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The use of methadone to facilitate opioid weaning in pediatric critical care patients: a systematic review of the literature and meta ‐analysis
ConclusionWe did not identify sufficient evidence to recommend any particular methadone weaning strategy, or to recommend methadone over other medications or prescribed infusion weaning, for successful weaning of continuous opioid infusions in the pediatric intensive care setting.
Source: Pediatric Anesthesia - January 21, 2017 Category: Anesthesiology Authors: Leslie A. Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M. Wolf Tags: Systematic Review Source Type: research

Reducing Ischemic Injury From Indwelling Peripheral Arterial Catheters in a Pediatric Cardiac ICU: A Quality Improvement Initiative*
Conclusions: Implementation of a quality improvement initiative and changing local practices reduced arterial catheter–associated harm in children with congenital and acquired heart disease requiring care in a cardiac ICU.
Source: Pediatric Critical Care Medicine - March 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Reorganizing Care With the Implementation of Electronic Medical Records: A Time-Motion Study in the PICU*
Conclusions: The reorganization of care with the implementation of an ICU-specific electronic medical record in the PICU did not change total patient care provided but improved nursing productivity, resulting in improved efficiency. Documentation time was significantly increased, and concern over reduced oral communication arose, which should be a focus for future electronic improvement strategies.
Source: Pediatric Critical Care Medicine - April 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Augmented intelligence in pediatric anesthesia and pediatric critical care
This article briefly explores recent work in the areas of automation, artificial intelligence and outcome prediction models in pediatric anesthesia and pediatric critical care. Recent findings Recent years have yielded little published research into pediatric physiological closed loop control (a type of automation) beyond studies focused on glycemic control for type 1 diabetes. However, there has been a greater range of research in augmented decision-making, leveraging artificial intelligence and machine-learning techniques, in particular, for pediatric ICU outcome prediction. Summary Most studies focusing on artific...
Source: Current Opinion in Anaesthesiology - May 13, 2020 Category: Anesthesiology Tags: PEDIATRIC ANESTHESIA: Edited by Jorge A. Gálvez Source Type: research

Near-Infrared Spectroscopy and Vascular Occlusion Test for Predicting Clinical Outcome in Pediatric Cardiac Patients: A Prospective Observational Study
This study is designed to determine the feasibility and utility of vascular occlusion test variables as measured by INVOS (Medtronic, Dublin, Ireland) in pediatric cardiac patients. Design: A prospective observational study. Setting: A tertiary children’s hospital. Patients: Children less than or equal to 8 years old who were scheduled for elective cardiac surgery under cardiopulmonary bypass. Interventions: A vascular occlusion test (3 min of ischemia and reperfusion) was performed on the calf at three time points: after induction of anesthesia (T0), during cardiopulmonary bypass (T1), and after sternal cl...
Source: Pediatric Critical Care Medicine - January 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Changes in Anesthetic and Postoperative Sedation–Analgesia Practice Associated With Early Extubation Following Infant Cardiac Surgery: Experience From the Pediatric Heart Network Collaborative Learning Study*
Objectives: The Pediatric Heart Network sponsored the multicenter Collaborative Learning Study that implemented a clinical practice guideline to facilitate early extubation in infants after repair of isolated coarctation of the aorta and tetralogy of Fallot. We sought to compare the anesthetic practice in the operating room and sedation-analgesia management in the ICU before and after the implementation of the guideline that resulted in early extubation. Design: Secondary analysis of data from a multicenter study from January 2013 to April 2015. Predefined variables of anesthetic, sedative, and analgesia exposure were...
Source: Pediatric Critical Care Medicine - October 1, 2019 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Development of an Undergraduate Medical Education Critical Care Content Outline Utilizing the Delphi Method
Conclusions: This study provides a national consensus undergraduate medical education critical care content outline. By including experts from multiple specialties, this content outline is meaningful for medical student education, independent of medical specialty. The content outline represents a first step in the development of a national undergraduate medical education critical care curriculum.
Source: Critical Care Medicine - December 14, 2019 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Cardiovascular Critical Care: A Perceived Deficiency Among U.S. Trainees*
Conclusions: Current critical care fellows may be unprepared to deal with the increasing prevalence of cardiovascular illness in the ICU. This potential educational gap warrants timely attention to ensure that future graduates have the requisite skills necessary to manage these critically ill patients and presents a unique opportunity to develop multidisciplinary partnerships for enhancing training.
Source: Critical Care Medicine - August 15, 2015 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Emergency Medicine/Critical Care Medicine (EM/CCM) Trainees ’ Performance on Standardized Critical Care Medicine Examinations: A Ten-Year Review
Emergency Medicine/Critical Care Medicine (EM/CCM) trainees may obtain board certification through Internal Medicine (American Board of Internal Medicine [ABIM]), Surgery (American Board of Surgery [ABS]), and Anesthesiology (American Board of Anesthesiology [ABA]). However, EM/CCM trainees experience challenges, including: 1) additional training requirements and 2) an unwillingness to accept EM graduates by many programs.
Source: The Journal of Emergency Medicine - March 31, 2020 Category: Emergency Medicine Authors: Brian T. Wessman, David Page, Matthew Greer, Brian M. Fuller Tags: Education Source Type: research

