Journal articles: 'Children intensive care unit'

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Lapinsky, Stephen E. "Children of the intensive care unit*." Critical Care Medicine 36, no. 10 (October 2008): 2934–35. http://dx.doi.org/10.1097/ccm.0b013e31818725c0.

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KHAN, HUMAYUN IQBAL, NAILA KHALIQ, and MUHAMMAD FAHEEM AFZAL. "PEDIATRIC INTENSIVE CARE UNIT." Professional Medical Journal 13, no. 03 (June 25, 2006): 358–61. http://dx.doi.org/10.29309/tpmj/2006.13.03.4982.

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Intensive care is predominantly concerned with the managementof patients with acute life threatening conditions in a specialized unit. Children having acute neurological deterioration,respiratory distress, cardiovascular compromise, severe infections and accidental poisonings constitute the majoradmission to a pediatric intensive care unit. Objective: To document the number, disease pattern and outcome ofpatients admitted to Pediatric intensive care unit. Design: Descriptive study. Place and Duration: The study wasconducted in the intensive care unit of department of Pediatrics, King Edward Medical University/Mayo hospital, Lahorefrom July 01, 2004 to June 30, 2005. Patients and Methods: The data of all the admitted patients was analyzed forage, sex, cause of admission and outcome. Results: A total of 1012 children were admitted during the study period.Among them 59.68% were male and 40.32% were female. Bronchopneumonia was the major cause of admission(29.05%) followed by septicemia (14.43%), acute bacterial meningitis (8.1%), acute watery diarrhea (6.92%), congenitalheart diseases (5.14%), tetanus (3.75%) ,acute myocarditis (2.67%) and others (29.94%) including acute bronchialasthma, hepatic encephalopathy, diabetic ketoacidosis, encephalitis, tuberculous meningitis, accidental poisoning andGuillain-Barre syndrome. Out of total admissions, 64.43% were shifted to different units of the department, 4.05%discharged in satisfactory condition, 9.49% left against medical advice (LAMA) and 22.03% died. The case fatality ofsepticemia (65.07%) was highest. Conclusion: Bronchopneumonia and septicemia were the major causes ofadmission while case fatality was highest for septicemia in intensive care unit.

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ERDOĞAN, Çiğdem, Türkan TURAN, and Bakiye PINAR. "Children Intensive Care Unit Experiences with Own Drawing." Turkiye Klinikleri Journal of Pediatrics 29, no. 2 (2020): 92–98. http://dx.doi.org/10.5336/pediatr.2020-73767.

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Upadhyay, Ranjani, C. Suneel, Shrikiran Hebbar, Nalini Bhaskaranand, and PushpaG Kini. "Thrombocytopenia in children admitted to intensive care unit." Journal of Pediatric Critical Care 5, no. 7 (2018): 92. http://dx.doi.org/10.21304/2018.0501.00306.

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Cunliffe, Peter H. "Communicating with children in the intensive care unit." Intensive Care Nursing 3, no. 2 (January 1987): 71–77. http://dx.doi.org/10.1016/0266-612x(87)90028-9.

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Pshenisnov, K. V., Yu S. Aleksandrovich, and M. Yu Kozubov. "Inhalation sedation in children in intensive care unit." Anesteziologiya i reanimatologiya, no. 3 (2021): 69. http://dx.doi.org/10.17116/anaesthesiology202103169.

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Levi, Eric, Andrés Alvo, Brian J. Anderson, and Murali Mahadevan. "Postoperative admission to paediatric intensive care after tonsillectomy." SAGE Open Medicine 8 (January 2020): 205031212092202. http://dx.doi.org/10.1177/2050312120922027.

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Objectives: To review interventions required by children admitted for intensive care management following tonsillectomy or adenotonsillectomy either as elective or unplanned admission in a tertiary children’s hospital. Methods: A retrospective chart review over a 10-year period between April 2007 and March 2017 was performed. Charts were interrogated for treatments that were administered in the paediatric intensive care unit. Respiratory support therapies such as supplemental oxygen administration, high-flow nasal oxygen, positive pressure ventilation, continuous positive airway pressure, airway interventions and tracheal intubation were reviewed. Results: There were 103 children admitted to the paediatric intensive care unit following tonsillectomy or adenotonsillectomy. The average age was 6.2 years (range 7 months–17 years). The main indications for the procedure were sleep disordered breathing or obstructive sleep apnoea syndrome. In all, 53 children had syndromes with medical comorbidities, 31 were current continuous positive airway pressure users and 5 had a tracheostomy in situ. Forty children admitted to paediatric intensive care unit did not require any high-level care. Ten children who had an unplanned admission had their respiratory interventions started in the theatre or in the post-anaesthetic care unit, before paediatric intensive care unit admission, and did not require escalation of care. Conclusion: Children may not require admission for intensive care after tonsillectomy if they have had an incident-free period in the post-anaesthetic care unit. Some of those who required high-flow nasal oxygen could have been managed on the ward provided with adequate training and monitoring facilities. The level of care they require in post-anaesthetic care unit reflected the level of care for the immediate postoperative period in the paediatric intensive care unit.

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Humphreys, Stacey, and Balagangadhar R. Totapally. "Rapid Response Team Calls and Unplanned Transfers to the Pediatric Intensive Care Unit in a Pediatric Hospital." American Journal of Critical Care 25, no. 1 (January 1, 2016): e9-e13. http://dx.doi.org/10.4037/ajcc2016329.

