Articoli di riviste: "Pediatric intensive care research"

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Prout, Andrew, e Kathleen L. Meert. "Research in Pediatric Intensive Care". Pediatric Clinics of North America 69, n. 3 (giugno 2022): 607–20. http://dx.doi.org/10.1016/j.pcl.2022.01.015.

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Hutchison, Jamie. "Research in Pediatric Intensive Care*". Pediatric Critical Care Medicine 17, n. 1 (gennaio 2016): 97. http://dx.doi.org/10.1097/pcc.0000000000000575.

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Pollack, Murray M. "Pediatric transport research". Critical Care Medicine 22, n. 7 (luglio 1994): 1073–74. http://dx.doi.org/10.1097/00003246-199407000-00003.

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Kleiber, Niina, Krista Tromp, Miriam G. Mooij, Suzanne van de Vathorst, Dick Tibboel e Saskia N. de Wildt. "Ethics of Drug Research in the Pediatric Intensive Care Unit". Pediatric Drugs 17, n. 1 (30 ottobre 2014): 43–53. http://dx.doi.org/10.1007/s40272-014-0101-5.

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Richardson, Douglas K., e William O. Tarnow-Mordi. "Measuring Illness Severity in Newborn Intensive Care". Journal of Intensive Care Medicine 9, n. 1 (gennaio 1994): 20–33. http://dx.doi.org/10.1177/088506669400900104.

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Measurement of illness severity has found increasing use in adult and pediatric intensive care research over the past decade. The development of illness severity indices for neonatal intensive care has lagged because birth weight has served as an excellent proxy for illness severity. However, a number of recent studies have shown marked variation in survival and morbidity among neonatal intensive care units (NICUs) despite birth weight adjustment, making clear the need for neonatal illness severity scoring. We discuss advantages and disadvantages of the 4 types of scoring systems used in adult intensive care—diagnosis, risk-factor, therapeutic, and physiological—and review their applications in adult and pediatric ICU research. Criteria for score design, as well as standards for validation and performance, are enumerated. The 30 neonatal scores fall in 5 major categories: obstetric risk, general use pediatric scores, predictors of developmental outcome, bronchopulmonary dysplasia risk, and acute mortality risk. Few have been adequately validated on large, concurrent independent samples. The most promising scores are those that measure acute physiological derangement on admission. Potential applications for these new illness severity scores are discussed.

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Ackerman, Alice D. "The Core of Pediatric Critical Care Research*". Critical Care Medicine 48, n. 12 (20 novembre 2020): 1909–11. http://dx.doi.org/10.1097/ccm.0000000000004699.

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Davidson, Jacob, Avani Shukla e Erin Paquette. "549: PARENT EXPERIENCES WITH RESEARCH IN A PEDIATRIC INTENSIVE CARE UNIT". Critical Care Medicine 44, n. 12 (dicembre 2016): 214. http://dx.doi.org/10.1097/01.ccm.0000509227.04261.b6.

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Truog, Robert D. "Ethical assessment of pediatric research protocols". Intensive Care Medicine 34, n. 1 (3 novembre 2007): 198–202. http://dx.doi.org/10.1007/s00134-007-0917-3.

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Rivara, Frederick P., e Keith T. Oldham. "Pediatric Trauma Care: Defining a Research Agenda". Journal of Trauma: Injury, Infection, and Critical Care 63, Supplement (dicembre 2007): S52—S53. http://dx.doi.org/10.1097/ta.0b013e31815aca0a.

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Burns, Karen E. A., Leena Rizvi, Anna Charteris, Samuel Laskey, Saima B. Bhatti, Kamalprit Chokar e Karen L. M. Choong. "Characterizing Citizens’ Preferences for Engagement in Patient Care and Research in Adult and Pediatric Intensive Care Units". Journal of Intensive Care Medicine 35, n. 2 (13 settembre 2017): 170–78. http://dx.doi.org/10.1177/0885066617729127.

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Rationale: Engagement promotes and supports the active participation of patients and families in health care and research to strengthen their influence on decision-making. We sought to characterize how citizens wish to be engaged in care and research in the intensive care unit (ICU). Methods: Interviewers administered questionnaires to visitors in 3 adult ICUs and 1 pediatric ICU. Results: We surveyed 202 (adult [n = 130] and pediatric [n = 72]) visitors. Adults and pediatric visitors prioritized 3 patient care topics (family involvement in rounds, improving communication between family members and health-care providers, and information transmission between health-care practitioners during patient transfers) and 2 research topics (evaluating prevention and recovery from critical illness). Preferred engagement activities included sharing personal experiences, identifying important topics and outcomes, and finding ways to make changes that respected their needs. Both respondent groups preferred to participate by completing electronic surveys or comment cards and answering questions on a website. Few respondents (<5%) wanted to participate in committees that met regularly. Although adult and pediatric respondents identified common facilitators and barriers to participation, they ranked them differently. Although both groups perceived engagement to be highly important, adult respondents were significantly less confident that their participation would impact care (7.6 ± 2.2 vs 8.3 ± 1.8; P = .01) and research (7.3 ± 2.4 vs 8.2 ± 2.0; P = .01) and were significantly less willing to participate in care (5.6 ± 2.9 vs 6.7 ± 3.0; P = .007) and research (4.7 ± 3.0 vs ± 5.8 ± 3.0; P = .02). Conclusions: Adult and pediatric visitors expressed comparable engagement preferences, identified similar facilitators and barriers, and rated engagement highly. Adult visitors were significantly less confident that their participation would be impactful and were significantly less willing to engage in care and research.

