Pediatr Crit Care Me
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Pediatr Crit Care Me · Jul 2005
Multicenter Study Comparative StudyGram-negative bacilli associated with catheter-associated and non-catheter-associated bloodstream infections and hand carriage by healthcare workers in neonatal intensive care units.
Bloodstream infections caused by Gram-negative bacilli are a substantial cause of morbidity and mortality in infants in neonatal intensive care units. This study describes the species of Gram-negative bacilli causing bloodstream infections in two neonatal intensive care units, compares characteristics of catheter-related and non-catheter-related bloodstream infections, and compares species and antibiotic resistance patterns of these organisms with those isolated from the hands of nurses working in the same neonatal intensive care units. ⋯ Gram-negative bacilli species isolated from neonatal bloodstream infections and nurses' hands varied significantly. Clean hands of providers are an unlikely source of endemic Gram-negative bacilli, suggesting that prevention strategies should focus more on control of endogenous neonatal flora or environmental sources.
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Pediatr Crit Care Me · Jul 2005
Comment ReviewCritical appraisal of Perez et al: Jugular venous oxygen saturation or arteriovenous difference of lactate content and outcome in children with severe traumatic brain injury.
To review the findings and discuss the implications of jugular venous bulb oxygenation monitoring in children with severe traumatic brain injury. ⋯ This study is the first to demonstrate that jugular venous monitoring may aid in predicting the neurologic outcome of children with severe traumatic brain injury. More studies need to be performed (particularly on safety) before adopting jugular venous bulb oxygenation monitoring as a prediction tool or, ultimately, as a therapeutic intervention to help manage and improve outcome for children with severe traumatic brain injury.
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Pediatr Crit Care Me · Jul 2005
Comparative Study Clinical TrialTissue Doppler echocardiographic and color M-mode estimation of left atrial pressure in infants.
Using recorded flow and tissue Doppler, we evaluated the relation of peak velocity of early transmitral Doppler filling (E)/early diastolic velocity of the lateral mitral annulus (Ea) ratio and of E/flow propagation velocity (Vp) ratio to mean left atrial pressure in infants after surgery for congenital heart disease. ⋯ Doppler ratios might be considered as promising noninvasive tools for left atrial pressure evaluation in infants after cardiac surgery.
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Pediatr Crit Care Me · Jul 2005
Recombinant factor VII for severe bleeding during extracorporeal membrane oxygenation following open heart surgery.
Severe bleeding is a recognized complication during mechanical cardiopulmonary support with extracorporeal membrane oxygenation. We present the use of recombinant activated factor VII (rFVIIa) for severe, refractory bleeding during extracorporeal membrane oxygenation support after open-heart surgery for congenital heart disease. ⋯ rFVIIa is effective to achieve control of refractory hemorrhage in patients on extracorporeal membrane oxygenation. Now a randomized controlled trial to evaluate risks and benefits of rFVIIa on patients undergoing extracorporeal membrane oxygenation is required.
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Pediatr Crit Care Me · Jul 2005
Clinical TrialUtility of airway exchange catheters in pediatric patients with a known difficult airway.
To evaluate the utility of the Cook airway exchange catheter (CAEC) for extubation/reintubation in pediatric patients with a known difficult airway. ⋯ In children with a known difficult airway who are at risk for a difficult reintubation, the CAEC is a useful tool for a trial of extubation in the intensive care unit.