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Background Variability in disposition of children according to the time of rapid response calls is unknown. Objective To evaluate times and disposition of rapid response alerts and outcomes for children transferred from acute care to intensive care. Methods Deidentified data on demographics, time and disposition of the child after activation of a rapid response, time of transfer to intensive care, and patient outcomes were reviewed retrospectively. Data for rapid-response patients on time of activation of the response and unplanned transfers to the intensive care unit were compared with data on other patients admitted to the unit. Results Of 542 rapid responses activated, 321 (59.2%) were called during the daytime. Out of all rapid response activations, 323 children (59.6%) were transferred to intensive care, 164 (30.3%) remained on the general unit, and 19 (3.5%) required resuscitation. More children were transferred to intensive care after rapid response alerts (P = .048) during the daytime (66%) than at night (59%). During the same period, 1313 patients were transferred to intensive care from acute care units. Age, sex, risk of mortality, length of stay, and mortality rate did not differ according to the time of transfer. Mortality among unplanned transfers (3.8%) was significantly higher (P < .001) than among other intensive care patients (1.4%). Conclusion Only 25% of transfers from acute care units to the intensive care unit occurred after activation of a rapid response team. Most rapid responses were called during daytime hours. Mortality was significantly higher among unplanned transfers from acute care than among other intensive care admissions.

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Mestrovic, Julije, Branka Polic, Marija Mestrovic, Goran Kardum, Eugenija Marusic, and Alan Sustic. "Functional outcome of children treated in intensive care unit." Jornal de Pediatria 84, no. 3 (May 30, 2008): 232–36. http://dx.doi.org/10.2223/jped.1779.

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Hersov, Kate. "Supporting Children with Relatives in the Intensive Care Unit." Journal of the Intensive Care Society 15, no. 3 (July 2014): 188–89. http://dx.doi.org/10.1177/175114371401500302.

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de Menezes, Fernanda Souza, Heitor Pons Leite, Juliana Fernandez, Silvana Gomes Benzecry, and Werther Brunow de Carvalho. "Hypophosphatemia in Children Hospitalized Within an Intensive Care Unit." Journal of Intensive Care Medicine 21, no. 4 (July 2006): 235–39. http://dx.doi.org/10.1177/0885066606287081.

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Fernanda Haverroth Schunemann, Soraia Hopfner Canani, and Constanza Marín. "Oral evaluation of children and adolescents in intensive care unit." RSBO 14, no. 3 (September 20, 2017): 135–41. http://dx.doi.org/10.21726/rsbo.v14i3.656.

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Hospitalized children can present some complications if they do not present a correct oral care during hospitalization. Objective: This study aimed to perform an oral evaluation of children and adolescents hospitalized in an intensive care unit of a children’s hospital at southern Brazil. Material and methods: 49 subjects were examined, aged from 0 to 17 years old, using the modified Oral Assessment Guide (OAGm). The lips, corner of the mouth, gums, oral mucosa, saliva, tongue, and teeth were examined. Each category was classified in a numeric scale from 1 to 3, where 1 means the better condition and 3 the worse. Results: The results showed alterations in the lips, tongue, oral biofilm, and saliva in most of the subjects. The OAGm value indicated a worse oral condition in older children. The OAGm values for children with teeth were higher than that for edentulous children, this difference was statistically significant (p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.> p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.

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Schunemann, Fernanda Haverroth, Soraia Hopfner Canani, and Constanza Marín. "Oral evaluation of children and adolescents in intensive care unit." RSBO 1, no. 3 (July 5, 2018): 135. http://dx.doi.org/10.21726/rsbo.v1i3.482.

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Introduction: Hospitalized children can present some complications if they do not present a correct oral care during hospitalization. Objective: This study aimed to perform an oral evaluation of children and adolescents hospitalized in an intensive care unit of a children’s hospital at southern Brazil. Material and methods: 49 subjects were examined, aged from 0 to 17 years old, using themodified Oral Assessment Guide (OAGm). The lips, corner of the mouth, gums, oral mucosa, saliva, tongue, and teeth were examined. Each category was classified in a numeric scale from 1 to 3, where 1 means the better condition and 3 the worse. Results: The results showed alterations in the lips, tongue, oral biofilm, and saliva in most of the subjects. The OAGm value indicated a worse oral condition in older children. The OAGm values for children with teeth were higher than that for edentulous children, this difference was statistically significant (p<0.05). Conclusion: It could be concluded that children hospitalized in an intensive care unit show deficiency in oral health when assessed through OAGm.

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Hatler, Carol, Linda Buckwald, Zoraida Salas-Allison, and Cathleen Murphy-Taylor. "Evaluating Central Venous Catheter Care in a Pediatric Intensive Care Unit." American Journal of Critical Care 18, no. 6 (November 1, 2009): 514–20. http://dx.doi.org/10.4037/ajcc2009168.

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Background Catheter-related bloodstream infection remains an important health problem for hospitalized children. Although placement of a central venous catheter is a life-saving intervention for critically ill children, these same central catheters are a potential source of infection. Objectives Few studies that directly address care of central venous catheters for children in intensive care units have been reported. This evaluation was designed to describe the extent of evidence-based practices for care of insertion sites of central venous catheters in the pediatric intensive care unit of an urban tertiary care center. Another goal was to determine the influence of 2 different regimens for dressing changes on rates of catheter-related bloodstream infections and costs. Methods A convenience sample and an exploratory design were used to collect data in 2 phases, including 30 days to establish baseline information and 30 days each during which patients received dressing care for a central venous catheter with a transparent dressing alone and with a transparent dressing plus a chlorhexidine-impregnated dressing. Nurses also participated in a survey of knowledge about infection control practices related to central catheters. Results Few differences were found between the transparent dressing alone and a chlorhexidine-impregnated dressing plus the transparent dressing. A serendipitous finding was the number of times that central catheters were accessed daily. Conclusions The results of this project suggest that infection control efforts may be most appropriately focused on processes rather than on products.

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Naik, Dr Neha, and Dr Vithalrao Dandge. "Role of Calcium in Critically Ill Children-Incidence of Hypocalcemia in Pediatric Intensive Care Unit Set Up." Indian Journal of Applied Research 4, no. 4 (October 1, 2011): 409–12. http://dx.doi.org/10.15373/2249555x/apr2014/124.

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Mattsson, Janet, Maria Forsner, Maaret Castrén, and Maria Arman. "Caring for children in pediatric intensive care units." Nursing Ethics 20, no. 5 (January 17, 2013): 528–38. http://dx.doi.org/10.1177/0969733012466000.

