Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies最新文献

{"title":"Editor's Choice Articles for July.","authors":"Robert C Tasker","doi":"10.1097/PCC.0000000000003013","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003013","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"481-483"},"PeriodicalIF":4.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beta-Lactams in Critically Ill Children: Time to Step Up Our Game?","authors":"Céline Thibault, Amélie Marsot, Julie Autmizguine","doi":"10.1097/PCC.0000000000002982","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002982","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"568-570"},"PeriodicalIF":4.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"If You Build It, They Will Come…But Why Do They Come?","authors":"Neethi P Pinto, Vijay Srinivasan","doi":"10.1097/PCC.0000000000002983","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002983","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"557-559"},"PeriodicalIF":4.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound Technology: Providing \"More\" for Research and Clinical Care in Low-Resource Settings.","authors":"Thomas W Conlon, Adam S Himebauch, Erin M Stratta, Vijay Srinivasan","doi":"10.1097/PCC.0000000000002984","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002984","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"560-562"},"PeriodicalIF":4.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40478610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Characteristics of Patients With 22q11 Deletion Undergoing Pulmonary Artery Reconstruction Surgery: Retrospective Cohort Study.","authors":"Danielle Sganga,&nbsp;Kara Meister,&nbsp;Douglas R Sidell,&nbsp;Lisa Wise-Faberowski,&nbsp;Jennifer Shek,&nbsp;Michael Ma,&nbsp;Elisabeth Martin,&nbsp;Frank L Hanley,&nbsp;Doff McElhinney,&nbsp;Ritu Asija","doi":"10.1097/PCC.0000000000002921","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002921","url":null,"abstract":"<p><strong>Objectives: </strong>We have previously shown that patients with a chromosome 22q11 microdeletion are at risk for prolonged respiratory failure after pulmonary artery reconstruction surgery compared with those with normal genotype. We sought to describe preexisting airway abnormalities in this patient population and examine relationships between airway abnormalities and outcomes.</p><p><strong>Design: </strong>Single-center retrospective chart review from Society of Thoracic Surgery and Pediatric Cardiac Critical Care Consortium databases and the electronic medical record.</p><p><strong>Setting: </strong>Lucile Packard Children's Hospital at Stanford from September 2017 to February 2019.</p><p><strong>Patients: </strong>All patients undergoing pulmonary artery reconstruction surgery were considered for inclusion.</p><p><strong>Interventions: </strong>We identified 127 patients meeting study inclusion criteria. Thirty-nine patients met specific criteria and underwent screening preoperative bronchoscopy including microdirect laryngoscopy and lower airway examination. Postoperative bronchoscopy was performed at the discretion of the intensive care team.</p><p><strong>Measurements and main results: </strong>Airway abnormalities were detected in 25/26 of children (96%) with a chromosome 22q11 deletion who underwent preoperative bronchoscopy. Upper and lower airway pathologies were found in 19/25 (73%) and 21/25 (81%) patients, respectively, and it was common for patients to have more than one abnormality. Presence of 22q11 deletion was associated with longer duration of mechanical ventilation (9.1 vs 4.3 d; p = 0.001), use of noninvasive positive pressure support (13 vs 6 d; p = 0.001), and longer hospital stays (30 vs 14 d; p = 0.002). These outcomes were worse when compared with patients with known airway abnormalities who did not have 22q11 deletion.</p><p><strong>Conclusions: </strong>Preexisting upper and lower airway pathologies are common in patients with a chromosome 22q11 deletion who undergo pulmonary artery reconstruction surgery. Despite similar postoperative hemodynamics and outcomes as their counterparts without 22q11 deletion, 22q11 deletion is associated with more postoperative respiratory complications not entirely explained by preexisting airway abnormalities.</p>","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"371-377"},"PeriodicalIF":4.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39961114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing Is Everything.","authors":"Daniel P Mahoney","doi":"10.1097/PCC.0000000000002887","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002887","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"383-384"},"PeriodicalIF":4.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39778306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weaning Dexmedetomidine in Non-ICU Areas: An Implementation Effort.","authors":"Jean C Solodiuk,&nbsp;Erin Sweet,&nbsp;Christine Greco,&nbsp;Shannon F Manzi,&nbsp;Maeve Giangregorio,&nbsp;Adam Homoki,&nbsp;Liza Li,&nbsp;Laura Mansfield,&nbsp;Judy Mahoney,&nbsp;Monica E Kleinman","doi":"10.1097/PCC.0000000000002889","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002889","url":null,"abstract":"<p><strong>Objectives: </strong>To develop and implement clinical practice guidelines for safely weaning dexmedetomidine infusions in non-ICU areas.</p><p><strong>Design: </strong>Development, implementation, and analysis of effectiveness of clinical practice guidelines.</p><p><strong>Setting: </strong>Quaternary care academic free-standing pediatric hospital.</p><p><strong>Patients: </strong>Children, otherwise medically ready for transfer to non-ICU areas, who were undergoing a planned wean of a dexmedetomidine infusion.</p><p><strong>Interventions: </strong>Subject matter experts developed evidence-based guidelines for weaning dexmedetomidine in patients whose critical phase of illness had resolved.</p><p><strong>Measurements and main results: </strong>Searches identified no prospective studies of dexmedetomidine weaning. We identified two retrospective reviews of withdrawal symptoms and one on the use of clonidine. There were case studies on withdrawal symptoms. Guidelines were piloted on a cohort of 24 patients while in the ICU. The guidelines were then implemented in non-ICU areas for patients undergoing dexmedetomidine weaning after ICU transfer. Over a 2-year period (October 1, 2018, to September 30, 2020), 63 patients (1 mo to 18 yr old) successfully weaned dexmedetomidine in non-ICU areas. The median time to discontinuation of dexmedetomidine after transfer to non-ICU areas was 5.8 days (interquartile range, 4.75-15 d). Fifty-eight percent (n = 41) of all patients were considered high risk for dexmedetomidine withdrawal based on the dose, duration of exposure, and the risk of experiencing physiologic detriment with more than mild withdrawal. Twenty-nine patients (46%) exhibited no signs or symptoms of withdrawal while weaning per guidelines. For those with signs and symptoms of withdrawal, the most common were tachycardia (n = 26, 40%), agitation (n = 9, 14%), and hypertension (n = 9, 11%).</p><p><strong>Conclusions: </strong>Weaning dexmedetomidine in non-ICU areas is feasible and can be accomplished safely even among pediatric patients at high risk for withdrawal using standardized weaning guidelines. At our institution, implementation was associated with reduced ICU length of stay for patients recovering from critical illness.</p>","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"353-360"},"PeriodicalIF":4.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39791021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Online Abstract Translations.","authors":"","doi":"10.1097/PCC.0000000000002893","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002893","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"e120-e125"},"PeriodicalIF":4.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39586431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do We Need to Reframe Our Approach to Short-Term Outcomes in the Cardiac ICU?","authors":"Justin J Elhoff","doi":"10.1097/PCC.0000000000002875","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002875","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"140-143"},"PeriodicalIF":4.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39586429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Choice Articles for February.","authors":"Robert C Tasker","doi":"10.1097/PCC.0000000000002899","DOIUrl":"https://doi.org/10.1097/PCC.0000000000002899","url":null,"abstract":"","PeriodicalId":520744,"journal":{"name":"Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies","volume":" ","pages":"77-78"},"PeriodicalIF":4.1,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39888973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}