scholarly journals Effectiveness of Closed-PICU Perioperative Management of Children with Congenital Tracheal Stenosis

Author(s):  
Kazunori Aoki ◽  
Hiroshi Kurosawa ◽  
Yusuke Seino ◽  
Keiichi Morita ◽  
Hironori Matsuhisa ◽  
...  

Perioperative management of congenital tracheal stenosis (CTS) is challenging. Objectives: We investigated the effect of closed-pediatric intensive care unit (PICU) perioperative management by pediatric intensivists, compared with open-PICU management by surgeons, on the ventilator-free days (VFD) and length of postoperative PICU stay in children with CTS. Methods: This retrospective cohort study was conducted in a PICU in Japan. Children with CTS who underwent slide tracheoplasty were grouped according to whether they were perioperatively managed in an open (January 2015 to April 2016) or a closed (May 2016 to July 2019) PICU. Data were extracted from patient medical records. Results: In total, 13 and 38 patients were included in the open- and closed-PICU groups, respectively. Compared to the open-PICU group, the closed-PICU group had shorter durations of muscle relaxant administration (median: 4 vs. 5 days; P < 0.001); earlier initiation of enteral feeding (median: postoperative day 1 vs. postoperative day 7; P < 0.001); more 28-day VFD (median: 21 vs. 20 days; P = 0.04); and shorter duration of postoperative PICU stay (median: 16 vs. 36 days; P = 0.002), but the mortality did not differ significantly (0/38 [0%] vs. 1/13 [8%]; P = 0.25). Conclusions: Closed-PICU perioperative management with pediatric intensivists’ participation significantly increased 28-day VFD and reduced the length of postoperative PICU stay in patients with CTS.

Medwave ◽  
2017 ◽  
Vol 17 (03) ◽  
pp. e6940-e6940 ◽  
Author(s):  
Lina María Serna-Higuita ◽  
John Fredy Nieto-Ríos ◽  
Jorge Eduardo Contreras-Saldarriaga ◽  
Juan Felipe Escobar-Cataño ◽  
Luz Adriana Gómez-Ramírez ◽  
...  

Author(s):  
Jeremy M. Loberger ◽  
Inmaculada B. Aban ◽  
Priya Prabhakaran

AbstractThe objective of this study was to explore correlations between sepsis-associated coagulopathy (SAC) in pediatric septic shock and clinical outcomes. This was a retrospective cohort study of all children admitted to a single, academic pediatric intensive care unit with septic shock over 6 years. The prevalence of SAC was 93.5% with 61% being severe. Those with severe SAC were more likely to have a positive blood culture and have longer median duration of ventilation. All observed mortalities occurred in the severe SAC and indeterminate SAC groups. SAC is highly prevalent in pediatric septic shock and may predict important outcomes.


2017 ◽  
Vol 52 (2) ◽  
pp. 133-139 ◽  
Author(s):  
Heidi L. Banasch ◽  
Deonne A. Dersch-Mills ◽  
Leah L. Boulter ◽  
Elaine Gilfoyle

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