications such as necrotizing enterocolitis. However, enteral nutrition is associated with the potential to improve the gut barrier and reduce the risk of morbidity and mortality. The purpose of this article is to review the existing evidence about providing exclusive enteral and parenteral nutrition and its association with rates of complications and mortality in critically ill neonatal and pediatric populations on ECMO. ⋯ The use of enteral nutrition in the neonatal and pediatric population while on ECMO has the potential to improve survival rates and reduce complications. Further studies are needed to investigate how to optimize this population's nutrition and develop feeding protocols and pathways.