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28 papers 25 to 100 followers
Erin K Stenson, Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie C Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Mark Hall, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Jocelyn R Grunwell, Hector R Wong
OBJECTIVE: Hyperchloremia is associated with poor outcome among critically ill adults, but it is unknown if a similar association exists among critically ill children. We determined if hyperchloremia is associated with poor outcomes in children with septic shock. DESIGN: Retrospective analysis of a pediatric septic shock database. SETTING: Twenty-nine PICUs in the United States. PATIENTS: Eight hundred ninety children 10 years and younger with septic shock...
February 2018: Pediatric Critical Care Medicine
Eugene M Dempsey, Afif Faisal El-Khuffash
Traditionally, cardiovascular well-being was essentially based on whether the mean blood pressure was above or below a certain value. However, this singular crude method of assessment provides limited insight into overall cardiovascular well-being. Echocardiography has become increasingly used and incorporated into clinical care. New objective modality assessments of cardiovascular status continue to evolve and are being evaluated and incorporated into clinical care. In this review article, we will discuss some of the recent advances in objective assessment of cardiovascular well-being, including the concept of multimodal monitoring...
January 2018: Archives of Disease in Childhood. Fetal and Neonatal Edition
James W Schurr, Paul M Szumita, Jeremy R DeGrado
Septic shock is a leading cause of mortality in intensive care units throughout the world. While this disease state represents a highly complex pathophysiology involving numerous organ systems, the early approach to care includes adequate hemodynamic support traditionally achieved via infusions of vasoactive medications after adequate fluid resuscitation. Relative adrenal and vasopressin deficiencies are a common feature of septic shock that contribute to impaired hemodynamics. Hydrocortisone and vasopressin are endocrine system hormone analogues that target the acute neuroendocrine imbalance associated with septic shock...
September 2017: Shock
Deidre St Peter, Christiana Gandy, Suma B Hoffman
BACKGROUND: In the premature neonate, there is no consensus regarding normal blood pressure (BP). The most common definition used is a mean arterial BP (MAP) less than the gestational age (GA); however, studies indicate that the neuroprotective mechanism of autoregulation is lost below a MAP of 30 mm Hg. OBJECTIVE: To determine whether hypotension defined as MAP <30 mm Hg or MAP less than the infant's GA better predicts adverse outcomes of intraventricular hemorrhage (IVH) and death...
2017: Neonatology
Bereketeab Haileselassie, Erik Su, Iraklis Pozios, Teresa Fiskum, Reid Thompson, Theodore Abraham
OBJECTIVES: In the progression of severe sepsis, sepsis-induced myocardial dysfunction contributes to severity of illness and ultimate mortality. Identification of sepsis-induced myocardial dysfunction causing depressed cardiac function during critical illness has implications for ongoing patient management. However, assessing pediatric cardiac function traditionally relies on echocardiographic qualitative assessment and measurement of left ventricular ejection fraction or fractional shortening...
May 2016: Pediatric Critical Care Medicine
Joshua W Salvin, Ronald Bronicki, John M Costello, Brady Moffett, David Procaccini
No abstract text is available yet for this article.
March 2016: Pediatric Critical Care Medicine
Darren Klugman, Elizabeth S Goswami, John T Berger
OBJECTIVE: Hypertension remains a common condition in pediatric cardiac intensive care. The physiologic effects of hypertension in this population are complex and are impacted by patient age, comorbidities, and primary cardiac disease. The objective of this study is to review current pharmacotherapies for the management of systemic hypertension in the pediatric cardiac ICU. DATA SOURCES: Relevant literature to the treatment of systemic hypertension in children was included...
March 2016: Pediatric Critical Care Medicine
Sebastian C Tume, Steven M Schwartz, Ronald A Bronicki
OBJECTIVES: To provide an evidence-based review of pharmacotherapies to treat acute heart failure. To accomplish this objective, we will discuss circulatory physiology, vasoactive agents, and their indications in the management of acute heart failure. DATA SOURCE: A MEDLINE-baseline review of the literature. CONCLUSIONS: The optimal selection of vasoactive agents requires a consideration of circulatory physiology and the tailored application of pharmacotherapies to treat patients with acute heart failure...
March 2016: Pediatric Critical Care Medicine
Joseph W Rossano, Antonio G Cabrera, John L Jefferies, M P H Maryam Y Naim, Timothy Humlicek
OBJECTIVE: Heart failure is a serious complication that can occur in patients with a variety of congenital and acquired disorders including congenital heart disease, cardiomyopathy, and myocarditis. Furthermore, heart failure patients comprise an increasing number of ICU admissions. Thus, it is important for those caring for patients with critical cardiovascular disease to have a thorough understanding of the medications used for the treatment of heart failure. The aim of this review is to provide an overview, rationale, indications, and adverse effects of medications used in the treatment of chronic heart failure...
