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Total 274889 results found since Jan 2013.

A Core Outcome Set for Pediatric Critical Care*
Conclusions: The PICU core outcome set and PICU core outcome set—extended are multistakeholder-recommended resources for clinical and research programs that seek to improve outcomes for children with critical illness and their families.
Source: Critical Care Medicine - November 22, 2020 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Mothers and Fathers Experience Stress of Congenital Heart Disease Differently: Recommendations for Pediatric Critical Care*
Conclusions: This study highlights the importance of understanding the paternal experience and tailoring interventions to the unique needs of both mothers and fathers. Opportunities for critical care practice change to promote the mental health of mothers and fathers following a diagnosis of congenital heart disease are discussed.
Source: Pediatric Critical Care Medicine - July 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

2022 Society of Critical Care Medicine Clinical Practice Guidelines on Prevention and Management of Pain, Agitation, Neuromuscular Blockade, and Delirium in Critically Ill Pediatric Patients With Consideration of the ICU Environment and Early Mobility
CONCLUSIONS: The current guidelines represent a comprehensive list of practical clinical recommendations for the assessment, prevention, and management of key aspects for the comprehensive critical care of infants and children. Main areas of focus included 1) need for the routine monitoring of pain, agitation, withdrawal, and delirium using validated tools, 2) enhanced use of protocolized sedation and analgesia, and 3) recognition of the importance of nonpharmacologic interventions for enhancing patient comfort and comprehensive care provision.
Source: Pediatric Critical Care Medicine - February 1, 2022 Category: Pediatrics Tags: Online Special Article Source Type: research

Pediatric Critical Care Nursing Research Priorities in Asia: An eDelphi Study*
Conclusions: This first PICU nursing research prioritization exercise within Asia identified key nursing research themes that should be prioritized and provide a framework for future collaborative studies.
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Pain and Sedation Management: 2018 Update for the: Rogers’ Textbook of Pediatric Intensive Care
Conclusions: Recent research into pediatric pain and sedation management has focused on optimizing the choice of sedative medications, in particular by increasing the use and understanding of nonopioid and nonbenzodiazepine options such as ketamine and alpha-2 agonists. Delirium has emerged as a significant morbidity in the critically ill pediatric patient, and recent articles have concentrated on the use of validated screening tools to determine the epidemiology and risk factors in specific populations, including patients with cardiac disease and those receiving extracorporeal membrane oxygenation. A consistent theme in...
Source: Pediatric Critical Care Medicine - January 1, 2019 Category: Pediatrics Tags: Rogers’ Update Source Type: research

Defining Futile and Potentially Inappropriate Interventions: A Policy Statement From the Society of Critical Care Medicine Ethics Committee
Conclusions: The Society of Critical Care Medicine supports the seven-step process presented in the multiorganization statement. This statement provides added guidance to clinicians in the ICU environment.
Source: Critical Care Medicine - August 16, 2016 Category: Emergency Medicine Tags: Special Article Source Type: research

Methodologic Innovation in Creating Clinical Practice Guidelines: Insights From the 2018 Society of Critical Care Medicine Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption Guideline Effort
Conclusions: Our multifaceted, interdisciplinary approach and novel methodologic strategies can help inform the development of future critical care clinical practice guidelines.
Source: Critical Care Medicine - August 16, 2018 Category: Emergency Medicine Tags: Clinical Investigations Source Type: research

Current practices of mobilization, analgesia, relaxants and sedation in Indian ICUs: A survey conducted by the Indian Society of Critical Care Medicine
Conclusion: The results of the survey suggest that compliance with existing guidelines is low. Benzodiazepines still remain the predominant ICU sedative. The recommended practice of giving analgesia before sedation is almost non-existent. Delirium remains an underrecognized entity. Monitoring of sedation levels, analgesia and delirium is low and validated and recommended scales for the same are rarely used. Although awareness of the benefits of early mobilization are high, the implementation is low.
Source: Indian Journal of Critical Care Medicine - September 4, 2014 Category: Intensive Care Authors: Rajesh ChawlaSheila Nainan MyatraNagarajan RamakrishnanSubhash TodiSudha KansalSananta Kumar Dash Source Type: research

End-of-Life Practices Among Tertiary Care PICUs in the United States: A Multicenter Study
Discussions with families about limitation or withdrawal of support occurred during the initial PICU stay for 173 patients (63%; 47–76%; p = 0.27) who died. Of these, palliative care was consulted for 67 (39%; 12–46%); pain service for 11 (6%; 10 of which were at a single site); and ethics committee for six (3%, from three sites). Mode of death was withdrawal of support for 141 (51%; 42–59%), failed cardiopulmonary resuscitation for 53 (19%; 12–28%), limitation of support for 46 (17%; 7–24%), and brain death for 35 (13%; 8–20%); mode of death did not differ across sites (p = 0.58). Organ donation was requested ...
Source: Pediatric Critical Care Medicine - September 1, 2015 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

SCCM Pod-329 A Bedside Model for Mortality Risk in Pediatric Patients with ARDS
Margaret Parker, MD, MCCM, speaks with Aaron C. Spicer, MD, MAS. Dr. Spicer completed a pediatric residency and critical care fellowship and now is a resident in the Department of Anesthesia, Critical Care, and Pain Medicine at the Massachusetts General Hospital in Boston, Massachusetts.
Source: SCCM PodCast - iCritical Care - October 3, 2016 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

Risk Factors Associated With Iatrogenic Opioid and Benzodiazepine Withdrawal in Critically Ill Pediatric Patients: A Systematic Review and Conceptual Model*
Conclusions: Given the state of existing evidence, well-designed prospective studies are required to better characterize iatrogenic withdrawal syndrome in critically ill pediatric patients. This review provides data to support the construction of a conceptual model of iatrogenic withdrawal syndrome risk that, if supported, could be useful in guiding future research.
Source: Pediatric Critical Care Medicine - February 1, 2015 Category: Pediatrics Tags: Review Article Source Type: research

Survey of Sedation and Analgesia Practice Among Canadian Pediatric Critical Care Physicians*
Conclusion: Our survey demonstrates great variation in practice in the management of pain and anxiety in Canadian PICUs. Standardized strategies for sedation, delirium and withdrawal, and sleep promotion are lacking. There is a need for research in this field and the development of evidence-based, pediatric sedation and analgesia guidelines.
Source: Pediatric Critical Care Medicine - September 1, 2016 Category: Pediatrics Tags: Feature Articles Source Type: research

Intermittent Versus Continuous and Intermittent Medications for Pain and Sedation After Pediatric Cardiothoracic Surgery; A Randomized Controlled Trial*
Objectives: Compare continuous infusions of morphine and midazolam in addition to intermittent doses with an intermittent only strategy for pain and sedation after pediatric cardiac surgery. Design: Randomized controlled trial. Setting: Advocate Children’s Hospital, Oak Lawn, IL. Patients: Sixty patients 3 months to 4 years old with early extubation after pediatric cardiac surgery. Interventions: Patients received a continuous infusion of morphine and midazolam or placebo for 24 hours. Both groups received intermittent morphine and midazolam doses as needed. Measurements and Main Results: Gender, age, by...
Source: Critical Care Medicine - December 19, 2017 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research