Pediatr Crit Care Me
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Pediatr Crit Care Me · May 2006
Evaluation of a noninvasive cardiac output monitor in mechanically ventilated children.
To compare measurements of cardiac output (CO) and cardiac index (CI) obtained by a recently developed noninvasive continuous cardiac output system, NICO (CONICO), and transthoracic Doppler echocardiography (COTTE) in mechanically ventilated children. ⋯ The NICO system is a new device that measures CO easily and automatically in mechanically ventilated children weighing >15 kg. CO values obtained with this technique were in agreement with those obtained with Doppler echocardiography in children in respiratory and hemodynamic stable condition. The NICO system needs further investigation in children in unstable respiratory and hemodynamic condition.
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Pediatr Crit Care Me · May 2006
Case ReportsHeparin-induced thrombocytopenia in a pediatric patient receiving extracorporeal support and treated with argatroban.
Heparin-induced thrombocytopenia (HIT) is rare in the pediatric population, with a majority occurring in the pediatric intensive care unit setting. All reported cases have been associated with the use of unfractionated heparin. Because unfractionated heparin is the anticoagulant of choice for extracorporeal life support, the development of HIT in these patients can be devastating. We report a case of HIT with evidence of small-vessel arterial thromboembolism in a 17-month-old child receiving extracorporeal membrane oxygenation and continuous renal replacement therapy successfully treated with argatroban. ⋯ This report documents a pediatric case of HIT successfully treated with argatroban, allowing continuation of the venovenous extracorporeal membrane oxygenation and continuous renal replacement therapy, with resolution of the thromboembolic ischemia and thrombocytopenia.
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Pediatr Crit Care Me · May 2006
Uncuffed endotracheal tubes should not be used in seriously burned children.
To document a complication associated with placement of uncuffed endotracheal tubes in seriously burned children. ⋯ If children are critically burned and expected to require more than transient mechanical ventilatory support, low-pressure cuffed endotracheal tubes should be placed, regardless of the child's age.
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To evaluate the effect of a Web-based calculator and decision-support system on infusion ordering errors and to estimate error frequency in pharmacy infusion preparation. ⋯ A Web-based calculator reduced significantly the total number of errors and eliminated all high-risk errors in the prescribing process for continuous pediatric infusions. With no observed errors in pharmacy preparation, this study provides data to support the use of computerized ordering as an independent safe and viable method for ordering continuous pediatric infusions.
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Pediatr Crit Care Me · May 2006
Case ReportsGenetic deafness in a preterm infant with a critical postnatal course.
We present a case of deafness in a preterm infant with several predisposing factors of an acquired hearing impairment that, however, turned out to have a genetic cause. We describe the severe postnatal course and review the relevant literature. ⋯ To elucidate the nature of a hearing disorder, it is worthwhile to consider a genetic cause, despite the fact that it may seem unlikely in a severely sick preterm infant with numerous risk factors for a postnatally acquired hearing impairment and without a positive family history.