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Burns, Jeffrey P., e Cynda Hylton Rushton. "End-of-life care in the pediatric intensive care unit: research review and recommendations". Critical Care Clinics 20, n. 3 (luglio 2004): 467–85. http://dx.doi.org/10.1016/j.ccc.2004.03.004.

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Burr, Jeri S., Tammara L. Jenkins, Rick Harrison, Kathleen Meert, K. J. S. Anand, John T. Berger, Jerry Zimmerman et al. "The Collaborative Pediatric Critical Care Research Network Critical Pertussis Study: Collaborative research in pediatric critical care medicine*". Pediatric Critical Care Medicine 12, n. 4 (luglio 2011): 387–92. http://dx.doi.org/10.1097/pcc.0b013e3181fe4058.

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VAROL, Fatih, Yasar Yusuf CAN, Büşra ÖZGÜNAY, Mehmet CENGİZ, Ugur ALTAS, Şirin GÜVEN e Halit CAM. "Pediatrik travma hastalarının retrospektif değerlendirilmesi: üçüncü basamak pediatrik yoğun bakım ünitesinin tek merkez deneyimi". Journal of Medicine and Palliative Care 3, n. 3 (26 settembre 2022): 158–64. http://dx.doi.org/10.47582/jompac.1134133.

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Aim: Due to the rapid development in pediatric critical care medicine, some past studies suggested that pediatric trauma patients have better outcomes such as lower mortality and lower length of hospital stay in the pediatric intensive care unit (PICU). In this study, we aim to describe the demographic, clinical features, mechanisms of injury, and outcomes of children hospitalized in our pediatric intensive care unit due to trauma. Material and Method: We performed a retrospective evaluation of 60 pediatric trauma patients (between 0 and16 years of age) admitted to the PICU at University of Health Science, Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital from August 2020 to February 2022. Results: A total of 60 pediatric trauma patients were followed up in our PICU. The median age of patients was 17 (0-724) months with a preponderance of male cases (n:38, 63.3%). The median duration of hospitalization in PICU was 6 (1-46) days. According to the trauma type, the majority of the injuries were falling from a height (n:37, 61.7%). Conclusion: We would like to draw attention to the fact that head traumas due to falling were so common and also affect mortality. The lactate and the lactate/albumin ratio of patients who developed mortality were significantly higher. Although there are studies on the association of lactate/albumin ratio with mortality in critically ill pediatric patients, we could not find any data on this issue in pediatric trauma patients in the literature. Our study will contribute to the literature on the relationship between lactate/albumin ratio and mortality in pediatric trauma patients. We suggest that the relationship between lactate/albumin ratio and mortality should be investigated in pediatric trauma patients with larger case numbers.

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Jose, James H., Saul M. Adler, William G. Keyes e James M. Bradford. "Clinical Information Systems for Intensive Care, Pediatric Critical Care, and Neonatology". Journal of Intensive Care Medicine 12, n. 2 (marzo 1997): 79–92. http://dx.doi.org/10.1177/088506669701200203.

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Computer information systems are expected to soon take the place of current paper charting practices, and they offer great promise to assist management of the considerable amounts of data encountered in the information-rich environment of intensive care units (ICUs). Efforts to create an electronic medical record (EMR) have been underway for more than two decades, and major national organizations, such as the Institute of Medicine, have issued recommendations on standards. Benefits of an EMR include a legible patient record, enhanced communication, provision of timely reminders and alerts to clinicians, reduction of calculation errors, access to data bases for quality assurance and research, reduced healthcare costs, and improved patient outcomes. Despite these benefits, successful EMR implementations have been confined to a few committed institutions, and expensive failures have occurred. Practitioners of neonatology and pediatric intensive care are likely to have substantial difficulty implementing an EMR to fit their specialized needs because most experience in this area has been gained through care of adult patients, and systems being developed are oriented toward nonpediatric patients. It is therefore important to examine experience thus far with the functional components of an EMR so practitioners will be able to evaluate systems better as they become available. System components discussed include nursing charting facilities, lab reporting, physician order entry, physician progress notes, structured reports, decision support systems, and problem list management. Other concerns discussed include research and quality assurance functions, data access and confidentiality issues, and electronic mail. Maximizing the “structured data” content, as opposed to narrative content of an EMR, is an important priority, and progress on developing a uniform medical language is discussed. An approach to evaluating clinical information systems for use in the ICU is presented; it should assist practitioners of pediatric critical care and neonatology in identifying computer-based charting solutions that are optimal for infants and children, while cooperating with medical center-wide needs for compatibility and a common data base.

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Bryant, Kristen J. "Pediatric Delirium in the Cardiac Intensive Care Unit: Identification and Intervention". Critical Care Nurse 38, n. 4 (1 agosto 2018): e1-e7. http://dx.doi.org/10.4037/ccn2018947.

