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Acute Care Clinical Indicators Associated With Discharge Outcomes in Children With Severe Traumatic Brain Injury*
Conclusions: Acute care clinical indicators of adherence to the Pediatric Guidelines were associated with significantly higher discharge survival and improved discharge Glasgow Outcome Scale. Some indicators were protective, regardless of treatment location, suggesting the need for an interdisciplinary approach to the care of children with severe traumatic brain injury.
Source: Critical Care Medicine - October 1, 2014 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research
Bedside ultrasonography: Applications in critical care: Part I
Jose Chacko, Gagan BrarIndian Journal of Critical Care Medicine 2014 18(5):301-309There is increasing interest in the use of ultrasound to assess and guide the management of critically ill patients. The ability to carry out quick examinations by the bedside to answer specific clinical queries as well as repeatability are clear advantages in an acute care setting. In addition, delays associated with transfer of patients out of the Intensive Care Unit (ICU) and exposure to ionizing radiation may also be avoided. Ultrasonographic imaging looks set to evolve and complement clinical examination of acutely ill patients, offering...
Source: Indian Journal of Critical Care Medicine - May 14, 2014 Category: Intensive Care Authors: Jose ChackoGagan Brar Source Type: research
Isolated Traumatic Subarachnoid Hemorrhage: An Evaluation of Critical Care Unit Admission Practices and Outcomes From a North American Perspective
The objective of this investigation is to evaluate the association between hospital-level ICU admission practices and clinically important outcomes for patients with isolated traumatic subarachnoid hemorrhage and mild clinical traumatic brain injury.
Design:
Multicenter observational cohort.
Setting:
Trauma centers participating in the American College of Surgeons Trauma Quality Improvement Program spanning January 2012 to March 2014.
Patients:
A total of 14,146 subjects, 16 years old and older, admitted to 215 trauma centers with isolated traumatic subarachnoid hemorrhage and Glasgow Coma Scale score 13 or greate...
Source: Critical Care Medicine - February 23, 2018 Category: Emergency Medicine Tags: Neurologic Critical Care Source Type: research
Children in Critical Care Due to Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Experience in a Spanish Hospital
Conclusions:
On the whole, the children were previously healthy and are more than 1 year old. Respiratory symptoms were the leading cause of PICU admission, making respiratory support the principal therapy. Patients requiring mechanical ventilation showed deterioration on the first day of admission. These children seemed to require close monitoring, and multicenter studies are necessary.
Source: Pediatric Critical Care Medicine - August 1, 2020 Category: Pediatrics Tags: Online Brief Reports Source Type: research
A Simple and Robust Bedside Model for Mortality Risk in Pediatric Patients With Acute Respiratory Distress Syndrome*
Objectives: Despite declining mortality, acute respiratory distress syndrome is still involved in up to one third of pediatric intensive care deaths. The recently convened Pediatric Acute Lung Injury Consensus Conference has outlined research priorities for the field, which include the need for accurate bedside risk stratification of patients. We aimed to develop a simple yet robust model of mortality risk among pediatric patients with acute respiratory distress syndrome to facilitate the targeted application of high-risk investigational therapies and stratification for enrollment in clinical trials.
Design: Prospective, ...
Source: Pediatric Critical Care Medicine - October 1, 2016 Category: Pediatrics Tags: Feature Articles Source Type: research
Incidence and outcome of acute lung injury and acute respiratory distress syndrome in the surgical intensive care unit
Conclusion: The incidence and mortality of ARDS was similar to other studies. Identifying those with risk factors for ARDS or mortality will enable appropriate interventional measures.
Source: Indian Journal of Critical Care Medicine - October 3, 2014 Category: Intensive Care Authors: Georgene SinghGeorge GladdyTony Thomson ChandyNagamani Sen Source Type: research
Ventilator-associated pneumonia in adult intensive care unit prevalence and complications
Conclusion: Ventilator-associated pneumonia was associated with a significant increase in ICU length of stay, time on mechanical ventilation and different complications.
