Currently nearly one-quarter of admissions to pediatric intensive care units (PICUs) worldwide are for neurocritical care diagnoses that are associated with significant morbidity and mortality. Pediatric neurocritical care is a rapidly evolving field with unique challenges due to not only age-related responses to primary neurologic insults and their treatments but also the rarity of pediatric neurocritical care conditions at any given institution. The structure of pediatric neurocritical care services therefore is most commonly a collaborative model where critical care medicine physicians coordinate care and are supported by a multidisciplinary team of pediatric subspecialists, including neurologists.
View Article and Find Full Text PDFObjectives: To describe our experience of using noninvasive neurally adjusted ventilatory assist (NIV-NAVA) in infants with bronchiolitis, its association with the evolution of respiratory effort, and PICU outcomes.
Design: Retrospective analysis of a prospectively curated, high-frequency electronic database.
Setting: A PICU in a university-affiliated maternal-child health center in Canada.
Objectives: Tonic diaphragmatic activity (tonic Edi, i.e., sustained diaphragm activation throughout expiration) reflects diaphragmatic effort to defend end-expiratory lung volumes.
View Article and Find Full Text PDFBackground: Z scores are the method of choice to report dimensions in pediatric echocardiography. Z scores based on body surface area (BSA) have been shown to cause systematic biases in overweight and obese children. Using aortic valve (AoV) diameters as a paradigm, the aims of this study were to assess the magnitude of z score underestimation in children with increased body mass index z score (BMI-z) and to determine if a predicting model with height and weight as independent predictors would minimise this bias.
View Article and Find Full Text PDFObjective: Parental accompaniment during transport is considered a core quality metrics in pediatric transport and a key measure of family-centered care in this setting. However, children's opinions on this topic have never been sought. The aim of this study was to evaluate the opinion of different actors of a specialized pediatric transport system on parental presence during transport.
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