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Delirium is characterized by transient behavioral manifestations of acute brain disturbances. Delirium in the intensive care unit has been well researched and documented in the adult population. Pediatric delirium research has lagged, but recent developments in screening tools have shed light on the prevalence of delirium among children. The overall prevalence of delirium in the pediatric intensive care unit is 25%. A recent study showed a prevalence of 49% in the pediatric cardiac intensive care unit; this higher prevalence may be due to factors related to critical illness and the postoperative environment. This article is intended to increase awareness of delirium in the pediatric cardiac intensive care unit and give nurses the tools to identify it and intervene when necessary. A definition of delirium is provided, and its prevalence, risk factors, and current knowledge are reviewed. Available screening tools and environmental and pharmacological interventions are explored.

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Willson, Douglas F., J. Michael Dean, Christopher Newth, Murray Pollack, K. J. S. Anand, Kathleen Meert, Joseph Carcillo, Jerry Zimmerman e Carol Nicholson. "Collaborative Pediatric Critical Care Research Network (CPCCRN)*". Pediatric Critical Care Medicine 7, n. 4 (luglio 2006): 301–7. http://dx.doi.org/10.1097/01.pcc.0000227106.66902.4f.

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Agus, Michael, e Carmen Soto-Rivera. "Tight Glycemic Control in the Pediatric Intensive Care Unit". Journal of Pediatric Intensive Care 05, n. 04 (11 maggio 2016): 198–204. http://dx.doi.org/10.1055/s-0036-1583281.

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AbstractHyperglycemia is a common complication in critically ill, nondiabetic children. Four large pediatric randomized controlled trials of tight glycemic control (TGC) have been conducted to date with contradicting results. This review will highlight the design and outcomes of these trials and other relevant studies to provide an overview of the advantages and disadvantages of TGC for different populations at risk of hyperglycemia along with future directions for research.

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Kobussen, Taylor A., Gregory Hansen, Rebecca J. Brockman e Tanya R. Holt. "Perspectives of Pediatric Providers on Patients With Complex Chronic Conditions: A Mixed-Methods Sequential Explanatory Study". Critical Care Nurse 40, n. 5 (1 ottobre 2020): e10-e17. http://dx.doi.org/10.4037/ccn2020710.

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Background Children with complex chronic conditions present unique challenges to the pediatric intensive care unit, including prolonged length of stay, complex medical regimens, and complicated family dynamics. Objectives To examine perspectives of pediatric intensive care unit health care providers regarding pediatric patients with complex chronic conditions, and to explore potential opportunities to improve these patients’ care. Methods A prospective mixed-methods sequential explanatory study was conducted in a tertiary medical-surgical pediatric intensive care unit using surveys performed with REDCap (Research Electronic Data Capture) followed by semistructured interviews. Results The survey response rate was 70.6% (77 of 109). Perspectives of health care providers did not vary with duration of work experience. Ten semistructured interviews were conducted. Eight overarching themes emerged from the interviews: (1) the desire for increased formal education specific to pediatric complex chronic care patients; (2) designation of a primary intensivist; (3) modifying delivery of care to include a discrete location for care provision; (4) establishing daily, short-term, and long-term goals; (5) monitoring and documenting care milestones; (6) strengthening patient and family communications with the health care team; (7) optimizing discharge coordination and planning; and (8) integrating families into care responsibilities. Conclusions Pediatric intensive care unit health care providers’ perspectives of pediatric patients with complex chronic conditions indicated opportunities to refine the care provided by establishing daily goals, coordinating discharge planning, and creating occasions for close communication between patients, families, and providers.

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Morris, Marilyn, Charles L. Schleien e Ruth L. Fischbach. "EXCEPTION FROM INFORMED CONSENT FOR PEDIATRIC REUSUSCITATION RESEARCH." Critical Care Medicine 33 (dicembre 2005): A67. http://dx.doi.org/10.1097/00003246-200512002-00241.

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Asim Khurshid, Muhammad Tariq Aziz, Muhammad Abu Talib e Imran Iqbal. "Nutritional stabilization in paediatric intensive care unit: A Literature Review." Professional Medical Journal 29, n. 04 (31 marzo 2022): 420–27. http://dx.doi.org/10.29309/tpmj/2022.29.04.6143.

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The subject of nutrition in intensive care is being discussed among the pediatric intensivists since long. The nutritional supplementation plays a vital role in treatment of pediatric intensive care patients. In recent past, due to technological advances the pathophysiology of critical diseases is being better understood so better nutritional strategies are being implemented in critical care units. As a result the prognosis of intensive care patients is improving resulting in decreased length of stay and less number of deaths of these patients. The metabolic stress in sick patients is an important factor to be considered while calculating the nutritional requirements of patients. The body’s physiological mechanisms in the event of stress due to critical illness, need to be understood to make nutritional assessment of pediatric critical patients. The purpose of the current review is to recognize the recent nutritional supplementation guidelines of pediatric critical patients and to discuss any controversial issues. A meticulous study of the published literature regarding supplemental nutrition, energy calculation and algorithmic protocols for nutritional targets in pediatric critical population was done and areas in need of future research were identified.

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Quinlan, Kyran. "Using Focus Groups in Pediatric Injury Prevention Research". Journal of Trauma: Injury, Infection, and Critical Care 63, Supplement (settembre 2007): S6. http://dx.doi.org/10.1097/ta.0b013e31812f5e96.

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Tamburro, Robert F., Tammara L. Jenkins e Patrick M. Kochanek. "Strategic Planning for Research in Pediatric Critical Care". Pediatric Critical Care Medicine 17, n. 11 (novembre 2016): e539-e542. http://dx.doi.org/10.1097/pcc.0000000000000946.