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Children in the pediatric intensive care unit are indisputably in a vulnerable position, dependent on nurses to acknowledge their needs. It is assumed that children should be approached from a holistic perspective in the caring situation to meet their caring needs. The aim of the study was to unfold the meaning of nursing care through nurses’ concerns when caring for children in the pediatric intensive care unit. To investigate the qualitative aspects of practice embedded in the caring situation, the interpretive phenomenological approach was adopted for the study. The findings revealed three patterns: medically oriented nursing—here, the nurses attend to just the medical needs, and nursing care is at its minimum, leaving the children’s needs unmet; parent-oriented nursing care—here, the nursing care emphasizes the parents’ needs in the situation, and the children are viewed as a part of the parent and not as an individual child with specific caring needs; and smooth operating nursing care orientation—here, the nursing care is focused on the child as a whole human being, adding value to the nursing care. The conclusion drawn suggests that nursing care does not always respond to the needs of the child, jeopardizing the well-being of the child and leaving them at risk for experiencing pain and suffering. The concerns present in nursing care has been shown to be the divider of the meaning of nursing care and need to become elucidated in order to improve the cultural influence of what can be seen as good nursing care within the pediatric intensive care unit.

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Bonilla–Félix, Melvin. "Peritoneal Dialysis in the Pediatric Intensive Care Unit Setting." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 29, no. 2_suppl (February 2009): 183–85. http://dx.doi.org/10.1177/089686080902902s36.

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Acute kidney injury (AKI) is a common complication in pediatric and neonatal intensive care units (ICUs). Renal replacement therapy (RRT) is frequently needed in children in whom supportive therapy is not enough to satisfy metabolic demands or to provide adequate nutrition in cases of oliguric kidney failure. The decision to begin dialysis should not be delayed, because experience in infants shows that the shorter the time from the ischemic insult to the beginning of dialysis, the higher the survival rate. The use of continuous RRT (CRRT) in pediatric patients in the ICU has almost tripled; at the same time, the use of peritoneal dialysis (PD) and intermittent hemodialysis has markedly declined. Patient age seems to be the most important factor influencing the decision on the choice of dialysis modality. Although CRRT is reported as the preferred dialysis modality for acutely ill children, PD is still the most common modality used in patients under 6 years of age. Among the several advantages that PD offers, relatively low cost is probably the most significant. Other advantages include technical simplicity, lack of a need for anticoagulation or placement of a central venous catheter, and excellent tolerance in hemodynamically unstable patients. Much controversy exists regarding the adequacy of PD in hypercatabolic patients in the ICU. Nonetheless, when Kt/V has been applied to acutely ill children, it has been shown that PD can provide adequate clearances for most infants. No prospective studies have evaluated the effect of dialysis modality on the outcomes of children with AKI in the ICU setting. The decision about dialysis modality should therefore be based on local expertise, resources available, and the patient's clinical status.

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Viski, Sandor, and Laszlo Olah. "Use of Transcranial Doppler in Intensive Care Unit." Journal of Critical Care Medicine 3, no. 3 (July 26, 2017): 99–104. http://dx.doi.org/10.1515/jccm-2017-0021.

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AbstractUse of transcranial Doppler has undergone much development since its introduction in 1982, making the technique suitable for general use in intensive care units. The main application in intensive care units is to assess intracranial pressure, confirm the lack of cerebral circulation in brain death, detect vasospasm in subarachnoid haemorrhage, and monitor the blood flow parameters during thrombolysis and carotid endarterectomy, as well as measuring stenosis of the main intracranial arteries in sickle cell disease in children. This review summarises the use of transcranial Doppler in intensive care units.

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Deep, Keerti, and Arundhati Patil. "Electrolyte Abnormalities in Children Admitted to Pediatric Intensive Care Unit." Pediatric Education and Research 4, no. 1 (2016): 9–17. http://dx.doi.org/10.21088/per.2321.1644.4116.2.

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Azemi, M. "784 Children with Severe Dehydration Treated in Intensive Care Unit." Pediatric Research 68 (November 2010): 396. http://dx.doi.org/10.1203/00006450-201011001-00784.

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Kean, Susanne. "Children and young people visiting an adult intensive care unit." Journal of Advanced Nursing 66, no. 4 (April 2010): 868–77. http://dx.doi.org/10.1111/j.1365-2648.2009.05252.x.

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Vidyasagar, Dharmapuri. "Stress of admission to pediatric intensive care unit on children*." Pediatric Critical Care Medicine 6, no. 3 (May 2005): 374–76. http://dx.doi.org/10.1097/01.pcc.0000161614.70943.42.

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Capitulo, Kathleen Leask, Sylvia M. Barchue, and Aneita Morgan. "Should Children Visit Patients in an Intensive Care Unit (ICU)?" MCN, The American Journal of Maternal/Child Nursing 37, no. 1 (2012): 8–9. http://dx.doi.org/10.1097/nmc.0b013e3182370fcc.

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Daylami, Amal Al, Kannan Sridharan, and Ali Mohammed Qader. "Vancomycin nomograms in children admitted to an intensive care unit." Drugs & Therapy Perspectives 36, no. 4 (February 11, 2020): 166–72. http://dx.doi.org/10.1007/s40267-020-00708-y.

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Jefferies, John Lynn, Timothy M. Hoffman, and David P. Nelson. "Heart Failure Treatment in the Intensive Care Unit in Children." Heart Failure Clinics 6, no. 4 (October 2010): 531–58. http://dx.doi.org/10.1016/j.hfc.2010.06.001.

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Cooper, Virginia Bonsal, and Catherine Haut. "Preventing Ventilator-Associated Pneumonia in Children: An Evidence-Based Protocol." Critical Care Nurse 33, no. 3 (June 1, 2013): 21–29. http://dx.doi.org/10.4037/ccn2013204.

