Archives of pediatrics & adolescent medicine
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Arch Pediatr Adolesc Med · Nov 2012
Multicenter StudyPhysiologic monitoring practices during pediatric procedural sedation: a report from the Pediatric Sedation Research Consortium.
To describe the frequency of different physiologic monitoring modalities and combinations of modalities used during pediatric procedural sedation; to describe how physiologic monitoring varies among different classes of patients, health care providers (ie, ranging from anesthesiologists to emergency medicine physicians to nurse practitioners), procedures, and sedative medications employed; and to determine the proportion of sedations meeting published guidelines for physiologic monitoring. DESIGN This was a prospective, observational study from September 1, 2007, through March 31, 2011. ⋯ A large degree of variability exists in the use of physiologic monitoring modalities for pediatric procedural sedation. Differences in monitoring are evident between sedation providers, medications, procedures, and patient types.
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Arch Pediatr Adolesc Med · Aug 2012
Multicenter StudyValidation and refinement of a prediction rule to identify children at low risk for acute appendicitis.
To validate and refine a clinical prediction rule to identify which children with acute abdominal pain are at low risk for appendicitis (Low-Risk Appendicitis Rule). ⋯ We have validated and refined a simple clinical prediction rule for pediatric appendicitis. For patients identified as being at low risk, clinicians should consider alternative strategies, such as observation or ultrasonographic examination, rather than proceeding to immediate computed tomographic imaging.
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Arch Pediatr Adolesc Med · Jul 2012
Randomized Controlled Trial Multicenter Study Comparative StudyVariation in intracranial pressure monitoring and outcomes in pediatric traumatic brain injury.
To describe between-hospital and patient-level variation in intracranial pressure (ICP) monitoring and to evaluate ICP monitoring in association with hospital features and outcome in children with traumatic brain injury (TBI). ⋯ There was significant between-hospital variation in ICP monitoring that cannot be attributed solely to differences in case mix. Hospitals that monitor ICP more frequently and hospitals with higher patient volumes had better patient outcomes. Infants with TBI are less likely to receive ICP monitoring than are older children.
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Arch Pediatr Adolesc Med · Jul 2012
Randomized Controlled Trial Multicenter Study Comparative StudyPrognostic utility of magnetic resonance imaging in neonatal hypoxic-ischemic encephalopathy: substudy of a randomized trial.
To investigate the effects of hypothermia treatment on magnetic resonance imaging (MRI) patterns of brain injury in newborns with hypoxic-ischemic encephalopathy compared with normothermia, including the prognostic utility of MRI for death and/or disability at a postnatal age of 2 years. ⋯ Brain injury on T1- and T2-weighted MRI is reduced in hypothermia-treated newborns. Abnormal MRI findings are prognostic of long-term outcome in moderate to severe hypoxic-ischemic encephalopathy regardless of treatment with hypothermia.
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Arch Pediatr Adolesc Med · Jun 2012
Multicenter StudyMulticenter study of neurodevelopment in 3-year-old children with and without single-suture craniosynostosis.
To evaluate the hypothesis that 3-year-old children with single-suture craniosynostosis would receive lower neurodevelopmental scores than a comparable group of children born with patent sutures. ⋯ In this large, carefully controlled, multicenter study, we observed consistently lower mean neurodevelopmental scores in children with single-suture craniosynostosis compared with controls. These results provide further support for neurodevelopmental screening in young children with single-suture craniosynostosis.