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O’Hearn, Katharine J., Dori-Ann Martin, Maryse Dagenais e Kusum Menon. "Ability to Assent in Pediatric Critical Care Research". Pediatric Critical Care Medicine 19, n. 8 (agosto 2018): e438-e441. http://dx.doi.org/10.1097/pcc.0000000000001637.

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Laussen, Peter C. "Learning and evolving". Cardiology in the Young 25, n. 5 (19 marzo 2015): 984–90. http://dx.doi.org/10.1017/s1047951115000347.

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AbstractIt is an honour to present the Anthony Chang lecture at this 10th International Conference of the Pediatric Cardiac Intensive Care Society. I have had the privilege of knowing Dr Chang for over 20 years, and although we only worked for a short period of time together at the Children’s Hospital, Boston, in the Cardiac Intensive Care Unit, we have remained close colleagues and friends since that time. The contributions of Dr Chang to the development of paediatric cardiac intensive care are very clear, based on his clinical expertise, research and scholarship, and the development of the Pediatric Cardiac Intensive Care Society in its early days. More than this, Dr Chang is an individual with vision; in many respects, he has been ahead of the curve, anticipating and leading the direction of paediatric cardiac intensive care.

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Sealey, Leslie Ann, Julia Raddatz, Nirav R. Shah, Kyle Cunningham, Jacqueline Morey, Paige Laverick e Toan Thiet Huynh. "Alignment in Surrogate Decision Maker Research Opinions: Adult vs Pediatric Intensive Care Patients". Journal of the American College of Surgeons 231, n. 4 (ottobre 2020): e177. http://dx.doi.org/10.1016/j.jamcollsurg.2020.08.468.

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Morrison, Wynne, Mark A. Helfaer e Vinay Nadkarni. "SURVEY OF PEDIATRIC CRITICAL CARE FELLOWSHIP CLINICAL AND RESEARCH WORKLOAD." Critical Care Medicine 34 (dicembre 2006): A119. http://dx.doi.org/10.1097/00003246-200612002-00410.

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Schexnayder, Stephen M., e D. Micah Hester. "A new perspective on community consultation in pediatric resuscitation research*". Critical Care Medicine 34, n. 10 (ottobre 2006): 2684–85. http://dx.doi.org/10.1097/01.ccm.0000239425.49809.8f.

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Woodruff, Alan G., e Karen Choong. "Long-Term Outcomes and the Post-Intensive Care Syndrome in Critically Ill Children: A North American Perspective". Children 8, n. 4 (24 marzo 2021): 254. http://dx.doi.org/10.3390/children8040254.

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Advances in medical and surgical care for children in the pediatric intensive care unit (PICU) have led to vast reductions in mortality, but survivors often leave with newly acquired or worsened morbidity. Emerging evidence reveals that survivors of pediatric critical illness may experience a constellation of physical, emotional, cognitive, and social impairments, collectively known as the “post-intensive care syndrome in pediatrics” (PICs-P). The spectrum of PICs-P manifestations within each domain are heterogeneous. This is attributed to the wide age and developmental diversity of children admitted to PICUs and the high prevalence of chronic complex conditions. PICs-P recovery follows variable trajectories based on numerous patient, family, and environmental factors. Those who improve tend to do so within less than a year of discharge. A small proportion, however, may actually worsen over time. There are many gaps in our current understanding of PICs-P. A unified approach to screening, preventing, and treating PICs-P-related morbidity has been hindered by disparate research methodology. Initiatives are underway to harmonize clinical and research priorities, validate new and existing epidemiologic and patient-specific tools for the prediction or monitoring of outcomes, and define research priorities for investigators interested in long-term outcomes.

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Upperman, Jeffrey S., Randall Burd, Charles Cox, Peter Ehrlich, David Mooney e Jonathan I. Groner. "Pediatric Applied Trauma Research Network: A Call to Action". Journal of Trauma: Injury, Infection, and Critical Care 69, n. 5 (novembre 2010): 1304–7. http://dx.doi.org/10.1097/ta.0b013e3181fa4858.

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Reddy, Sushma, Angelo Polito, Sandra Staveski e Heidi Dalton. "A process for academic societies to develop scientific statements and white papers: experience of the Pediatric Cardiac Intensive Care Society". Cardiology in the Young 29, n. 2 (4 dicembre 2018): 174–77. http://dx.doi.org/10.1017/s1047951118002019.

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AbstractThere are substantial knowledge gaps, practice variation, and paucity of controlled trials owing to the relatively small number of patients with critical heart disease. The Pediatric Cardiac Intensive Care Society has recognised this knowledge gap as an area needing a more comprehensive and evidence-based approach to the management of the critically ill child with heart disease. To address this, the Pediatric Cardiac Intensive Care Society created a scientific statements and white papers committee. Scientific statements and white papers will present the current state-of-the-art in areas where controversy exists, providing clinicians with guidance in diagnostic and therapeutic strategies, particularly where evidence-based data are lacking. This paper provides a template for other societies and organisations faced with the task of developing scientific statements and white papers. We describe the methods used to perform a systematic literature search and evidence rating that will be used by all scientific statements and white papers emerging from the Pediatric Cardiac Intensive Care Society. The Pediatric Cardiac Intensive Care Society aims to revolutionise the care of children with heart disease by shifting our efforts from individual institution-based practices to national standardised protocols and to lay the ground work for multicentre high-impact research directions.

