Impact of the Updated Guideline for Pediatric Brain Death Determination on Current Practice.

A guideline to determine pediatric brain death was updated in 2011. It is unknown how pediatric intensivists have accepted and adopted the revised guideline into clinical practice. We surveyed US pediatric critical care attending physicians July 2013 to September 2013 and February 2020 to May 2020.

Pediatric cardiac arrest due to drowning and other respiratory etiologies: Neurobehavioral outcomes in initially comatose children.

Aim: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial.

Methods: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36.

Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children.

Background: Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiac arrest; however, data on temperature management after in-hospital cardiac arrest are limited.

Methods: In a trial conducted at 37 children's hospitals, we compared two temperature interventions in children who had had in-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose children older than 48 hours and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.

Management of the Potential Organ Donor in the ICU: Society of Critical Care Medicine/American College of Chest Physicians/Association of Organ Procurement Organizations Consensus Statement.

This document was developed through the collaborative efforts of the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations. Under the auspices of these societies, a multidisciplinary, multi-institutional task force was convened, incorporating expertise in critical care medicine, organ donor management, and transplantation. Members of the task force were divided into 13 subcommittees, each focused on one of the following general or organ-specific areas: death determination using neurologic criteria, donation after circulatory death determination, authorization process, general contraindications to donation, hemodynamic management, endocrine dysfunction and hormone replacement therapy, pediatric donor management, cardiac donation, lung donation, liver donation, kidney donation, small bowel donation, and pancreas donation.

Therapeutic hypothermia after out-of-hospital cardiac arrest in children.

Background: Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiac arrest, but data about this intervention in children are limited.

Methods: We conducted this trial of two targeted temperature interventions at 38 children's hospitals involving children who remained unconscious after out-of-hospital cardiac arrest. Within 6 hours after the return of circulation, comatose patients who were older than 2 days and younger than 18 years of age were randomly assigned to therapeutic hypothermia (target temperature, 33.

Pediatric brain death determination.

Clinical guidelines for the determination of brain death in children were first published in 1987. These guidelines were revised in 2011 under the auspices of the Society of Critical Care Medicine, the American Academy of Pediatrics, and the Child Neurology Society, and provide the minimum standards that must be satisfied before brain death can be declared in infants and children. After achieving physiologic stability and exclusion of confounders, two examinations including apnea testing separated by an observation period (24 hours for term newborns up to 30 days of age, and 12 hours for infants and children from 31 days up to 18 years) are required to establish brain death.

Effect of high-dose continuous albuterol nebulization on clinical variables in children with status asthmaticus.

Objectives: Continuous albuterol nebulization is generally administered at 2.5-20 mg/hr at most centers. We examined the effect of high-dose (75 or 150 mg/hr) albuterol on clinical variables in children with status asthmaticus.

Identifying potential kidney donors among newborns undergoing circulatory determination of death.

Background: Over 96,000 patients await kidney transplantation in the United States, and 35,000 more are wait-listed annually. The demand for donor kidneys far outweighs supply, resulting in significant waiting list morbidity and mortality. We sought to identify potential kidney donors among newborns because en bloc kidney transplantation donation after circulatory determination of death (DCDD) may broaden the donor pool.

Circulatory death determination in uncontrolled organ donors: a panel viewpoint.

One barrier for implementing programs of uncontrolled organ donation after the circulatory determination of death is the lack of consensus on the precise moment of death. Our panel was convened to study this question after we performed a similar analysis on the moment of death in controlled organ donation after the circulatory determination of death. We concluded that death could be determined by showing the permanent or irreversible cessation of circulation and respiration.

Abdominal compartment syndrome in children.

Abdominal compartment syndrome is defined as sustained intra-abdominal pressure greater than 20 mm Hg (with or without abdominal perfusion pressure <60 mm Hg) associated with new organ failure or dysfunction. The syndrome is associated with 90% to 100% mortality if not recognized and treated in a timely manner. Nurses are responsible for accurately measuring intra-abdominal pressure in children with abdominal compartment syndrome and for alerting physicians about important changes.

Pediatric critical care nurses' experience with abdominal compartment syndrome.

Background: Abdominal compartment syndrome (ACS) is a syndrome associated with multi-system effects of elevated intra-abdominal pressure (IAP) in critically ill children. It has a 90-100% mortality rate if not recognized and treated promptly. Measuring IAP helps identify patients developing intra-abdominal hypertension (IAH) which allows for timely intervention before progression to ACS.

Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations-executive summary.

Objective: To review and revise the 1987 pediatric brain death guidelines.

Methods: Relevant literature was reviewed. Recommendations were developed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system.

Abdominal decompression in children.

Abdominal compartment syndrome (ACS) increases the risk for mortality in critically ill children. It occurs in association with a wide variety of medical and surgical diagnoses. Management of ACS involves recognizing the development of intra-abdominal hypertension (IAH) by intra-abdominal pressure (IAP) monitoring, treating the underlying cause, and preventing progression to ACS by lowering IAP.

Effect of early nutritional support on intensive care unit length of stay and neurological status at discharge in children with severe traumatic brain injury.

Pediatric severe traumatic brain injury treatment guidelines for nutrition indicate that "there are insufficient data to support a treatment guideline for this topic" (P. D. Adelson et al.

Abdominal compartment syndrome: focus on the children.

This article is a concise summary of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) with an emphasis on factors relevant to their occurrence in children. It discusses the limitations in the direct application of the current World Society of Abdominal Compartment Syndrome consensus definitions and extrapolation of management practices derived from studying adult patients to the pediatric age group. Techniques that may be used for measuring intra-abdominal pressure (IAP) in children, normal IAP ranges, risk factors for developing ACS as well as current medical and surgical management options in children are discussed.

Clinical report—Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations.

Objective: To review and revise the 1987 pediatric brain death guidelines.

Methods: Relevant literature was reviewed. Recommendations were developed using the GRADE system.

Guidelines for the determination of brain death in infants and children: an update of the 1987 Task Force recommendations.

Objective: To review and revise the 1987 pediatric brain death guidelines.

Methods: Relevant literature was reviewed. Recommendations were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system.

Identifying potential heart donors among newborns undergoing circulatory determination of death.

Background: Infants younger than 1 year old have the highest heart transplant wait-list mortality. Transplantation from donors after circulatory determination of death (DCDD) is an innovative new option for these patients. We examined the potential for heart donation in neonatal intensive care unit (NICU) patients undergoing elective withdrawal of life support.

Understanding of Abdominal Compartment Syndrome among Pediatric Healthcare Providers.

Background. The sparse reporting of abdominal compartment syndrome (ACS) in the pediatric literature may reflect inadequate awareness and recognition among pediatric healthcare providers (HCP). Purpose.

The circulatory-respiratory determination of death in organ donation.

Objective: Death statutes permit physicians to declare death on the basis of irreversible cessation of circulatory-respiratory or brain functions. The growing practice of organ donation after circulatory determination of death now requires physicians to exercise greater specificity in circulatory-respiratory death determination. We studied circulatory-respiratory death determination to clarify its concept, practice, and application to innovative circulatory determination of death protocols.