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Ventilator-associated pneumonia, the second most common hospital-acquired infection in pediatric intensive care units, is linked to increased morbidity, mortality, and lengths of stay in the hospital and intensive care unit, adding tremendously to health care costs. Prevention is the most appropriate intervention, but little research has been done in children to identify necessary skills and strategies. Critical care nurses play an important role in identification of risk factors and prevention of ventilator-associated pneumonia. A care bundle based on factors, including evidence regarding the pathophysiology and etiology of pneumonia, mechanical ventilation, duration of ventilation, and age of the child, can offer prompts and consistent prevention strategies for providers caring for children in the pediatric intensive care unit. Following the recommendations of the Centers for Disease Control and Prevention and adapting an adult model also can support this endeavor. Ultimately, the bedside nurse directs care, using best evidence to prevent this important health care problem.

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Bae, Woori, Beomjoon Kim, Kyunghoon Kim, Hyejin Lee, and Jongseo Yoon. "1342: COMPARISON OF CHILDREN MANAGED IN THE PEDIATRIC INTENSIVE CARE UNIT AND OTHER INTENSIVE CARE UNITS." Critical Care Medicine 46, no. 1 (January 2018): 654. http://dx.doi.org/10.1097/01.ccm.0000529345.57135.43.

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Abdelatif, Rania G., Montaser M. Mohammed, Ramadan A. Mahmoud, Mohamed A. M. Bakheet, Masafumi Gima, and Satoshi Nakagawa. "Characterization and Outcome of Two Pediatric Intensive Care Units with Different Resources." Critical Care Research and Practice 2020 (March 17, 2020): 1–6. http://dx.doi.org/10.1155/2020/5171790.

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Background. The pediatric intensive care units (PICUs) in developing countries have a higher mortality outcome due to a wide variety of causes. Identifying differences in the structure, patient characteristics, and outcome between PICUs with different resources may add evidence to the need for incorporating more PICUs with limited resources in the contemporary critical care research to improve the care provided for severely ill children. Methods. A retrospective study was conducted at Egyptian and Japanese PICUs as examples of resource-limited and resource-rich units, respectively. We collected and compared data of nonsurgical patients admitted between March 2018 and February 2019, including the patients’ demographics, diagnosis, PICU length of stay, outcome, predicted risk of mortality using pediatric index of mortality-2 (PIM-2), and functional neurological status using the Pediatric Cerebral Performance Category (PCPC) scale. Results. The Egyptian unit had a lower number of beds with a higher number of annual admission/bed than the Japanese unit. There was a shortage in the number of the skilled staff at the Egyptian unit. Nurse : patient ratios in both units were only similar at the nighttime (1 : 2). Most of the basic equipment and supplies were available at the Egyptian unit. Both actual and PIM-2 predicted mortalities were markedly higher for patients admitted to the Egyptian unit, and the mortality was significantly associated with age, severe sepsis, and PIM-2. The length of stay was shorter at the Egyptian unit. Conclusion. The inadequate structure and the burden of more severely ill children at the Egyptian unit appear to be the most important causes behind the higher mortality at this unit. Increasing the number of qualified staff and providing cost-effective equipment may help in improving the mortality outcome and the quality of care.

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Walker, P., B. Whitehead, and M. Rowley. "Role of paediatric intensive care following adenotonsillectomy for severe obstructive sleep apnoea: criteria for elective admission." Journal of Laryngology & Otology 127, S1 (September 4, 2012): S26—S29. http://dx.doi.org/10.1017/s0022215112001739.

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AbstractAims:This study aimed to critically review our criteria for elective admission to the paediatric intensive care unit following adenotonsillectomy for obstructive sleep apnoea.Materials and methods:We reviewed 122 children electively admitted between 1997 and 2011. During this time, our criteria for admission evolved.Results:In these 122 children, the respiratory disturbance index during rapid eye movement sleep ranged from 6 to 159 (mean, 83). Forty-one per cent of the children had a recognised co-morbidity. Nine children required extra intervention, i.e. in addition to re-positioning and/or supplemental oxygen. One child was an unplanned re-admission after discharge from the paediatric intensive care unit. Over the same period, five children required unplanned transfers into the paediatric intensive care unit following adenotonsillectomy for sleep-disordered breathing.Conclusion:Based upon these results, we describe our current criteria for elective admission to the paediatric intensive care unit following adenotonsillectomy for severe obstructive sleep apnoea.

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Muñoz-Bonet, Juan I., José L. López-Prats, Eva M. Flor-Macián, Teresa Cantavella, Laura Bonet, Amparo Domínguez, and Juan Brines. "Usefulness of telemedicine for home ventilator-dependent children." Journal of Telemedicine and Telecare 26, no. 4 (December 11, 2018): 207–15. http://dx.doi.org/10.1177/1357633x18811751.

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Introduction Medical care for ventilator-dependent children must avoid hospital confinement, which is detrimental to the patient, their family and Paediatric Intensive Care Unit. Our objective was to assess the role of telemedicine in facilitating early and permanent discharge of such patients to home care. Methods This was a prospective clinical study (2007–2017) in tracheotomised ventilator-dependent children. We used a Big Data Telemedicine home system (Medlinecare 2.1) from the Paediatric Intensive Care Unit. Specialised home-nursing services were available. Clinical events were analysed using the Chi-square test (significance p < 0.05). Families subsequently completed a satisfaction survey. The Paediatric Intensive Care Unit management indicators were analysed. Results All of our ventilator-dependent children were included ( n=12). At time of discharge from the Paediatric Intensive Care Unit, they all required continuous mechanical ventilation and met the criteria of groups I–III of the OTA classification. In the first two years there were 141 events; the main cause was respiratory (69.5%, p < 0.001) and telemedicine was the main care approach (86.5%, p < 0.001). Eleven events required hospitalisation (7.8%) but 38 (27.0%) hospitalisations were avoided. The emergency readmission time accounted for 0.99% of the total time. Six patients were decannulated, and one patient died due to primary cardiac arrest. All the families considered that the telemedicine had helped to avoid hospital visits, was not an intrusion into their privacy, and improved the child’s safety and quality of life. An improvement in Paediatric Intensive Care Unit indicators was achieved. Discussion Telemedicine facilitated early and permanent discharge of our ventilator-dependent children to home care without affecting their quality of care.