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Doroba, Jaime Esbensen. "NRP Versus PALS for Infants Outside the Delivery Room: Not If, but When?" Critical Care Nurse 41, n. 6 (1 dicembre 2021): 22–27. http://dx.doi.org/10.4037/ccn2021339.

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Background Both the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines can be used for infants requiring cardiopulmonary resuscitation outside the delivery room. Each set of guidelines has supporting algorithms for resuscitation; however, there are no current recommendations for transitioning older infants outside the delivery room. Objective To provide background information on the algorithms in the Neonatal Resuscitation Program and Pediatric Advanced Life Support guidelines and to discuss the role that nurses and advanced practice nurses play in advancing scientific research on resuscitation. Content Covered Summaries of both sets of guidelines, differences in practices, and recommendations for practice changes will be discussed. Discussion Provider preference and unit practice determine which guidelines are used for infants outside the delivery room. Providers in pediatric intensive care units and pediatric cardiac intensive care units often use the Pediatric Advanced Life Support guidelines, whereas providers in neonatal intensive care units use the Neonatal Resuscitation Program guidelines for infants of the same age. The variation in resuscitation practices for infants outside the delivery room can negatively affect resuscitation outcomes.

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Safaei-Asl, Afshin, Mahsa Jilani, Abtin Heydarzadeh e Shohreh Maleknejad. "Prognosis of acute kidney injury based on pRIFLE criteria among patients admitted to pediatric intensive care unit in Northern Iran; a single center study". Journal of Renal Injury Prevention 8, n. 2 (28 gennaio 2019): 140–45. http://dx.doi.org/10.15171/jrip.2019.26.

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Introduction: Acute kidney injury (AKI) is a frequent problem in pediatric intensive care units, while it is associated with significant mortality. Objectives: The aim of this study was to determine the prevalence and prognosis of AKI based on pRIFLE (pediatric risk, injury, failure, loss, end-stage renal disease) criteria among children admitted to a pediatric intensive care unit Patients and Methods: This research included 323 children from 1 month to 14 years old age, admitted to the pediatric intensive care unit. The pRIFLE was determined in patients along with urinary output and creatinine level. The pediatric risk of mortality (PRISM) score was also assessed. Results: Mean PRISM III score was 34.66 ± 15.97 and 17.72 ± 6.06 respectively in children with and without AKI (P=0.001). It was found that variables of encephalopathy, PRISMIII score and gender were the only variables affecting the incidence of AKI. Conclusion: While pRIFLE criteria are appropriate and efficient criteria for early diagnosis of AKI, their role alone as prognostic factors of mortality require further studies.

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Tzuh Tang, Siew, Yen-Ni Hung, Tsang-Wu Liu, Dong-Tsamn Lin, Yueh-Chih Chen, Shiao-Chi Wu e Tsui Hsia Hsu. "Pediatric End-of-Life Care for Taiwanese Children Who Died As a Result of Cancer From 2001 Through 2006". Journal of Clinical Oncology 29, n. 7 (1 marzo 2011): 890–94. http://dx.doi.org/10.1200/jco.2010.32.5639.

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Purpose Patterns of aggressive end-of-life (EOL) care have not been extensively explored in a pediatric cancer population, especially outside Western countries. The purpose of this population-based study was to examine trends in aggressive pediatric EOL cancer care in Taiwan. Methods Retrospective cohort study that used administrative data among 1,208 pediatric cancer decedents from 2001 through 2006. Results Taiwanese pediatric cancer patients who died in 2001 through 2006 received aggressive EOL care. The majority of these patients in their last month of life continued to receive chemotherapy (52.5%), used intensive care (57.0%), underwent intubation (40.9%), underwent mechanical ventilation (48.2%), or spent greater than 14 days (69.5%) in hospital, and they died in an acute care hospital (78.8%). Of these pediatric cancer patients, one in four received cardiopulmonary resuscitation in the month before they died, and only 7.2% received hospice care. Among those who received hospice care, 21.8% started such care within the last 3 days of life. This pattern of aggressive EOL care did not change over the study period except for significantly decreased intubation in the last month of life. Conclusion Continued chemotherapy and heavy use of life-sustaining treatments in the last month of life coupled with lack of hospice care to support Taiwanese pediatric cancer patients dying at home may lead to multiple unplanned health care encounters, prolonged hospitalization at EOL, and eventual death in an acute care hospital for the majority of these patients. Future research should design interventions that enable Taiwanese pediatric cancer patients to receive EOL care that best meets the individual or the parental needs and preferences.

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Tume, Lyvonne N., Minette Coetzee, Karen Dryden-Palmer, Patricia A. Hickey, Sharon Kinney, Jos M. Latour, Mavilde L. G. Pedreira, Gerri R. Sefton, Lauren Sorce e Martha A. Q. Curley. "Pediatric Critical Care Nursing Research Priorities—Initiating International Dialogue". Pediatric Critical Care Medicine 16, n. 6 (luglio 2015): e174-e182. http://dx.doi.org/10.1097/pcc.0000000000000446.

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Duffett, Mark, Melissa Brouwers, Maureen O. Meade, Grace M. Xu e Deborah J. Cook. "Research Collaboration in Pediatric Critical Care Randomized Controlled Trials". Pediatric Critical Care Medicine 21, n. 1 (gennaio 2020): 12–20. http://dx.doi.org/10.1097/pcc.0000000000002120.