March 2016: Pediatric Critical Care Medicine
Sarah Scarpace Lucas, Viviane G Nasr, Angelica J Ng, Charlene Joe, Meredyth Bond, James A DiNardo
OBJECTIVE: This article reviews pharmacotherapies currently available to manage sedation, analgesia, and neuromuscular blockade for pediatric cardiac critical patients. DATA SOURCES: The knowledge base of an expert panel of pharmacists, cardiac anesthesiologists, and a cardiac critical care physician involved in the care of pediatric cardiac critical patients was combined with a comprehensive search of the medical literature to generate the data source. STUDY SELECTION: The panel examined all studies relevant to management of sedation, analgesia, and neuromuscular blockade in pediatric cardiac critical patients...
March 2016: Pediatric Critical Care Medicine
Amy N McCammond, David M Axelrod, David K Bailly, E Zachary Ramsey, John M Costello
OBJECTIVE: In this Consensus Statement, we review the etiology and pathophysiology of fluid disturbances in critically ill children with cardiac disease. Clinical tools used to recognize pathologic fluid states are summarized, as are the mechanisms of action of many drugs aimed at optimal fluid management. DATA SOURCES: The expertise of the authors and a review of the medical literature were used as data sources. DATA SYNTHESIS: The authors synthesized the data in the literature in order to present clinical tools used to recognize pathologic fluid states...
March 2016: Pediatric Critical Care Medicine
Brady S Moffett, Joshua W Salvin, Jeffrey J Kim
OBJECTIVE: Arrhythmias are a common occurrence in critically ill pediatric patients. Pharmacotherapy is a usual modality for treatment and prevention of arrhythmias in this patient population. This review will highlight particular arrhythmias in the pediatric critical care population and discuss salient points of pharmacotherapy of these arrhythmias. The mechanisms of action for the various agents, potential adverse events, place in therapy, and evidence for their use will be summarized...
March 2016: Pediatric Critical Care Medicine
John S Kim, Julia McSweeney, Joanne Lee, Dunbar Ivy
OBJECTIVE: To review the pharmacologic treatment options for pulmonary arterial hypertension in the cardiac intensive care setting and summarize the most-recent literature supporting these therapies. DATA SOURCES AND STUDY SELECTION: Literature search for prospective studies, retrospective analyses, and case reports evaluating the safety and efficacy of pulmonary arterial hypertension therapies. DATA EXTRACTION: Mechanisms of action and pharmacokinetics, treatment recommendations, safety considerations, and outcomes for specific medical therapies...
March 2016: Pediatric Critical Care Medicine
Therese M Giglia, Char Witmer, David E Procaccini, Jonathan W Byrnes
OBJECTIVE: Thrombotic complications are increasingly being recognized as a significant cause of morbidity and mortality in pediatric and congenital heart disease. The objective of this article is to review the medications currently available to prevent and treat such complications. DATA SOURCES: Online searches were conducted using PubMed. STUDY SELECTION: Studies were selected for inclusion based on their scientific merit and applicability to the pediatric cardiac population...
March 2016: Pediatric Critical Care Medicine
Jayanta Banerjee, Terence S Leung, Narendra Aladangady
BACKGROUND: Extremely preterm infants receive frequent blood transfusions in the first week of life. The aim of this study was to measure the effect of blood transfusion on intestinal blood flow and oxygenation during the first week of life in extremely preterm infants. STUDY DESIGN AND METHODS: Superior mesenteric artery (SMA) peak systolic velocity (PSV) and diastolic velocities were measured 30 to 60 minutes before and after transfusion. Splanchnic tissue hemoglobin index (sTHI), splanchnic tissue oxygenation index (sTOI), and splanchnic fractional tissue oxygen extraction (sFTOE) were measured continuously from 15 to 20 minutes before to after transfusion along with vital variables...
April 2016: Transfusion
Amy Keir, Bernd Froessler, Simon Stanworth
No abstract text is available yet for this article.
February 2016: Archives of Disease in Childhood
J Michael Brewer, Michael A Puskarich, Alan E Jones
No abstract text is available yet for this article.
December 2015: Annals of Emergency Medicine
María Carmen Bravo, Paloma López-Ortego, Laura Sánchez, Joan Riera, Rosario Madero, Fernando Cabañas, Adelina Pellicer
OBJECTIVE: To gather information for a future confirmatory trial of dobutamine (DB) for circulatory impairment (ie, low superior vena cava [SVC] flow). STUDY DESIGN: A total of 127 infants born at < 31 weeks gestational age were serially scanned from birth to 96 hours after birth. The infants were randomly assigned to 2 groups and were treated with DB (stepwise dose increase, 5-10-15-20 μg/kg/min) or placebo if they had an SVC flow < 41 mL/kg/min within the first 24 hours after birth...
September 2015: Journal of Pediatrics
Istvan Seri, Shahab Noori
No abstract text is available yet for this article.
August 2015: Seminars in Fetal & Neonatal Medicine
Thomas Alderliesten, Petra M A Lemmers, Willem Baerts, Floris Groenendaal, Frank van Bel
BACKGROUND: The perfusion index (PI) derived from pulse oximetry readings represents the ratio of pulsatile (arterial blood) and nonpulsatile contributors to infrared light absorption. PI has been shown to correlate with cardiac performance. In theory, PI is readily available on every pulse oximeter; therefore, no additional sensors or infant handling are required. Currently, reference values are lacking in (preterm) neonates and the association with common clinical conditions is unclear...
2015: Neonatology
2015-03-04 05:54:26
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