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Peddy, Stacie B., Mary Fran Hazinski, Peter C. Laussen, Ravi R. Thiagarajan, George M. Hoffman, Vinay Nadkarni, and Sarah Tabbutt. "Cardiopulmonary resuscitation: special considerations for infants and children with cardiac disease." Cardiology in the Young 17, S4 (September 2007): 116–26. http://dx.doi.org/10.1017/s1047951107001229.

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AbstractPulseless cardiac arrest, defined as the cessation of cardiac mechanical activity, determined by unresponsiveness, apneoa, and the absence of a palpable central pulse, accounts for around one-twentieth of admissions to paediatric intensive care units, be they medical or exclusively cardiac. Such cardiac arrest is higher in children admitted to a cardiac as opposed to a paediatric intensive care unit, but the outcome of these patients is better, with just over two-fifths surviving when treated in the cardiac intensive care unit, versus between one-sixth and one-quarter of those admitted to paediatric intensive care units. Children who receive chest compressions for bradycardia with pulses have a significantly higher rate of survival to discharge, at 60%, than do those presenting with pulseless cardiac arrest, with only 27% surviving to discharge. This suggests that early resuscitation before the patient becomes pulseless, along with early recognition and intervention, are likely to improve outcomes. Recently published reports of in-hospital cardiac arrests in children can be derived from the multi-centric National Registry of Cardiopulmonary Resuscitation provided by the American Heart Association. The population is heterogeneous, but most arrests occurred in children with progressive respiratory insufficiency, and/or progressive circulatory shock. During the past 4 years at the Children’s Hospital of Philadelphia, 3.1% of the average 1000 annual admissions to the cardiac intensive care unit have received cardiopulmonary resuscitation. Overall survival of those receiving cardiopulmonary resuscitation was 46%. Survival was better for those receiving cardiopulmonary resuscitation after cardiac surgery, at 53%, compared with survival of 33% for pre-operative or non-surgical patients undergoing resuscitation. Clearly there is room for improvement in outcomes from cardiac resuscitation in children with cardiac disease. In this review, therefore, we summarize the newest developments in paediatric resuscitation, with an expanded focus upon the unique challenges and importance of anticipatory care in infants and children with cardiac disease.

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Bosnak, Mehmet, Hayri Levent Yilmaz, Aydin Ece, Dincer Yildizdas, Ilyas Yolbas, Halil Kocamaz, Metin Kaplan, and Vuslat Bosnak. "Severe scorpion envenomation in children: Management in pediatric intensive care unit." Human & Experimental Toxicology 28, no. 11 (October 7, 2009): 721–28. http://dx.doi.org/10.1177/0960327109350667.

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Background: Scorpion envenomation is a common public health problem worldwide and children are at greater risk of developing severe cardiac, respiratory and neurological complications. The aim of this study was to evaluate the effects of antivenin and/or prazosin use on prognosis of scorpion-envenomed children admitted to pediatric intensive care unit (PICU). Methods: The standardized medical records of 45 children hospitalized with severe scorpion sting in PICU were retrospectively evaluated. General characteristics of the children, clinical and laboratory findings, treatment approaches and prognosis were evaluated. Results: The mean age of the patients were 6.1 ± 4.1 years ranging between 4 month and 15 years. Male to female ratio was 1.8. Thirty-three (71.1%) cases of scorpion stings came from rural areas. Twenty-six (57.8%) of the patients were stung by Androctonus crassicauda. The most common sting localization was the foot-leg (55.6%). The mean duration from the scorpion sting to hospital admission was 4.5 ± 2.6 hours. The most common findings at presentation were cold extremities (95.5%), excessive sweating (91.1%) and tachycardia (77.7%). The mean leukocyte count, and serum levels of glucose, lactate dehydrogenase, creatine phosphokinase and international normalized ratio were found above the normal ranges. Prazosin was used in all patients, dopamine in 11 (24.4%) and Na-nitroprusside in 4 (8.8%) patients. Two children died (4.4%) due to pulmonary oedema. These children, in poor clinical status at hospital admission, needed mechanical ventilation, and death occurred despite use of antivenin and prazosin in both of them. Conclusion: The current management of children with severe scorpion envenomation consists of administration of specific antivenom and close surveillance in a PICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The aggressive medical management directed at the organ system specifically can be effective. Our data indicated that when admission to hospital is late, the beneficial effect of antivenom and/or prazosin is questionable in severe scorpion stings.

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Aliyeva, F. S., M. S. Muldahmetov, and B. K. Nurmagambetova. "Causes of transfer and mortality in children with oncohematological diseases admitted to the intensive care unit." Pediatric Hematology/Oncology and Immunopathology 20, no. 1 (April 21, 2021): 180–83. http://dx.doi.org/10.24287/1726-1708-2021-20-1-180-183.

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The last few decades survival rates of children with hematologic malignancies have improved significantly, due to a potentially curative chemotherapy protocols, the expansion of biological knowledge and innovative methods of therapy. However oncohematological pediatric patients are at high risk for rapid clinical deterioration due to numerous factors such as the severity of the underlying condition, interventions toxicity and associated immunosuppression. Using aggressive tactics of therapy with oncohematological diseases in children is also associated with complications and life-threatening events that lead to admission to the pediatric intensive care unit. Historically, these children have been considered as poor candidates for intensive care. Discussions around the transfer of children with hematological malignancies to intensive care units and also the expected prognosis raised complicate and delicate questions, especially from an ethical point of view. Despite the general tendency of improved survival rate, mortality in the intensive care unit on hematological malignancies children, unfortunately, is still high and, in comparison to adults, has remained relatively invariable over the past decades. These findings highlight the necessity for research in this group of patients.

