Articles: intensive-care-units.
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To summarize the nursing experience of treating pediatric fulminant myocarditis with extracorporeal membrane oxygenation (ECMO). The intensive care unit of our hospital treated 6 children with fulminant myocarditis with ECMO from 2019 to 2022. ⋯ One child's family abandoned treatment and left the hospital, while the other 5 children were transferred to the cardiovascular department after stable weaning from ECMO and continued treatment, with good condition, and eventually discharged. Pediatric fulminant myocarditis has a high mortality rate, but detailed evaluation and nursing care can improve the outcome of these patients.
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Anaphylaxis is an acute multisystem syndrome typically resulting from the sudden release of mast cell and basophil-derived mediators into the circulatory system. Isosulfan blue dye is a rare, but known, mediator of anaphylaxis with an incidence between 0.16% and 2% of cases. ⋯ Both of the patients we report had grade 3 anaphylactic reactions requiring vasopressors to correct significant hypotension. Both patients required overnight monitoring in the intensive care unit with the second patient also requiring continued vasopressor support.
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Understanding the variation in training and nuances of trauma provider practice between the countries in Europe and the United States is a daunting task. This article briefly reviews the key specialties of trauma care in Europe including emergency medical services (EMS), emergency medicine, anesthesia, trauma surgery, and critical care. The authors hope to inform U. ⋯ Because of the historical predominance of blunt trauma in Europe, in many countries, trauma surgery is a subspecialty with initial orthopedic surgery training versus general surgery. Intensive care medicine has various training pathways across Europe, but there have been great advances in standardizing competency requirements across the European Union. Finally, the authors suggest some strategies to mitigate the potential negative consequences of joint medical teams and how to leverage some key differences to advance life-saving medical interoperability across the North Atlantic Treaty Organization alliance.
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Critical care medicine · Nov 2023
Case Reports Multicenter StudyPrevalence and Characteristics of Diagnostic Error in Pediatric Critical Care: A Multicenter Study.
Effective interventions to prevent diagnostic error among critically ill children should be informed by diagnostic error prevalence and etiologies. We aimed to determine the prevalence and characteristics of diagnostic errors and identify factors associated with error in patients admitted to the PICU. ⋯ Among critically ill children, 1.5% had a diagnostic error up to 7 days after PICU admission. Diagnostic errors were associated with atypical presentations and diagnostic uncertainty on admission, suggesting possible targets for intervention.
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Acta Anaesthesiol Scand · Nov 2023
The relationship between ICU survivorship, comorbidity and educational level in quality of life after intensive care.
ICU survivors have lower quality of life (QoL) compared to a non-ICU-treated population. The reason for this is not fully understood, but differences in baseline characteristics may be an important factor. This study evaluates the roles of comorbidity and educational level as possible explanatory factors for differences in QoL in ICU survivors compared to a non-ICU-treated population. ⋯ Lower QoL seen in ICU survivors compared to non-ICU-treated controls, as measured by our provisional questionnaire, cannot be explained only by a higher burden of comorbidity, and rarely by only educational level. In issues where comorbidity or educational level was associated to QoL, it often was so in parallel to an association from belonging to the ICU survivor group. Comparing QoL in ICU survivors to that of a non-ICU-treated population may be adequate despite differences in baseline characteristics.