Pediatric clinics of North America
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Pediatr. Clin. North Am. · Jun 2013
ReviewAcute kidney injury in children: an update on diagnosis and treatment.
The concept and definition of acute kidney injury (AKI) in adults and children has undergone significant change in recent years. Biomarker assessment is aiding in description, defining and understanding timing of AKI. ⋯ Treatment remains problematic, but growing experience with pediatric continuous renal replacement therapies has improved the delivery of care in children. Increasingly, continuous renal replacement therapy is provided in combination with other extracorporeal technologies, and approaches are advancing to improve combined therapy use.
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Because pediatric intensive care units (PICUs) improve survival for a range of acute diseases, attention has turned toward ensuring the best possible functional outcomes after critical illness. The neurocritical care of children is of increasing interest. ⋯ This article reviews the special challenges faced by PICUs with regards to diseases, technologies, and skills and the progress that has been made in treatment, monitoring, and prognostication. Recent advances in translational research expected to modify the field in the near-term are described.
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Pediatr. Clin. North Am. · Jun 2013
A parents' perspective on the pediatric intensive care unit: our family's journey.
The pediatric intensive care unit (PICU) can be an intimidating and frightening place for parents and family members of critically ill children. Most parents experience a loss of control and feelings of utter helplessness. Many PICUs are working with family members to improve the quality of care provided through patient- and family-centered care, which is in fact 1 of the 6 tenets of the Institute of Medicine's definition of quality health care. However, as highlighted by the tragic and very personal experience described by one family, PICUs can and should be doing more to improve the patient and family experience.
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Pediatr. Clin. North Am. · Jun 2013
ReviewPediatric delirium: monitoring and management in the pediatric intensive care unit.
This review article updates the pediatric medical community on the current literature regarding diagnosis and treatment of delirium in critically ill children. This information will be of value to pediatricians, intensivists, and anesthesiologists in developing delirium monitoring and management protocols in their pediatric critical care units.
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Pediatr. Clin. North Am. · Jun 2013
ReviewFamily-centered care in the pediatric intensive care unit.
Patient-centered and family-centered care (PFCC) has been endorsed by many professional health care organizations. Although variably defined, PFCC is an approach to care that is respectful of and responsive to the preferences, needs, and values of individual patients and their families. Research regarding PFCC in the pediatric intensive care unit has focused on 4 areas including (1) family visitation; (2) family-centered rounding; (3) family presence during invasive procedures and cardiopulmonary resuscitation; and (4) family conferences. Although challenges to successful implementation exist, the growing body of evidence suggests that PFCC is beneficial to patients, families, and staff.