Endotracheal intubation skills of pediatricians versus anesthetists in neonates and children.

This study compares the performance of pediatricians and anesthetists in neonatal and pediatric endotracheal intubations (ETI) during simulated settings. Participants completed a questionnaire and performed an ETI scenario on a neonatal and a child manikin. The procedures were recorded with head cameras and cameras attached to standard laryngoscope blades.

Pediatric Early Warning System Scores: Lessons to be Learned.

The objective was to evaluate the use of a pediatric early warning system (PEWS) score in Dutch general and university hospitals, 4 years after the introduction of a national safety program in which the implementation of a PEWS was advised. An electronic cross-sectional survey was used. All general and university hospitals (  = 91) with a pediatric department in The Netherlands were included in the study.

The effects of dexamethasone and oxygen in ventilated adult sheep with early phase acute respiratory distress syndrome.

Background: Acute respiratory distress syndrome (ARDS) is a life-threating condition with high morbidity and mortality. Inflammation is the main factor in the pathogenesis of ARDS. Therefore systemic corticosteroids are a rational therapeutic approach, but the effect of corticosteroids is still unclear.

Dutch paediatrician's opinions about acute care for critically ill children in general hospitals.

Unlabelled: Paediatricians in general hospitals have limited experience with critically ill children, due to the low incidence and their diversity in age, pathology and presentation. Consequently, adequate organization, training and materials and medication are of major importance. This voluntary and anonymous survey-based study was conducted to gain insight in the current status of these aspects.

The forthcoming DSM-5, critical care medicine, and pediatric neuropsychiatry: which new concepts do we need?

Examination and comparison of the current DSM-IV-TR and the proposed revisions for the forthcoming DSM-5, with regard to neuropsychiatric aspects of critical illness, identified five important issues. These remain to be addressed in order to improve the care of critically ill patients. These are 1) sickness behavior, as part of the organic reaction types of the brain; 2) delirium in children and the "Differential Diagnosis of Mental Disorders Due to a General Medical Condition" in children; 3) catatonia; 4) regressive disorders in childhood in relation to somatic disorders (e.

Comparison of recruitment manoeuvres in ventilated sheep with acute respiratory distress syndrome.

Background: Recruitment manoeuvres are widely used in clinical practice to open the lung and prevent lung injury by derecruitment, although the evidence is still discussed. In this study two different recruitment manoeuvres were compared to no recruitment manoeuvres (control) in ventilated sheep with acute respiratory distress syndrome (ARDS), induced by lung lavage.

Methods: We performed a prospective, randomised study in 26 ventilated sheep with ARDS, to evaluate the effect of two different recruitment manoeuvres on gas exchange, blood pressure and lung injury.

Diagnostic considerations regarding pediatric delirium: a review and a proposal for an algorithm for pediatric intensive care units.

Context: If delirium is not diagnosed, it is unlikely that any effort will be made to reverse it. Given evidence for under-diagnosis, tools that aid recognition are required.

Objective: Relating three presentations of pediatric delirium (PD) to standard criteria and developing a diagnostic algorithm.

Gut mucosal cell damage in meningococcal sepsis in children: relation with clinical outcome.

Objective: The pathophysiological sequelae of meningococcal sepsis are mainly caused by deregulated microvasculature function, leading to impaired tissue blood flow. Because mature enterocytes are known to be susceptible to altered perfusion, we aimed to investigate: (1) the development of enterocyte damage; and (2) the relation between enterocyte damage and severity of disease and outcome in children with meningococcal sepsis.

Design: Retrospective human study.

Minimizing limb amputations in meningococcal sepsis by early microsurgical arteriolysis.

Purpose: Surgical treatment of children with meningococcal sepsis has mainly involved debridement of necrotic skin and amputation of limbs. This resulted in major functional impairment. On the contrary, when early microsurgical arteriolysis was performed, freeing up the blood vessels, the impaired blood flow could be restored, thereby significantly reducing the amputation levels.

Evaluation of a non-invasive bladder volume measurement in children.

Objective: Postoperative urinary retention (PUR) is associated with overdistension of the bladder. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Postoperative monitoring of the bladder volume by ultrasound to prevent PUR is reliable in adults, but has not been evaluated in children.

Vanishing spleen after Nissen fundoplication: a case report.

Nissen fundoplication is a generally accepted treatment for severe gastro-oesophageal reflux after conservative management has failed. The surgical techniques and the complications that may develop following the operation have been well described. However, necrosis of the spleen is a rare complication.

Pediatric illness severity measures predict delirium in a pediatric intensive care unit.

Context: Delirium in children is a serious but understudied neuropsychiatric disorder. So there is little to guide the clinician in terms of identifying those at risk.

Objective: To study, in a pediatric intensive care unit (PICU), the predictive power of widely used generic pediatric mortality scoring systems in relation to the occurrence of pediatric delirium (PD).

Pediatric delirium in critical illness: phenomenology, clinical correlates and treatment response in 40 cases in the pediatric intensive care unit.

Objective: To study the phenomenology, clinical correlates, and response to treatment of delirium in critically ill children in the pediatric intensive care unit (PICU).

Design, Setting And Patients: Descriptive study of a cohort of child psychiatric consultations from a tertiary PICU between January 2002 and December 2005. Demographic data, clinical presentation, and response to treatment of children subsequently diagnosed with delirium were analyzed.

Point-of-care blood analyzer during the interhospital transport of critically ill children.

Objectives: To investigate the influence of point-of-care laboratory results (arterial blood gases, ionized calcium, potassium, sodium, glucose, hematocrit and hemoglobin) on therapeutic interventions during interhospital pediatric intensive care transport.

Design: Prospective observational study.

Settings: Specialist pediatric intensive care retrieval team of a university hospital.

Hyperglycemia in children with meningococcal sepsis and septic shock: the relation between plasma levels of insulin and inflammatory mediators.

Context: Hyperglycemia and insulin resistance are common findings in critically ill adult patients and are associated with increased morbidity and mortality.

Objectives: The objective of this study was to investigate the hyperglycemic response to critical illness in children.

Design: The study was designed as an observational cohort study.

Assessment of whole body protein metabolism in critically ill children: can we use the [15N]glycine single oral dose method?

Background & Aims: Most stable-isotope methods to evaluate whole body protein metabolism in patients are invasive and difficult to use in children. In this study protein metabolism was evaluated with the non-invasive [15N]glycine single oral dose method in critically ill children and the value of the method is discussed.

Methods: [15N]glycine (100mg) was given orally to children (mean age 5.

Comparison of interhospital pediatric intensive care transport accompanied by a referring specialist or a specialist retrieval team.

Objective: Interhospital transfers of critically ill pediatric patients in The Netherlands are accompanied by referring specialists or by specialist retrieval teams. We compared the interventions before and directly after transports and the complications and the equipment available during transports in the two groups.

Design And Setting: Prospective observational clinical study in pediatric intensive care units of Dutch university hospitals.

Interhospital paediatric intensive care transport: a novel transport unit based on a standard ambulance trolley.

A recent development in providing intensive care for children is that it is more and more centralized in tertiary centres. The centralization of intensive care facilities for children in tertiary centres demands a safe and well-organized transport system. The transfer of critically ill children from a referring general hospital to a tertiary paediatric intensive care centre should be performed by a specially trained and fully equipped transport team.