Source: The Egyptian Journal of Critical Care Medicine - June 28, 2017 Category: Intensive Care Source Type: research
How useful is extravascular lung water measurement in managing lung injury in intensive care unit ?
Conclusions: EVLWI and PVPI may have a prognostic significance in the assessment of lung injury in septic shock patients with ARDS. Further research is required to reveal the usefulness of EVLWI as an end point of fluid resuscitation in the management of septic shock with ARDS.
Source: Indian Journal of Critical Care Medicine - August 14, 2017 Category: Intensive Care Authors: Anirban Bhattacharjee Debasis Pradhan Prithwis Bhattacharyya Samarjit Dey Daniala Chhunthang Akash Handique Angkita Barman Mohd Yunus Source Type: research
Autoimmune Encephalitis in Critical Care: Optimizing Immunosuppression
Semin Respir Crit Care Med 2017; 38: 807-820 DOI: 10.1055/s-0037-1608771Autoimmune diseases affecting the nervous systems are a common cause of admission to the intensive care unit (ICU). Although there exist several well-described clinical syndromes, patients more commonly present with progressive neurologic dysfunction and laboratory and radiographic evidence of central nervous system (CNS) inflammation. In the critical care setting, the urgency to intervene to prevent permanent damage to the nervous system and secondary injury from the systemic manifestations of these syndromes often conflicts with diagnostic uncertaint...
Source: Seminars in Respiratory and Critical Care Medicine - December 20, 2017 Category: Respiratory Medicine Authors: Rubin, Daniel B. Batra, Ayush Vodopivec, Ivana Vaitkevicius, Henrikas Tags: Review Article Source Type: research
Elimination of radiographic confirmation for small-bowel feeding tubes in critical care.
Conclusions Use of EMPD technology allowed clinicians to safely and effectively place feeding tubes at the bedside and eliminate radiographs in most cases. EMPD placement was not limited to specialized nurses or teams. This procedure should be easily reproducible in other critical care environments.
PMID: 24186824 [PubMed - in process]
Source: American Journal of Critical Care - November 1, 2013 Category: Nursing Authors: Powers J, Fischer MH, Ziemba-Davis M, Brown J, Phillips DM Tags: Am J Crit Care Source Type: research
Outcomes of Children With Critical Bronchiolitis Meeting at Risk for Pediatric Acute Respiratory Distress Syndrome Criteria*
Objectives:
New definitions of pediatric acute respiratory distress syndrome include criteria to identify a subset of children “at risk for pediatric acute respiratory distress syndrome.” We hypothesized that, among PICU patients with bronchiolitis not immediately requiring invasive mechanical ventilation, those meeting at risk for pediatric acute respiratory distress syndrome criteria would have worse clinical outcomes, including higher rates of pediatric acute respiratory distress syndrome development.
Design:
Single-center, retrospective chart review.
Setting:
Mixed medical-surgical PICU within a tertiary ac...
Source: Pediatric Critical Care Medicine - February 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
The Occurrence and Risk Factors of Inappropriately Deep Tip Position of Microcuff Pediatric Endotracheal Tube During PICU Stay: A Retrospective Cohort Pilot Study*
Objectives:
Cuffed endotracheal tubes are being used increasingly for pediatric patients on mechanical ventilation. Appropriate placement of the tube tip for Microcuff (Kimberley-Clark, Roswell, GA) pediatric endotracheal tube is guided by the intubation depth mark on the device. However, inappropriately deep tip position is sometimes observed during PICU stay. The purpose of this study was to assess the occurrence and risk factors of inappropriately deep tip position of Microcuff pediatric endotracheal tube during PICU stay.
Design:
A retrospective cohort study.
Setting:
The PICU at the National Center for Child H...
Source: Pediatric Critical Care Medicine - November 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations 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 chest computed tomography at a radiation dose approaching a chest radiograph.
PMID: 23992595 [PubMed - in process]
Source: American Journal of Respiratory and Critical Care Medicine - September 1, 2013 Category: Respiratory Medicine Authors: Willemink MJ, de Jong PA Tags: Am J Respir Crit Care Med Source Type: research
