Articles: child.
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Review
Family presence during pediatric resuscitation: an integrative review for evidence-based practice.
Many pediatric health care institutions lack guidelines to address the presence of family members during resuscitation activities. This integrative literature review was used to establish an evidence-based approach that would compliment our institution's philosophy of "family centered care." The evidence supports a partnering with the families: Hospital staff ask families whether they want to be present during life-saving interventions by health care professions. ⋯ No literature was found to support beliefs that family member presence is harmful to the family or the institution. A practice policy is provided that respects family choice and presence during life-saving measures in pediatric care facilities.
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Curr Opin Crit Care · Feb 2004
ReviewMechanical ventilation in children with acute respiratory failure.
Acute respiratory failure requiring mechanical ventilation continues to contribute to mortality and affect long-term functional outcomes in patients admitted to the pediatric intensive care unit (ICU). Studies in adults with acute respiratory distress syndrome (ARDS) far outnumber those conducted in the pediatric age group, and pediatric intensivists are left with the task of carefully selecting and critically appraising relevant adult data and extrapolating results to their domain of practice. ⋯ Mechanical ventilation strategies aiming for optimal alveolar recruitment with the judicious use of positive end-expiratory pressure (PEEP) and low tidal volumes will remain the mainstay for managing respiratory failure in children. Dexamethasone may prevent postextubation stridor. Prone positioning, surfactant therapy, HFOV, and inhaled NO are used sporadically and need to be evaluated for their effect on mortality and duration of ventilation.