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pediatrics, trauma, congenital heart, critical care

François Proulx, Jean Sébastien Joyal, M Michele Mariscalco, Stéphane Leteurtre, Francis Leclerc, Jacques Lacroix
OBJECTIVES: To review the epidemiology of pediatric multiple organ dysfunction syndrome (MODS) and summarize current concepts regarding the pathophysiology of shock, organ dysfunction, and nosocomial infections in this population. DATA SOURCE: A MEDLINE-based literature search using the keywords MODS and child, without any restriction to the idiom. MAIN RESULTS: Critically ill children may frequently develop multisystemic manifestations during the course of severe infections, multiple trauma, surgery for congenital heart defects, or transplantations...
January 2009: Pediatric Critical Care Medicine
Ori Efrati, Udi Sadeh-Gornik, Dalit Modan-Moses, Asher Barak, Amir Szeinberg, Amir Vardi, Gidon Paret, Amos Toren, Daphna Vilozni, Yaacov Yahav
OBJECTIVE: The use of flexible bronchoscopy (FOB) and bronchoalveolar lavage (BAL) in investigating pediatric patient with airway abnormalities and pulmonary infiltrates are indispensable and are now a routine procedure in many centers. Immunocompromised and cancer patients, especially after bone marrow transplantation, and children who have undergone surgery for congenital heart disease (CHD) are at high risk for pulmonary disease. Our aim was to study the diagnostic rate, safety, and clinical yield of FOB in critically ill pediatric patients...
January 2009: Pediatric Critical Care Medicine
D D Vernon, J M Dean, O D Timmons, W Banner, E M Allen-Webb
OBJECTIVE: To determine the frequency of withdrawal or limitation of supportive care for children dying in a pediatric intensive care unit (ICU). DESIGN: Retrospective review of medical records. SETTING: Pediatric ICU in a tertiary care children's hospital. PATIENTS: All children dying in the pediatric ICU over a 54-month period (n = 300). INTERVENTIONS: Medical record review. MEASUREMENTS AND MAIN RESULTS: Data recorded for each patient included diagnosis, mode of death, and whether the child was brain dead...
November 1993: Critical Care Medicine
P Rothstein, P Johnson
Four hundred sixty-one consecutive admissions to the Pediatric Intensive Care Unit (PICU) were evaluated using the Therapeutic Intervention Scoring System (TISS). Patients requiring an increased level of care, defined as TISS points greater than or equal to 10, accounted for 75% of patient days in the ICU. Within this group, the primary reason for admission to the ICU was congenital heart disease, trauma, malignancy, respiratory failure, and sepsis. Survival was inversely related to TISS points, through TISS itself could not differentiate between survivors and nonsurvivors...
January 1982: Critical Care Medicine
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