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Nicholson, Carol E., Bruce M. Gans, Anthony C. Chang, Murray M. Pollack, James Blackman, Brett P. Giroir, Douglas Wilson et al. "Pediatric critical care medicine: Planning for our research future". Pediatric Critical Care Medicine 4, n. 2 (aprile 2003): 196–202. http://dx.doi.org/10.1097/01.pcc.0000059728.63798.da.

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Cooper, Virginia Bonsal, e Catherine Haut. "Preventing Ventilator-Associated Pneumonia in Children: An Evidence-Based Protocol". Critical Care Nurse 33, n. 3 (1 giugno 2013): 21–29. http://dx.doi.org/10.4037/ccn2013204.

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Ventilator-associated pneumonia, the second most common hospital-acquired infection in pediatric intensive care units, is linked to increased morbidity, mortality, and lengths of stay in the hospital and intensive care unit, adding tremendously to health care costs. Prevention is the most appropriate intervention, but little research has been done in children to identify necessary skills and strategies. Critical care nurses play an important role in identification of risk factors and prevention of ventilator-associated pneumonia. A care bundle based on factors, including evidence regarding the pathophysiology and etiology of pneumonia, mechanical ventilation, duration of ventilation, and age of the child, can offer prompts and consistent prevention strategies for providers caring for children in the pediatric intensive care unit. Following the recommendations of the Centers for Disease Control and Prevention and adapting an adult model also can support this endeavor. Ultimately, the bedside nurse directs care, using best evidence to prevent this important health care problem.

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Board, R., e N. Ryan-Wenger. "State of the science on parental stress and family functioning in pediatric intensive care units". American Journal of Critical Care 9, n. 2 (1 marzo 2000): 106–22. http://dx.doi.org/10.4037/ajcc2000.9.2.106.

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BACKGROUND: Critical illness of a child is stressful for parents and may affect family functioning. Most research on hospitalization in pediatric intensive care units has focused on the immediate responses of parents to the experience. OBJECTIVE: To critically review literature about pediatric intensive care units and to link those studies to a theoretical framework: McCubbin and McCubbin's resiliency model of family stress, adjustment, and adaptation. An updated synthesis of the literature is essential to prevent unnecessary duplication of research. METHODS: Guidelines presented by Ryan-Wenger were used to critique the scientific credibility and integrity of 38 research reports found by searching MEDLINE, the Cumulative Index to Nursing and Allied Health, and reference lists. The critique was organized according to the components of the research process, and then study results were reviewed according to the variables of the resiliency model. RESULTS: Most publications focused on variables in the adjustment phase, including stressors, resources, perceptions of stressors, and outcomes for patients' families. Obvious gaps in knowledge were related to families' vulnerability, type, and problem-solving and coping strategies. Many of the studies were biased toward white persons and toward mothers. CONCLUSIONS: Further research is warranted on (1) families of various ethnic backgrounds; (2) fathers and their low participation rates; (3) mother and father comparisons; (4) replication of interventional research with larger and more diverse samples; (5) exploratory and prospective, longitudinal research; and (6) research with children in pediatric intensive care units.

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Pandurov, Marina, Izabella Fabri-Galambos, Andjela Opancina, Anna Uram-Benka, Goran Rakic e Biljana Draskovic. "Nosocomial infections in a pediatric surgical intensive care unit: An unicentric cross-sectional study". Medical review 74, n. 3-4 (2021): 112–16. http://dx.doi.org/10.2298/mpns2104112p.

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Introduction. Nosocomial infections are a common complication in patients hospitalized in intensive care units. The aims of this research were to examine the incidence of nosocomial infections in patients admitted to the pediatric surgical intensive care unit, the impact of hospital length of stay and type of surgical disease on the incidence of nosocomial infections, the frequency of microorganisms causing nosocomial infections and their antibiotic susceptibility profile. Material and Methods. Data on 50 subjects were extracted from the database. The following data were taken from the medical histories of the examinees: age, sex, diagnosis, number of days at the hospital before admission to the intensive care unit, number of days in the intensive care unit, levels of C-reactive protein, applied antimicrobial drugs, isolated microorganisms and their susceptibility to antibiotics. Results. The incidence of nosocomial infections in the study period was 52%. Patients who developed nosocomial infection remained longer in the intensive care unit than those who did not develop it (p = 0.003). Patients with the diagnosis of acute abdomen had a statistically significantly higher incidence of nosocomial infections compared to other patients (p = 0.001). Gram-negative bacteria were the most commonly isolated pathogens (46.8%). Acinetobacter baumanii proved to be the most resistant species in this study, since 80% of the strains did not show sensitivity to any of the tested antibiotics. Conclusion. Nosocomial infections are present in slightly more than half of the patients treated at the pediatric surgical intensive care unit. Patients who developed nosocomial infections stayed longer in the pediatric surgical intensive care unit, which had negative consequences for their health and treatment costs.

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Romanin-Jacur, Giorgio, e Paola Facchin. "Optimal planning of a pediatric semi-intensive care unit via simulation". European Journal of Operational Research 29, n. 2 (maggio 1987): 192–98. http://dx.doi.org/10.1016/0377-2217(87)90109-3.

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Stayer, Debbie, e Joan Such Lockhart. "Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective". American Journal of Critical Care 25, n. 4 (1 luglio 2016): 350–56. http://dx.doi.org/10.4037/ajcc2016251.