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Terai, Takekazu, Hidekazu Yukioka, and Akira Asada. "Pain Evaluation in the Intensive Care Unit." Regional Anesthesia & Pain Medicine 23, no. 2 (March 1998): 147–51. http://dx.doi.org/10.1136/rapm-00115550-199823020-00006.

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Background and ObjectivesThe visual analog scale (VAS) is a simple and sensitive mean of pain assessment. The faces scale is also a simple, self-reporting method for children. Facial signs of pain have not been used to assess pain in postoperative adult patients in the intensive care unit (ICU).MethodsFifty patients undergoing esophageal cancer surgery by a thoracoabdominal procedure were studied. Epidural opioids, such as morphine or buprenorphine, combined with bupivacaine were administered during and after surgery. Pain measurement was performed by a physician in the ICU using the self-reported VAS 0.5, 1, 2, 4, and 6 hours after tracheal extubation and thereafter every 4 hours during the stay in the ICU. A nurse who was unaware of the patients' VAS scores assessed facial expression as a measure of pain intensity using a five-grade faces scale immediately before pain evaluation by VAS. The VAS was rescaled into five discrete units that would match the five faces scale scores. Weighted kappa statistics were used to establish a relative level of agreement between the five-grade VAS and faces scale.ResultsGood agreement was found between the five-grade VAS and the faces scale 30 minutes and 1 hour after tracheal extubation (weighted kappa values .67 and .62, respectively). The VAS and faces scales were measured 7-13 times per patient during the stay in the ICU, and 518 observations were collected. Although moderate agreement was found between the five-graded VAS and faces scale for all pairs of observation (weighted kappa values .54), less agreement was found between them in patients with moderate pain. In addition, the calculated mean differences between the five-graded VAS and faces scale differed significantly between patients.ConclusionThe faces scale may be useful for pain evaluation in the ICU.

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Mitchell, Sarah, and Jeremy Dale. "Advance Care Planning in palliative care: A qualitative investigation into the perspective of Paediatric Intensive Care Unit staff." Palliative Medicine 29, no. 4 (February 26, 2015): 371–79. http://dx.doi.org/10.1177/0269216315573000.

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Background: The majority of children and young people who die in the United Kingdom have pre-existing life-limiting illness. Currently, most such deaths occur in hospital, most frequently within the intensive care environment. Aim: To explore the experiences of senior medical and nursing staff regarding the challenges associated with Advance Care Planning in relation to children and young people with life-limiting illnesses in the Paediatric Intensive Care Unit environment and opportunities for improvement. Design: Qualitative one-to-one, semi-structured interviews were conducted with Paediatric Intensive Care Unit consultants and senior nurses, to gain rich, contextual data. Thematic content analysis was carried out. Setting/participants: UK tertiary referral centre Paediatric Intensive Care Unit. Eight Paediatric Intensive Care Unit consultants and six senior nurses participated. Findings: Four main themes emerged: recognition of an illness as ‘life-limiting’; Advance Care Planning as a multi-disciplinary, structured process; the value of Advance Care Planning and adverse consequences of inadequate Advance Care Planning. Potential benefits of Advance Care Planning include providing the opportunity to make decisions regarding end-of-life care in a timely fashion and in partnership with patients, where possible, and their families. Barriers to the process include the recognition of the life-limiting nature of an illness and gaining consensus of medical opinion. Organisational improvements towards earlier recognition of life-limiting illness and subsequent Advance Care Planning were recommended, including education and training, as well as the need for wider societal debate. Conclusions: Advance Care Planning for children and young people with life-limiting conditions has the potential to improve care for patients and their families, providing the opportunity to make decisions based on clear information at an appropriate time, and avoid potentially harmful intensive clinical interventions at the end of life.

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Hussain, Manzoor, Mohammad Abdullah Al Mamun, Nurul Akhtar Hasan, Rezoana Rima, and Abdul Jabbar. "Establishing Pediatric Cardiac Intensive Care Unit in a Low Resource Setting: Bangladesh Perspective and Dhaka Shishu (Children) Hospital Paediatric Cardiac Intensive Care Unit Model." Bangladesh Journal of Child Health 39, no. 3 (February 13, 2017): 141–47. http://dx.doi.org/10.3329/bjch.v39i3.31580.

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Advances in technology and training in paediatric cardiology have improved longterm outcome and promised better quality of life. Bangladesh is facing multitude of health problems and congenital heart disease is one of them. With facilities for accurate diagnosis and scope of complete correction, more and more children are undergoing cardiac intervention and surgical treatment for congenital heart diseases. So there is increasing demand for dedicated personnel for the specialized intensive care of these critically ill children. A dedicated team dictating specialized intensive care has translated into better outcomes in several centers. Over recent decades, specialized paediatric cardiac intensive care has emerged as a central component in the management of critically ill neonatal and paediatric patients with congenital and acquired heart disease worldwide. The majority of developed centers have dedicated paediatric cardiac intensive care units to care for paediatric cardiac patients. In developing countries with limited resources, pediatric cardiac intensive care is yet to take root as a distinctive discipline. Congenital heart surgery, together with transcatheter interventions, has resulted in marked improvement in cardiac care in Bangladesh. So, we need to establish more and more dedicated paediatric cardiac center and cardiac intensive care units to care for paediatric cardiac patients.Bangladesh J Child Health 2015; VOL 39 (3) :141-147

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Dimand, Robert J., James P. Marcin, Harry J. Kallas, and Roland Mawes. "CLINICAL OUTCOMES OF PEDIATRIC INTENSIVE CARE UNIT BASED TELEMEDICINE CONSULTATIONS FOR INFANTS AND CHILDREN IN A RURAL ADULT INTENSIVE CARE UNIT." Critical Care Medicine 30, Supplement (December 2002): A15. http://dx.doi.org/10.1097/00003246-200212001-00055.

