Pediatr Crit Care Me
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Pediatr Crit Care Me · Jan 2003
Comparative StudySedation monitoring of children by the Bispectral Index in the pediatric intensive care unit.
To compare the Bispectral Index with clinical sedation assessment using the Ramsay score in normal sedated and paralyzed critically ill children. ⋯ The Bispectral Index correlates well with the Ramsay score in the normal sedated child. The Ramsay score and bedside nurse assessment are inadequate for monitoring the depth of sedation in paralyzed children. The Bispectral Index is a useful adjunct in assessing sedation in a paralyzed patient.
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Pediatr Crit Care Me · Jan 2003
Nosocomial urinary tract infections in children in a pediatric intensive care unit: a follow-up after 10 years.
To define nosocomial urinary tract infection (NUTI) rates in a pediatric intensive care unit, and determine whether practice recommendations have been sustained after 10 yrs. ⋯ NUTIs in children in our pediatric intensive care unit were associated with previous cardiovascular surgery and with urinary tract catheterization of at least 3 days. The need for careful fluid monitoring by catheterization must be balanced against the increased risk of catheter-related urinary tract infection. Removal of urinary catheters at the earliest opportunity will prevent many infections. Ongoing education or innovative strategies will be required to sustain optimal practice.
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Pediatr Crit Care Me · Jan 2003
Intrapleural instillation of fibrinolytic agents for treatment of pleural empyema.
To describe the use of intrapleural instillation of fibrinolytic agents as adjunctive therapy for children with complicated pleural effusions and empyema. ⋯ Intrapleural instillation of fibrinolytic agents appears to be an effective and less invasive alternative to surgical drainage for children who have complicated pleural effusions or empyemas that do not drain adequately with tube thoracostomy alone.
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Pediatr Crit Care Me · Jan 2003
Ductus arteriosus with left-to-right shunt during venoarterial extracorporeal membrane oxygenation: effects on cerebral oxygenation and hemodynamics.
To investigate the effect on cerebral oxygenation and hemodynamics of a patent ductus arteriosus with left-to-right shunt during venoarterial extracorporeal membrane oxygenation in a lamb model. ⋯ In this lamb model, a considerable left-to-right shunt over the ductus during venoarterial extracorporeal membrane oxygenation reduced cerebral circulation and oxygenation.
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Pediatr Crit Care Me · Jan 2003
Case ReportsSubarachnoid hemorrhage in a child with status asthmaticus: significance of permissive hypercapnia.
To report an 11-yr-old boy with acute status asthmaticus being managed with permissive hypercapnia who developed a subarachnoid hemorrhage during the course of his illness. ⋯ We conclude that this patient suffered subarachnoid hemorrhage in association with the use of permissive hypercapnia in the settling of severe asthma.