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Total 116873 results found since Jan 2013.

Pediatric neurocritical care in the 21st century: from empiricism to evidence
Purpose of review: Approximately one in five children admitted to a pediatric ICU have a new central nervous system injury or a neurological complication of their critical illness. The spectrum of neurologic insults in children is diverse and clinical practice is largely empirical, as few randomized, controlled trials have been reported. This lack of data poses a substantial challenge to the practice of pediatric neurocritical care (PNCC). PNCC has emerged as a novel subspecialty, and its presence is expanding within tertiary care centers. This review highlights the recent advances in the field, with a focus on traumatic b...
Source: Current Opinion in Critical Care - March 6, 2016 Category: Nursing Tags: NEUROSCIENCE: Edited by J. Claude Hemphill Source Type: research

Adverse Tracheal Intubation-Associated Events in Pediatric Patients at Nonspecialist Centers: A Multicenter Prospective Observational Study*
Conclusions: Tracheal intubation-associated events are common in critically ill pediatric patients who present to nonspecialist centers. The rate of severe tracheal intubation-associated events is much higher in these centers as compared with the PICU setting. There should be a greater focus on improving the safety of intubations occurring in nonspecialist centers.
Source: Pediatric Critical Care Medicine - June 1, 2019 Category: Pediatrics Tags: Feature Articles Source Type: research

Refractory Status Epilepticus in Children: Intention to Treat With Continuous Infusions of Midazolam and Pentobarbital*
Conclusions: Midazolam and pentobarbital remain the mainstay of continuous infusion therapy for refractory status epilepticus in the pediatric patient. The majority of patients experience seizure termination within a median of 30 hours. These data have implications for the design and feasibility of future intervention trials. That is, testing a new anesthetic anticonvulsant after failure of both midazolam and pentobarbital is unlikely to be feasible in a pediatric study, whereas a decision to test an alternative to pentobarbital, after midazolam failure, may be possible in a multicenter multinational study.
Source: Pediatric Critical Care Medicine - October 1, 2016 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Physician training in critical care in the United States: Update 2018
Critical care fellowship training in the United States differs based on specific specialty and includes medicine, surgery, anesthesiology, pediatrics, emergency medicine, and neurocritical care training pathways. We provide an update regarding the number and growth of US critical care fellowship training programs, on-duty residents and certified diplomates, and review the different critical care physician training pathways available to residents interested in pursuing a fellowship in critical care. Data were obtained from the Accreditation Council for Graduate Medical Education and specialty boards (American Board of Inter...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - June 1, 2018 Category: Orthopaedics Tags: Review Articles Source Type: research

Designing a national pediatric critical care database: a Delphi consensus study
ConclusionWe present the methodological framework used to select data elements by consensus for a national pediatric critical care database, with participation from a diverse stakeholder group of experts and caregivers from all PICUs in Canada. The selected core data elements will provide standardized and synthesized data for research, benchmarking, and quality improvement initiatives of critically ill children.
Source: Canadian Journal of Anesthesia - May 22, 2023 Category: Anesthesiology Source Type: research

The shortage of critical care physicians: Is there a solution?
Conclusions: Family Practice is the second largest collective group of physicians in the United States—second only to internal medicine. In most of rural America, where there are limited physicians serving the population, family practitioners fill the gap and provide services otherwise unavailable to those patients. This group that can potentially be trained in critical care and help solve the crisis has been prevented from doing so.
Source: Journal of Critical Care - August 11, 2014 Category: Intensive Care Authors: Manuel Lois Tags: Letters Source Type: research

Point-of-Care Ultrasound in Sternal Notch Confirms Depth of Endotracheal Tube in Children*
Conclusions: Visualization of the cuff at the suprasternal notch by ultrasound demonstrates potential as a means of confirming correct depth of the endotracheal tube following endotracheal intubation.
Source: Pediatric Critical Care Medicine - July 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Critical Care Compendium update
LITFL’s Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care. Currently there are almost 1,500 entries with more in the works… Some pages are more developed than others, and all the pages are being constantly revised and improved. Links to new references and online resources are added daily, with an emphasis on those that are free and open access (FOAM!). These pages originated from the FCICM exam study notes created by Dr Jeremy Fernando in 2011, and have been updated, modified and added to since. As such will be particularly us...
Source: Life in the Fast Lane - November 17, 2013 Category: Emergency Medicine Doctors Authors: Chris Nickson Tags: Critical Care Compendium Education eLearning Emergency Medicine Featured CCC LITFL collection Source Type: blogs

Pediatric Perioperative Cardiac Arrest and Mortality: A Study From a Tertiary Teaching Hospital*
Conclusions: Despite the improvements achieved in the pediatric anesthesia safety in our institution, the perioperative cardiac arrest rates are still high and similar to the developing countries rates, with the child’s disease or condition being the most important trigger for cardiac arrest. Airway management continues to be the greatest cause of anesthesia-related cardiac arrest.
Source: Pediatric Critical Care Medicine - November 1, 2014 Category: Pediatrics Tags: Quality and Safety Source Type: research

Cardiac Surgery–Associated Kidney Injury in Children and Renal Oximetry
Conclusions: Findings demonstrate that preoperative oxygen supply/demand balance is an important predictor of cardiac surgery–associated acute kidney injury, suggesting lower preoperative (and intraoperative) renal blood flow may be protective. There is not yet a definite link between remote ischemic preconditioning and prevention of cardiac surgery–associated acute kidney injury; however, renal protective effects of sublethal ischemia should continue to be explored.
Source: Pediatric Critical Care Medicine - September 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Long-Axis In-Plane Approach Versus Short-Axis Out-of-Plane Approach for Ultrasound-Guided Central Venous Catheterization in Pediatric Patients: A Randomized Controlled Trial*
Conclusions: The long-axis in-plane approach for ultrasound-guided central venous catheterization is a useful technique for avoiding posterior wall puncture in pediatric patients, compared with the short-axis out-of-plane approach.
Source: Pediatric Critical Care Medicine - November 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Driving Pressure and Normalized Energy Transmission Calculations in Mechanically Ventilated Children Without Lung Disease and Pediatric Acute Respiratory Distress Syndrome*
CONCLUSIONS: Driving pressure is the variable that better discriminates pediatric acute respiratory distress syndrome from nonpediatric acute respiratory distress syndrome in children than the calculations derived from the equation of motion, even when indexed by ideal body weight. Unindexed mechanical power was useless to differentiate against both groups. Future studies should determine the threshold for variables of the energy dissipated by the lungs and their association with clinical outcomes.
Source: Pediatric Critical Care Medicine - October 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Queer(ing) medical spaces: queer theory as a framework for transformative social change in anesthesiology and critical care medicine
This article grapples with the cis-heteronormative medical gaze and queer people's apprehensions of violence in medical settings to offer new ways of thinking about structural changes needed in medicine, medical language, and the dehumanizing application of medical modes of care. Using a series of clinical vignettes, this article outlines the historical context underlying queer peoples' distrust of medicine, a primer in queer theory, and an understanding of how to begin to "queer" medical spaces using this critical framework.PMID:37217735 | DOI:10.1007/s12630-023-02449-8
Source: Canadian Journal of Anaesthesia - May 22, 2023 Category: Anesthesiology Authors: Nicholas Hrynyk John K Peel Daniel Grace Jason Lajoie Joshua Ng-Kamstra Ayelet Kuper Mic Carter Gianni R Lorello Source Type: research