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Haque, Anwarul, Laila A. Ladak, Muhammad H. Hamid, Sadiq Mirza, Naveed R. Siddiqui, and Zulfiqar A. Bhutta. "A National Survey of Pediatric Intensive Care Units in Pakistan." Journal of Critical Care Medicine 2014 (January 5, 2014): 1–4. http://dx.doi.org/10.1155/2014/842050.

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Purpose. To describe the structure, staffing resources, equipment, academic activities, and characteristics of pediatric population of pediatric intensive care units across the country. Material & Method. This was a prospective, descriptive, and observational survey of pediatric intensive care units from January to December 2009 across Pakistan. A questionnaire survey was emailed to director of each unit. Results. 16 PICUs were participated in this survey (100% response rate). A total of units with 155 beds were identified (1.1 bed /500,000 children). Regarding the categories, 12 (75%) were medical, 3 (19%) were pure cardiac intensive care units, and one unit (6%) was combined multidisciplinary cardiothoracic unit. 13 (81%) units were in public sector as compared to 3 (19%) were in private sector. The mean unit size was 9.7 (range 4–28) beds. Twelve (75%) units were located in three large cities. Only 3 (19%) units have trained intensivist. 37% (6/16) had nurse to patient ratio of 1 : 1-1 : 2 while others had ratios of 1 : 3–1 : 5 with all nurses specialized trained for pediatric intensive care units with bachelor degree or diploma in nursing. Only 50% had capacity for invasive monitoring. Conclusion. We found inadequacies in several aspects of PICUs in Pakistan including fewer PICUs, inadequate PICU beds, and lack of trained personal to look after critically ill pediatric population.

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Agus, Michael, and Carmen Soto-Rivera. "Tight Glycemic Control in the Pediatric Intensive Care Unit." Journal of Pediatric Intensive Care 05, no. 04 (May 11, 2016): 198–204. http://dx.doi.org/10.1055/s-0036-1583281.

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AbstractHyperglycemia is a common complication in critically ill, nondiabetic children. Four large pediatric randomized controlled trials of tight glycemic control (TGC) have been conducted to date with contradicting results. This review will highlight the design and outcomes of these trials and other relevant studies to provide an overview of the advantages and disadvantages of TGC for different populations at risk of hyperglycemia along with future directions for research.

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Roychowdhury, Satyabrata, Tamoghna Biswas, and Sibarjun Ghosh. "Super-refractory status epilepticus in children: A tertiary care intensive care unit experience." Journal of Pediatric Critical Care 5, no. 7 (2018): 75. http://dx.doi.org/10.21304/2018.0501.00274.

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Elbilgahy, Amal Ahmed, Sahar Farouk Hashem, and Doaa Shokry Abd El Khalek Alemam. "Mothers’ Satisfaction with Care Provided for Their Children in Pediatric Intensive Care Unit." Middle East Journal of Nursing 13, no. 2 (April 2019): 17–28. http://dx.doi.org/10.5742/mejn.2019.93636.

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Walker, Paul, and Vito Forte. "Failed Extubation in the Neonatal Intensive Care Unit." Annals of Otology, Rhinology & Laryngology 102, no. 7 (July 1993): 489–95. http://dx.doi.org/10.1177/000348949310200701.

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One of the roles of the pediatric otolaryngologist in the neonatal intensive care unit (NICU) is the assessment and management of the neonate who fails a trial of extubation. This paper reviews the recent 5-year institutional experience at The Hospital for Sick Children, Toronto, with neonates who failed extubation and who subsequently underwent diagnostic endoscopy. One hundred twenty-eight neonates from the NICU underwent diagnostic endoscopy. Of these, 58 neonates underwent diagnostic endoscopy for failure to extubate. Nine neonates were extubated after diagnostic endoscopy and retrial (16% of the series). Eleven neonates were extubated after additional endoscopic procedures (19% of the series). Twenty-four neonates underwent anterior cricoid split, of whom 20 or 83% (34% of the series) were eventually successfully extubated with no further airway intervention required during the study period (minimum 6 months' follow-up). Eleven neonates underwent tracheotomy (19% of the series). Four neonates underwent another external procedure to allow extubation (7% of the series). Three neonates died while still intubated (5% of the series). Our management of the neonate who fails a trial of extubation is discussed.

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Robb, Joy A. "Caring for children in an adult intensive care unit — part 2." Intensive and Critical Care Nursing 11, no. 3 (June 1995): 161–69. http://dx.doi.org/10.1016/s0964-3397(95)80683-0.

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Robb, Joy A. "Caring for children in an adult intensive care unit — part I." Intensive and Critical Care Nursing 11, no. 2 (April 1995): 100–110. http://dx.doi.org/10.1016/s0964-3397(95)82021-3.

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Tobias, Joseph D. "Sedation and Analgesia for Children in the Pediatric Intensive Care Unit." Journal of Intensive Care Medicine 10, no. 6 (November 1995): 294–314. http://dx.doi.org/10.1177/088506669501000604.

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Several situations arise in the Pediatric Intensive Care Unit (PICU) patient which may require the pharmacologic control of pain and anxiety. The author discusses the various pharmacologic agents available for sedation and analgesia including the inhalational anesthetic agents, nitrous oxide, benzodiasepines, opioids, ketamine, propofol, and the barbiturates. While intravenous administration is generally chosen for the PICU patient, certain situations may arise which preclude this route. The available information concerning alternative routes of delivery for the various agents including subcutaneous and transmucosal administration is presented. The role of various regional anesthetic techniques to control pain in the PICU patient are reviewed.

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Franklin, D., N. Senior, I. James, and G. Roberts. "Oral Health Status of Children in a Paediatric Intensive Care Unit." Intensive Care Medicine 26, no. 3 (March 27, 2000): 319–24. http://dx.doi.org/10.1007/s001340051156.

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Joiya, Samia Jabeen, Muhammad Azam Khan, and Irfan Shabbir. "Hypomagnesaemia among children at pediatric intensive care unit, Nishtar Hospital, Multan." Professional Medical Journal 27, no. 03 (March 10, 2020): 461–66. http://dx.doi.org/10.29309/tpmj/2020.27.03.2478.