Assessing Competence in Critical Care Echocardiography: Development and Initial Results of an Examination and Certification Processes*
CONCLUSIONS: The CCEeXAM is designed to assess a knowledge base that is shared with echocardiologists in addition to that which is unique to critical care. The National Board of Echocardiography certification establishes that the physician has achieved the ability to independently perform and interpret critical care echocardiography at a standard recognized by critical care professional societies encompassing a wide spectrum of backgrounds. The interest shown and the success achieved on the CCEeXAM by practitioners of critical care echocardiography support the standards set by the National Board of Echocardiography for...
Source: Critical Care Medicine - July 26, 2021 Category: Emergency Medicine Tags: Feature Articles Source Type: research

Intensive care medicine in Europe: perspectives from the European Society of Anaesthesiology and Intensive Care
CONCLUSION Amongst the 42 European national societies surveyed (41 members of ESAIC-NASC plus Luxembourg), nineteen (45%) also include terms related to critical care medicine or ICM in their names, seven (17%) include terms related to reanimation and three (7%) to resuscitation. In recent years, several national societies revised their names to better reflect their gradual embrace of peri-operative medicine, ICM, CREM and pain management. Approximately 70% of ICU beds in Europe, and 100% in Scandinavia, are being run by anaesthesiologists, the remaining 30% being managed by physicians from other surgical or medical spe...
Source: European Journal of Anaesthesiology - September 15, 2022 Category: Anesthesiology Tags: Intensive care medicine Source Type: research

Audit of postoperative surgical intensive care unit admissions
Conclusion: The need for postoperative critical care is significantly higher in males, elderly, patients with poor preoperative risk stratification scores, preexisting medical illness, major intraoperative hemorrhage, hypotension requiring inotropic support, perioperative respiratory problems and patients undergoing abdominal, trauma, and emergent surgeries. A larger study inclusive of other surgical subspecialties would aid in optimal decision-making for admissions to the SICU.
Source: Indian Journal of Critical Care Medicine - January 15, 2018 Category: Intensive Care Authors: Shaili K Patel Samir M Kacheriwala Dipesh D Duttaroy Source Type: research

A small step for sedation that may become a giant leap for critical care medicine
Publication date: October 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 5Author(s): Jean-Michel Constantin, Thomas Godet, Arthur James, Antoine Monsel
Source: Anaesthesia, Critical Care and Pain Medicine - October 2, 2019 Category: Anesthesiology Source Type: research

Unplanned intensive care unit admission following elective surgical adverse events: Incidence, patient characteristics, preventability, and outcome
Conclusions: Our analysis of UIA is a quality control exercise that helps identify high-risk patient groups and patterns of anesthesia or surgical care requiring improvement.
Source: Indian Journal of Critical Care Medicine - March 8, 2017 Category: Intensive Care Authors: Mohammed Meziane Sidi Driss El Jaouhari Abdelghafour ElKoundi Mustapha Bensghir Hicham Baba Redouane Ahtil Khalil Aboulaala Hicham Balkhi Charki Haimeur Source Type: research