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Background Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. Objectives To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children’s families. Methods A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Results Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child’s death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Conclusion Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children’s families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.

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Wessel, David L., e Jane W. Newburger. "Research in the cardiac intensive care unit". Progress in Pediatric Cardiology 4, n. 3 (agosto 1995): 177–84. http://dx.doi.org/10.1016/1058-9813(95)00127-o.

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Zucchetti, Giulia, Giorgia Ambrogio, Marina Bertolotti, Luigi Besenzon, Fabio Borghino, Filippo Candela, Chiara Galletto e Franca Fagioli. "Effects of a high-intensity psychosocial intervention among child–parent units in pediatric oncology". Tumori Journal 106, n. 5 (16 giugno 2020): 362–68. http://dx.doi.org/10.1177/0300891620926226.

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Aim: To compare the efficacy of a high-intensity psychosocial intervention with standardized usual care in countering psychosocial complexity among child–parent units in a pediatric oncology setting. Methods: Two hundred pediatric oncology patients and their parents were recruited from Italian hospitals. A total of 81 child–parent units were assigned to the high-intensity psychosocial intervention and 119 child–parent units to standardized usual care. Psychosocial factors were assessed before and 1 year after intervention to measure efficacy. Results: More improvements over time were observed in the high-intensity intervention group of child–parent units compared to the standard intervention group. Conclusion: An intensive, structured, and tailored high-intensity intervention positively affects the psychosocial factors of child–parent units. Patients and families should have access to intensive psychosocial support throughout the cancer trajectory.

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Lee, Suzie, Marinka Twilt e Simon J. Parsons. "Elevated serum ferritin levels in the pediatric intensive care unit". Alberta Academic Review 2, n. 3 (18 dicembre 2019): 19. http://dx.doi.org/10.29173/aar110.

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Background: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening inflammatory condition caused by dysregulation of the immune system. HLH can develop in children with a variety of underlying causes including genetic cause, infection, autoimmune diseases, malignancy, etc. The symptoms of HLH are often similar to other conditions such as bacterial sepsis or systemic inflammatory response syndrome. This is a problem as the similarities among those different diseases make it difficult for the doctors to diagnose HLH and this can possibly lead to a delay in treatment. 50-75% mortality is reported in patients with secondary HLH (non-inherited) who do not receive treatment. Elevated serum ferritin level, referred to as hyperferritinemia, is the most characteristic feature of HLH and may be helpful in diagnosing HLH apart from other illnesses. This research investigates the incidences of patients with elevated serum ferritin level at the pediatric intensive care unit (PICU) of Alberta Children’s Hospital from 2014-2018 to gain a better understanding of HLH and hyperferritinemia. Objectives: The objectives of the study are i. identify diseases associated with hyperferritinemia on the PICU; ii. predict which PICU patient with hyperferritinemia is at risk to develop HLH during PICU admission; and iii. determine mortality risk in patients with hyperferritinemia and HLH at the PICU. Methods: This project is a retrospective chart review. A literature review was performed on the topic of hyperferritinemia and HLH, and relevant variables were identified for creating a Redcap database. Patient charts and medical records were examined for data collection of different elements including diagnosis, laboratory values, treatments, and survival status. Data of 91 patients who presented with hyperferritinemia in PICU from 2014 to 2018 is being examined. Results: Although this study is currently in progress, it is anticipated to provide insight into the features associated with hyperferritinemia and determine patients with hyperferritinemia who are at risk of developing HLH. Conclusion: Overall, the findings from this study may contribute to better understanding of hyperferritinemia and HLH in pediatric patients and contribute to decreasing mortality and morbidity of patients with hyperferritinemia and HLH.

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Somani, Arif, Aurora Wiseman, Mary-Grace Hickman, Sarah J. Militello, Rebecca E. Wiersma, Michelle T. Vu, Lexie Goertzen, Michael Shyne e Maria Kroupina. "Night-time Screen Media Use in the Pediatric Intensive Care Unit". Global Pediatric Health 8 (gennaio 2021): 2333794X2110497. http://dx.doi.org/10.1177/2333794x211049758.

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This prospective observational study quantified screen media use within the night-time pre-sleep period in a pediatric intensive care unit and postulated possible implications. Seventy-five patients between the ages of newborn to 19 years old were observed 5 evenings per week for 3 weeks. Trained observers documented the patient’s screen use, type of screen used, screen engagement, sleep state, light level, and parental presence. Patients in the ICU had on average 65 minutes of screen media use, per evening. The total screen media use averaged 59 minutes for the 0 to18-month age group; 83 minutes for the 18 to 24-month age group; 66 minutes for 2 to 6 year olds; 72 minutes for 6 to 13 year olds; and 74 minutes for those above 13. This research demonstrates that children are engaging in more screen time during the night hours than is recommended by the AAP.

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Soeteman, Marijn, Jenny Potratz, Jeppe S. Angaard Nielsen, Jef Willems, Frédéric V. Valla, Joe Brierley e Roelie M. Wösten-van Asperen. "Research priorities in pediatric onco-critical care: an international Delphi consensus study". Intensive Care Medicine 45, n. 11 (23 agosto 2019): 1681–83. http://dx.doi.org/10.1007/s00134-019-05706-x.

