Prediction of fluid responsiveness in mechanically ventilated children: Comparison of pleth variability index (PVI) with Transthoracique echocardiography dynamic parameters in pediatric intensive care unit

2016 ◽  
Author(s):  
Kamel Elhalimi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Fluid Responsiveness ◽  
Pediatric Intensive Care ◽  
Dynamic Parameters ◽  
Pleth Variability Index ◽  
Mechanically Ventilated ◽  
Variability Index

scholarly journals RISK FACTORS FOR EXTUBATION FAILURE IN MECHANICALLY VENTILATED CHILDREN IN PEDIATRIC INTENSIVE CARE UNIT

2019 ◽  
Vol 6 (7) ◽  
pp. 379-382
Author(s):  
Supreet Khurana ◽  
Siddharth Bhargava ◽  
Puneet A Pooni ◽  
Deepak Bhat ◽  
Gurdeep Dhooria ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Extubation Failure ◽  
Mechanically Ventilated

scholarly journals Use of Dexamethasone to Prevent Extubation Failure in Pediatric Intensive Care Unit: A Randomized Controlled Clinical Trial

2020 ◽  
Author(s):  
Haroldo Teófilo de Carvalho ◽  
José Roberto Fioretto ◽  
Rossano Cesar Bonatto ◽  
Cristiane Franco Ribeiro ◽  
Joelma Gonçalves Martin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Extubation Failure ◽  
Controlled Clinical Trial ◽  
Loading Dose ◽  
Randomized Controlled Clinical Trial ◽  
Mechanically Ventilated ◽  
Randomized Controlled

AbstractExtubation failure is a common event in intensive care units. Corticosteroids are effective in preventing failure in adults, but no consensus has been reached on this matter in pediatrics. We assessed the efficacy of intravenous dexamethasone in mechanically ventilated children and adolescents for more than 48 hours, with at least one risk factor for failure. Extubations were scheduled 24 hours in advance when possible, and patients were randomly assigned into two groups: one group received a loading dose followed by up to four doses of dexamethasone, and the other group received no corticosteroids. Need for reintubation and length of stay in the pediatric intensive care unit were similar in both groups, and frequency of reintubation was 12.9%.

scholarly journals Association Between Deep Sedation from Continuous Intravenous Sedatives and Extubation Failures in Mechanically Ventilated Patients in the Pediatric Intensive Care Unit

2017 ◽  
Vol 22 (2) ◽  
pp. 106-111
Author(s):  
Jennifer M. Schultheis ◽  
Travis S. Heath ◽  
David A. Turner
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Continuous Infusion ◽  
Pediatric Intensive Care Unit ◽  
Deep Sedation ◽  
Pediatric Intensive Care ◽  
Extubation Failure ◽  
Mechanically Ventilated ◽  
Significant Difference

OBJECTIVE The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors associated with deep sedation. METHODS This was a retrospective cohort study conducted between January 1, 2009, and October 31, 2012, in the pediatric intensive care unit (PICU) at Duke Children's Hospital. Patients were included in the study if they had been admitted to the PICU, had been mechanically ventilated for ≥48 hours, and had received at least one continuous infusion benzodiazepine and/or opioid infusion for ≥24 hours. Patients were separated into 2 groups: those deeply sedated and those not deeply sedated. Deep sedation was defined as having at least one documented State Behavioral Scale (SBS) of −3 or −2 within 72 hours prior to planned extubation. RESULTS A total of 108 patients were included in the analysis. Both groups were well matched with regard to baseline characteristics. For the primary outcome, there was no difference in extubation failures in those who were deeply sedated compared to those not deeply sedated (14 patients [22.6%] versus 7 patients [15.2%], respectively; p = 0.33). After adjusting for potential risk factors, patients with a higher weight percentile for age (odds ratio [OR] 1.02; 95% confidence interval [CI] 1.00–1.03), lower Glasgow Coma Score (GCS) score prior to intubation (OR 0.85; 95% CI 0.74–0.97), and larger maximum benzodiazepine dose (OR 1.93; 95% CI 1.01–3.71) were associated with greater odds of deep sedation. A higher GCS prior to intubation was significantly associated with increased odds of extubation failure (OR 1.19; 95% CI 1.02–1.39). CONCLUSIONS While there was no statistically significant difference in extubation failures between the 2 groups included in this study, considering the severe consequences of extubation failure, the numerical difference reported may be clinically important.

