Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2005
Multicenter StudyEvolution of the medical practices and modes of death on pediatric intensive care units in southern Brazil.
To study the possible change on mode of deaths, medical decision practices, and family participation on decisions for limiting life-sustaining treatments (L-LST) over a period of 13 yrs in three pediatric intensive care units (PICUs) located in southern Brazil. ⋯ We observed that the modes of deaths in southern Brazilian PICUs changed over the last 13 yrs, with an increment in L-LST. However, this change was not uniform among the studied PICUs and did not reach the levels described in countries of the Northern Hemisphere. Family participation in the L-LST decision-making process has increased over time, but it is still far behind what is observed in other parts of the world.
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Pediatr Crit Care Me · May 2005
Multicenter StudyExtubation failure in pediatric intensive care incidence and outcomes.
To evaluate the hypotheses that children requiring reintubation are at an increased risk of prolonged hospitalizations, congenital heart disease, and death compared with age- and disease-severity-matched control patients. ⋯ In the present trial, 4.1% of mechanically ventilated children failed extubation. Pediatric intensive care unit patients with failed extubation have longer hospital, pediatric intensive care unit, and ventilator courses but are not at increased risk of death relative to nonfailed extubation patients.
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Pediatr Crit Care Me · May 2004
Multicenter Study Comparative StudyForgoing life-sustaining treatments in children: a comparison between Northern and Southern European pediatric intensive care units.
This study was conducted to determine how the decision-making process to forgo life support differs between southern and northern European pediatric intensive care units. ⋯ The decision-making process appears to be similar between northern and southern European countries. The respective contributions of the parents and the medical staff in the final decision itself seem to be identical between northern and southern countries. However, in northern European countries, the level of parents' information about the decision-making process appears higher and the decision is more often documented in the medical chart.
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Pediatr Crit Care Me · Mar 2004
Multicenter Study Clinical TrialOropharyngeal aspiration in pediatric patients with endotracheal intubation.
To determine the prevalence and factors associated with oropharyngeal aspiration in pediatric patients submitted to mechanical ventilation and endotracheal intubation. ⋯ Aspiration around the tracheal tube is a frequent finding (28%) in children undergoing mechanical ventilation. The frequent swallowing movements and the orotracheal intubation route were significantly associated with aspiration. These results suggest that the nasotracheal intubation route could be recommended as the first choice for reducing this potential clinical complication.
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Pediatr Crit Care Me · Jan 2004
Multicenter Study Comparative StudySeverity of injury and mortality associated with pediatric blunt injuries: hospitals with pediatric intensive care units versus other hospitals.
To a) compare in-hospital mortality rates for pediatric (age <13 yrs) patients with blunt injuries in the New York State Trauma Registry based on hospital type (dedicated pediatric intensive care unit [PICU] and designated trauma centers and noncenters that do not have a dedicated PICU) for the purpose of determining whether there is a reduction in mortality at a specialty hospital and b) determine the extent to which high-risk patients are admitted to specialty hospitals. ⋯ There is significant triaging of the most seriously injured pediatric trauma inpatients to PICUs, and there is evidence that this policy is effective.