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Radiologic, Neurologic and Cardiopulmonary Aspects of Submersion Injury
We report 2 cases of submersion injury and discuss the usefulness and application of common respiratory and critical care indices. The respiratory indices help better understand the pulmonary pathophysiology and characterize the severity of lung injury and ventilation/perfusion mismatch. Severe lung injury resolved after ventilation support with appropriate positive end-expiratory pressure in both cases. The 6-year-old girl survived the near-fatal submersion injury intact despite grossly abnormal initial Glasgow Coma Scale (GCS) and high Pediatric Index of Mortality 2 scores, whereas the 5-year-old boy with grossly abnorma...
Source: Pediatric Emergency Care - September 1, 2016 Category: Emergency Medicine Tags: Illustrative Cases Source Type: research

Feasibility of Family-Assisted Severity of Illness Monitoring for Hospitalized Children in Low-Income Settings
Conclusions: Caregiver involvement in recognition of critical illness in hospitalized children in low-resource settings may be feasible. This may facilitate earlier detection of clinical deterioration where staffing is severely limited by constrained resources. Further validation of the Family-Assisted Severe Febrile Illness Therapy tool is warranted, followed by its application in a larger multisite patient population to assess provider response and associated clinical outcomes.
Source: Pediatric Critical Care Medicine - February 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Traumatic Brain Injury Practice Guidelines: Variability in U.K. PICUs
Conclusions: Significant variability in pediatric traumatic brain injury management guidelines exists. Despite the heterogeneity, we have highlighted a few points of consistency within the key topic areas of pediatric traumatic brain injury management. We anticipate that this provides impetus for further work around standardization.
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Brief Report Source Type: research

Prevalence of Cardiac Dysfunction in Malawian Children With Severe Febrile Illness*
CONCLUSIONS: Cardiac dysfunction may be present in one in four Malawian children with severe febrile illness, and mortality in these patients is especially high. Larger studies are needed to further clarify the role cardiac dysfunction plays in mortality and integrate practical bedside assessments for decision support around individualized resuscitation strategies.
Source: Pediatric Critical Care Medicine - July 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Prone Positioning Improved Ventilation/Perfusion Matching in Severe Pediatric ARDS
Am J Respir Crit Care Med. 2023 Feb 7. doi: 10.1164/rccm.202208-1571IM. Online ahead of print.NO ABSTRACTPMID:36749567 | DOI:10.1164/rccm.202208-1571IM
Source: American Journal of Respiratory and Critical Care Medicine - February 7, 2023 Category: Respiratory Medicine Authors: Long Xiang Hong Ren Ying Wang Zhulin Wang In éz Frerichs Zhanqi Zhao Source Type: research

Bedside Ultrasound in the Pediatric Intensive Care Unit: Newer Uses
AbstractPurpose of ReviewTo explore recent advancements in the use of point-of-care ultrasound in the pediatric intensive care unit or during the perioperative period.Recent FindingsUltrasound is useful for selecting an appropriate endotracheal tube size, predicting postextubation stridor, assessing vocal cord paralysis, performing ultrasound-guided lung recruitment, assessing circulatory volume status, performing transcranial Doppler for assessment of cerebral perfusion, assessing intracranial hypertension, assessing central venous catheter tip position, and performing arterial line cannulation.SummaryThere has been rapid...
Source: Current Pediatrics Reports - November 9, 2019 Category: Pediatrics Source Type: research

Augmented renal clearance in pediatric intensive care: are we undertreating our sickest patients?
AbstractMany critically ill patients display a supraphysiological renal function with enhanced renal perfusion and glomerular hyperfiltration. This phenomenon described as augmented renal clearance (ARC) may result in enhanced drug elimination through renal excretion mechanisms. Augmented renal clearance seems to be triggered by systemic inflammation and therapeutic interventions in intensive care. There is growing evidence that ARC is not restricted to the adult intensive care population, but is also prevalent in critically ill children. Augmented renal clearance is often overlooked due to the lack of reliable methods to ...
Source: Pediatric Nephrology - December 9, 2019 Category: Urology & Nephrology Source Type: research

Personalization and Pragmatism: Pediatric Intracranial Pressure and Cerebral Perfusion Pressure Treatment Thresholds*
No abstract available
Source: Pediatric Critical Care Medicine - February 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