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Youngblut, JM, e SY Shiao. "Characteristics of a child's critical illness and parents' reactions: preliminary report of a pilot study". American Journal of Critical Care 1, n. 3 (1 novembre 1992): 80–84. http://dx.doi.org/10.4037/ajcc1992.1.3.80.

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OBJECTIVE: To explore the relationships between parents' reactions to the pediatric intensive care unit admission of a child and characteristics of the child's illness. METHOD: A convenience sample, consisting of 16 mothers and 13 fathers of 16 children aged 5 years and younger, was used. The Pediatric Risk of Mortality scale was used to measure severity of illness. Parental reactions were measured at about 24 hours after the child's admission with the Parental Stressor Scale: PICU and the Parental Concerns Scale. RESULTS: Mothers' concerns and stressors were not related to the child's Pediatric Risk of Mortality score. However, fathers reported greater concern about the child's experience and about parenting as the child's Pediatric Risk of Mortality score increased. CONCLUSIONS: Parents' reactions to their child's critical illness and admission to the pediatric intensive care unit were not related to characteristics of the child's condition in this small sample. Future research needs are suggested.

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Berkenbosch, John W., Nina Lubisch, Susan Gallagher e Joe P. Cravero. "DEXMEDETOMIDINE FOR PEDIATRIC PROCEDURAL SEDATION???RESULTS FROM THE PEDIATRIC SEDATION RESEARCH CONSORTIUM (PSRC)". Pediatric Critical Care Medicine 7, n. 5 (settembre 2006): 521. http://dx.doi.org/10.1097/00130478-200609000-00107.

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Holden, Richard, Kathryn Flynn, Yushi Yang, Laila Azam, Matthew Scanlon e Onur Asan. "Provider Use of a Novel EHR display in the Pediatric Intensive Care Unit". Applied Clinical Informatics 07, n. 03 (luglio 2016): 682–92. http://dx.doi.org/10.4338/aci-2016-02-ra-0030.

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SummaryThe purpose of this study was to explore providers’ perspectives on the use of a novel technology, “Large Customizable Interactive Monitor” (LCIM), a novel application of the electronic health record system implemented in a Pediatric Intensive Care Unit.We employed a qualitative approach to collect and analyze data from pediatric intensive care physicians, pediatric nurse practitioners, and acute care specialists. Using semi-structured interviews, we collected data from January to April, 2015. The research team analyzed the transcripts using an iterative coding method to identify common themes.Study results highlight contextual data on providers’ use routines of the LCIM. Findings from thirty six interviews were classified into three groups: 1) providers’ familiarity with the LCIM; 2) providers’ use routines (i.e. when and how they use it); and 3) reasons why they use or do not use it.It is important to conduct baseline studies of the use of novel technologies. The importance of training and orientation affects the adoption and use patterns of this new technology. This study is notable for being the first to investigate a LCIM system, a next generation system implemented in the pediatric critical care setting. Our study revealed this next generation HIT might have great potential for family-centered rounds, team education during rounds, and family education/engagement in their child’s health in the patient room. This study also highlights the effect of training and orientation on the adoption patterns of new technology. Citation: Asan O, Holden RJ, Flynn KE, Yang Y, Azam L, Scanlon MC. Provider use of a novel EHR display in the pediatric intensive care unit: Large customizable interactive monitor (LCIM).

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Parri, Niccolò, Anna Maria Magistà, Federico Marchetti, Barbara Cantoni, Alberto Arrighini, Marta Romanengo, Enrico Felici et al. "Characteristic of COVID-19 infection in pediatric patients: early findings from two Italian Pediatric Research Networks". European Journal of Pediatrics 179, n. 8 (3 giugno 2020): 1315–23. http://dx.doi.org/10.1007/s00431-020-03683-8.

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Abstract Detailed data on clinical presentations and outcomes of children with COVID-19 in Europe are still lacking. In this descriptive study, we report on 130 children with confirmed COVID-19 diagnosed by 28 centers (mostly hospitals), in 10 regions in Italy, during the first months of the pandemic. Among these, 67 (51.5%) had a relative with COVID-19 while 34 (26.2%) had comorbidities, with the most frequent being respiratory, cardiac, or neuromuscular chronic diseases. Overall, 98 (75.4%) had an asymptomatic or mild disease, 11 (8.5%) had moderate disease, 11 (8.5%) had a severe disease, and 9 (6.9%) had a critical presentation with infants below 6 months having significantly increased risk of critical disease severity (OR 5.6, 95% CI 1.3 to 29.1). Seventy-five (57.7%) children were hospitalized, 15 (11.5%) needed some respiratory support, and nine (6.9%) were treated in an intensive care unit. All recovered. Conclusion:This descriptive case series of children with COVID-19, mostly encompassing of cases enrolled at hospital level, suggest that COVID-19 may have a non-negligible rate of severe presentations in selected pediatric populations with a relatively high rates of comorbidities. More studies are needed to further understand the presentation and outcomes of children with COVID-19 in children with special needs. What is Known:• There is limited evidence on the clinical presentation and outcomes of children with COVID-19 in Europe, and almost no evidence on characteristics and risk factors of severe cases. What is New:• Among a case series of 130 children, mostly diagnosed at hospital level, and with a relatively high rate (26.2%) of comorbidities, about three-quarter had an asymptomatic or mild disease.• However, 57.7% were hospitalized, 11.5% needed some respiratory support, and 6.9% were treated in an intensive care unit.

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