scholarly journals Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Diaaeldin Badr Metwally Kotb Aboelnile ◽  
Mohamed Ismail Abdelfattah Elseidy ◽  
Yasir Ahmed Elbasiony Mohamed Kenawey ◽  
Ibrahim Mohammed Alsayed Ahmed Elsherif
Keyword(s):  
Intensive Care Unit ◽  
Fluid Responsiveness ◽  
Threshold Value ◽  
Surgical Intensive Care Unit ◽  
Pleth Variability Index ◽  
Surgical Intensive Care ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Variability Index ◽  
Ventilated Patients

Abstract Background Patients may have signs of hypovolemia, but fluid administration is not always beneficial. We are in need of bedside devices and techniques, which can predict fluid responsiveness effectively and safely. This study is aiming to compare the effectiveness and reliability of the pleth variability index (PVI) and IVC distensibility index (dIVC) as predictors of fluid responsiveness by simultaneous recordings in all sedated mechanically ventilated patients in the surgical intensive care unit (ICU). We used the passive leg raising test (PLR) as a harmless reversible technique for fluid challenge, and patients were considered responders if the cardiac index (CI) measured by transthoracic echocardiography (TTE) increased ≥ 15% after passive leg raising test (PLR). Results This observational cross-sectional study was performed randomly on 88 intubated ventilated sedated patients. Compared with CI measured by transthoracic echocardiography, the dIVC provided 79.17% sensitivity and 80% specificity at a threshold value of > 19.42% for fluid responsiveness prediction and was statistically significant (P < .0001), with an area under the curve (AUC) of 0.886 (0.801–0.944), while PVI at a threshold value of > 14% provided 93.75% sensitivity and 87.5% specificity and was statistically significant (P < .0001), with an AUC of 0.969 (0.889–0.988). Conclusion PVI and dIVC are effective non-invasive bedside methods for the assessment of fluid responsiveness in ICU for intubated ventilated sedated patients with sinus rhythm, but PVI has the advantage of being continuous, operator-independent, and more reliable than dIVC.

scholarly journals Clinical Profile and Outcome of Mechanically Ventilated Children in a Pediatric Intensive Care Unit Surabaya

2020 ◽  
Vol 3 (2) ◽  
pp. 91
Author(s):  
Qorri Aina ◽  
Arina Setyaningtyas ◽  
Atika Atika
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Pediatric Intensive Care Unit ◽  
Cardiac Failure ◽  
Pediatric Intensive Care ◽  
Asian Countries ◽  
Inclusion Criteria ◽  
Microsoft Excel ◽  
Mechanically Ventilated

Introduction: Ventilator is used as one of the most frequent life-supportive technology in Pediatric Intensive Care Unit (PICU). There are only few studies from Asian Countries, especially Indonesia regarding the use of ventilator in PICU. The aim of this study was to describe the demographic, indications, length of use, complication, and outcome of patients with ventilator in PICU Dr.Soetomo Hospital, Surabaya.Methods: This is a descriptive study. Collecting data was done retrospectively using medical records of patients using ventilator in PICU Dr. Soetomo General Hospital from January-December 2017 . Statistical analysed was performed using Microsoft Excel 2016.Results: 59 patients met the inclusion criteria. Of the 59 patients, 34 (57.63%) were female and 27 (45.76%) were infant (1-12 months). Common indication of ventilator were status epilepticus and shock that happened in 17 (28.81%) patients. 44 (74.58%) patient was using ventilator >48 hours. There are only 4 (6.78%) of 59 patients that happened to had Ventilator Associated Pneumonia (VAP) as a complication of using ventilator. Mortality occurred in 40 (67.80%) patients and mostly happened in female (60%) and infant (50%). Mortality occurred in 10 (90%) of 11 patients with cardiac failure as the indication of ventilator and in 11 (73.33%) patients who used ventilator ≤48 hours.Conclusion: Status epilepticus and shock was the most common reason for ventilation. Incidence of VAP as the complication of ventilator is relatively low. Relatively high mortality found in age group infants, patients with cardiac failure as indication of ventilator and in patient with short duration use of ventilator.

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