ZOLL to Showcase Advanced Resuscitation and Acute Critical Care Solutions at European Resuscitation Council Congress
October 20, 2015—CHELMSFORD, MASS.—ZOLL® Medical Corporation, an Asahi Kasei Group Company that manufactures medical devices and related software solutions, today announced that it will display its fully integrated advanced resuscitation solutions and acute critical care solutions in booth A02 during the European Resuscitation Council (ERC) 2015 Congress 29-31 October in Prague, Czech Republic. ZOLL’s Portfolio of Unsurpassed CPR Support ZOLL’s commitment to high-quality CPR is evident in the company’s suite of technology products for optimal resuscitation response. Virtually all ZOLL defibrillators, from AED...
Source: JEMS Patient Care - October 20, 2015 Category: Emergency Medicine Tags: Equipment & Gear Resuscitation Shock Technology Source Type: news

Consider brain perfusion imaging rather than just the delay from symptoms onset to indicate reperfusion strategies after stroke: Implications for perioperative care
Publication date: August 2019Source: Anaesthesia Critical Care & Pain Medicine, Volume 38, Issue 4Author(s): Thomas Geeraerts, Ségolène Mrozek, Clément Monet, Jean-Marc Olivot
Source: Anaesthesia, Critical Care and Pain Medicine - July 23, 2019 Category: Anesthesiology Source Type: research

Bench-to-bedside review: the effects of hyperoxia during critical illness
Oxygen administration is uniformly used in emergency and intensive care medicine and has life-saving potential in critical conditions. However, excessive oxygenation also has deleterious properties in various pathophysiological processes and consequently both clinical and translational studies investigating hyperoxia during critical illness have gained increasing interest. Reactive oxygen species are notorious by-products of hyperoxia and play a pivotal role in cell signaling pathways. The effects are diverse, but when the homeostatic balance is disturbed, reactive oxygen species typically conserve a vicious cycle of tissu...
Source: Critical Care - August 17, 2015 Category: Intensive Care Authors: Hendrik HelmerhorstMarcus SchultzPeter van der VoortEvert de JongeDavid van Westerloo Source Type: research

Postoperative care of the adult cardiac surgical patient
Publication date: Available online 11 September 2015 Source:Anaesthesia & Intensive Care Medicine Author(s): Christopher P. Press, Jonathan H. Rosser, Alison D. Parnell Most patients are ready to be transferred to a ward after 24–48 hours on a cardiac intensive care unit (CICU); however, several potential complications can occur during this period. The risks during transfer from theatre to CICU increase if a long distance is involved. A thorough handover to nursing staff is mandatory. Problems with blood pressure and arrhythmias are common on the CICU. Patients undergoing hypothermic cardiopulmonary bypass a...
Source: Anaesthesia and intensive care medicine - September 11, 2015 Category: Anesthesiology Source Type: research

Human Lung Resident Macrophages Co-localize with and Provide Co-stimulation to PD1hi Tissue Resident Memory T Cells.
CONCLUSIONS: Ex-vivo lung perfusion provides an innovative technique to study resident immune populations in humans. Human lung resident macrophages co-localize with and provide co-stimulation signaling to tissue resident memory T cells, augmenting their effector function. PMID: 33306940 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - December 11, 2020 Category: Respiratory Medicine Authors: Snyder ME, Sembrat J, Noda K, Myerburg MM, Craig A, Mitash N, Harano T, Furukawa M, Pilewski J, McDyer J, Rojas M, Sanchez P Tags: Am J Respir Crit Care Med Source Type: research

Patient-Centric Blood Pressure Targeted CPR Improves Survival from Cardiac Arrest.
Conclusions: Blood pressure targeted CPR improves 24-hour survival compared to optimal American Heart Association care in a porcine model of asphyxia-associated ventricular fibrillation cardiac arrest. PMID: 25321490 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - October 16, 2014 Category: Respiratory Medicine Authors: Sutton RM, Friess SH, Naim MY, Lampe JW, Bratinov G, Weiland Iii TR, Garuccio M, Nadkarni VM, Becker LB, Berg RA Tags: Am J Respir Crit Care Med Source Type: research

Accuracy of Brain Multimodal Monitoring to Detect Cerebral Hypoperfusion After Traumatic Brain Injury*
Objective: To examine the accuracy of brain multimodal monitoring—consisting of intracranial pressure, brain tissue PO2, and cerebral microdialysis—in detecting cerebral hypoperfusion in patients with severe traumatic brain injury. Design: Prospective single-center study. Patients: Patients with severe traumatic brain injury. Setting: Medico-surgical ICU, university hospital. Intervention: Intracranial pressure, brain tissue PO2, and cerebral microdialysis monitoring (right frontal lobe, apparently normal tissue) combined with cerebral blood flow measurements using perfusion CT. Measurements and Main Results: Cerebral ...
Source: Critical Care Medicine - January 17, 2015 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research