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Objectives: Magnesium is the 2nd most abundant intracellular cation and it is vital for more than 300 enzymatic reactions which are involved in various metabolic processes in our body, but still, it is often a parameter which is overlooked by the clinicians. This study was conducted to determine the frequency of hypomagnesaemia among children admitted in pediatric intensive care unit (PICU). Study Design: Cross-sectional study. Setting: Department of Pediatric medicine, Unit-I, Nishtar Hospital, Multan. Periods: From 1st August 2017 to 31st May 2018. Material & Methods: A total of 379 children of age group 1-12 years and either gender were admitted at PICU irrespective of presenting complaint with duration of illness less than 2 weeks were included. Post stratification chi-square test was applied to see the effect of different variables like age of the patients, BMI, duration of illness and serum Magnesium levels, hypomagnesaemia, residential status, socioeconomic status, mother’s education and gender, on hypomagnesaemia. P value < 0.05 was considered as significant. Results: Of these 379 study cases, 221(58.3%) were boys while 158 (41.7%) were girls. Mean age of our study cases was 4.81 ± 2.27 years. Mean duration of illness was 5.57 ± 2.34 days. Mean weight of study cases was 17. 30 ± 5.92 kilograms. Mean serum Magnesium level was 1.45 ± 0.67 mg/dl. Hypomagnesemia was found to be present in 190 (50.1%). Male gender, urban residential status, illiteracy, hospitalization before PICU admission, disease duration of 1 to 2 weeks and weight < 20 kg turned out to be significantly associated (p < 0.05) with hypomagnesaemia. Conclusion: High frequency of hypomagnesaemia was noted among children admitted at PICU. Children with hypomagnesaemia had prolonged hospital stay and adverse outcomes. Hypomagnesaemia was significantly associated with male gender, residential status, mother’s educational level, hospitalization before PICU admission, disease duration and weight.

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Jensen, Hanne Irene, Kristin Halvorsen, Heidi Jerpseth, Isabell Fridh, and Ranveig Lind. "Practice Recommendations for End-of-Life Care in the Intensive Care Unit." Critical Care Nurse 40, no. 3 (June 1, 2020): 14–22. http://dx.doi.org/10.4037/ccn2020834.

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Topic A substantial number of patients die in the intensive care unit, so high-quality end-of-life care is an important part of intensive care unit work. However, end-of-life care varies because of lack of knowledge of best practices. Clinical Relevance Research shows that high-quality end-of-life care is possible in an intensive care unit. This article encourages nurses to be imaginative and take an individual approach to provide the best possible end-of-life care for patients and their family members. Purpose of Paper To provide recommendations for high-quality end-of-life care for patients and family members. Content Covered This article touches on the following domains: end-of-life decision-making, place to die, patient comfort, family presence in the intensive care unit, visiting children, family needs, preparing the family, staff presence, when the patient dies, after-death care of the family, and caring for staff.

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Stayer, Debbie, and Joan Such Lockhart. "Living with Dying in the Pediatric Intensive Care Unit: A Nursing Perspective." American Journal of Critical Care 25, no. 4 (July 1, 2016): 350–56. http://dx.doi.org/10.4037/ajcc2016251.

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Background Despite reported challenges encountered by nurses who provide palliative care to children, few researchers have examined this phenomenon from the perspective of nurses who care for children with life-threatening illnesses in pediatric intensive care units. Objectives To describe and interpret the essence of the experiences of nurses in pediatric intensive care units who provide palliative care to children with life-threatening illnesses and the children’s families. Methods A hermeneutic phenomenological study was conducted with 12 pediatric intensive care unit nurses in the northeastern United States. Face-to-face interviews and field notes were used to illuminate the experiences. Results Five major themes were detected: journey to death; a lifelong burden; and challenges delivering care, maintaining self, and crossing boundaries. These themes were illuminated by 12 subthemes: the emotional impact of the dying child, the emotional impact of the child’s death, concurrent grieving, creating a peaceful ending, parental burden of care, maintaining hope for the family, pain, unclear communication by physicians, need to hear the voice of the child, remaining respectful of parental wishes, collegial camaraderie and support, and personal support. Conclusion Providing palliative care to children with life-threatening illnesses was complex for the nurses. Findings revealed sometimes challenging intricacies involved in caring for dying children and the children’s families. However, the nurses voiced professional satisfaction in providing palliative care and in support from colleagues. Although the nurses reported collegial camaraderie, future research is needed to identify additional supportive resources that may help staff process and cope with death and dying.

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Broden, Elizabeth G., Janet Deatrick, Connie Ulrich, and Martha A. Q. Curley. "Defining a “Good Death” in the Pediatric Intensive Care Unit." American Journal of Critical Care 29, no. 2 (March 1, 2020): 111–21. http://dx.doi.org/10.4037/ajcc2020466.

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Background Societal attitudes about end-of-life events are at odds with how, where, and when children die. In addition, parents’ ideas about what constitutes a “good death” in a pediatric intensive care unit vary widely. Objective To synthesize parents’ perspectives on end-of-life care in the pediatric intensive care unit in order to define the characteristics of a good death in this setting from the perspectives of parents. Methods A concept analysis was conducted of parents’ views of a good death in the pediatric intensive care unit. Empirical studies of parents who had experienced their child’s death in the inpatient setting were identified through database searches. Results The concept analysis allowed the definition of antecedents, attributes, and consequences of a good death. Empirical referents and exemplar cases of care of a dying child in the pediatric intensive care unit serve to further operationalize the concept. Conclusions Conceptual knowledge of what constitutes a good death from a parent’s perspective may allow pediatric nurses to care for dying children in a way that promotes parents’ coping with bereavement and continued bonds and memories of the deceased child. The proposed conceptual model synthesizes characteristics of a good death into actionable attributes to guide bedside nursing care of the dying child.

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Journal articles on the topic 'Children intensive care unit'

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