BACKGROUND We hypothesized that bedside nurses perceive significant variability in the pediatric intensivist thresholds for approaching a family about withdrawal/limitation of life-sustaining therapy. METHODS All nurses working in four university-affiliated medical-surgical pediatric intensive care units staffed by 11, 7, 6, and 5 intensivists with 36, 18, 10, and 8 beds were sent three maili...

Sepsis remains a common problem in all age groups. Recently surviving sepsis campaign has taken up a worldwide initiative by publishing international guidelines 2008 with a hope to disseminate information regarding management of sepsis for all age groups. This article presents a review of recent advances as they apply to pediatric age group supported by the available evidence with reference to ...

OBJECTIVE Outcome of patients is determined not only by severity of illness index, but also by the impact of patients' preadmission comorbid status. Therefore, we aimed at evaluating the outcome of patients treated in a pediatric intensive care unit, with special focus on the group of children with chronic diseases. METHODS Data were obtained prospectively and outcome was assessed according t...

OBJECTIVE To assess the health-related quality of life (HRQoL) of children surviving to pediatric intensive care discharge. METHODS A prospective evaluation of HRQoL at admission and 6 months later was carried out with children aged 6 years or more, admitted to three tertiary pediatric intensive care units (PICUs) from May 2002 to June 2004. HRQoL was measured with the Health Utilities Index ...

OBJECTIVE Our goal was to identify and describe types of meaning-making processes that occur among parents during bereavement meetings with their child's intensive care physician after their child's death in a pediatric intensive care unit. METHODS Fifty-three parents of 35 deceased children participated in a bereavement meeting with their child's physician 14.5 ± 6.3 weeks after the child's ...

OBJECTIVE To determine whether the use of exogenous surfactant (Infasurf) in pediatric acute hypoxemic respiratory failure is cost-effective. DESIGN Deterministic cost-effectiveness analysis based on a Markov model. The model was calibrated using outcomes and resource utilization observed in a multiple-centered, prospective, randomized, controlled unblinded trial of Infasurf in pediatric acut...

OBJECTIVES Sedation scores are important tools for use in pediatric intensive care units. The Comfort-Behavior scale is a valid method for the assessment of children although it is considered an extensive scale. The motor activity assessment scale is validated for an adult population. We considered it simpler then the one above and suitable for application in children. None of these scores had ...

OBJECTIVE To examine the clinical factors associated with increased opioid dose among mechanically ventilated children in the pediatric intensive care unit. DESIGN Prospective, observational study with 100% accrual of eligible patients. SETTING Seven pediatric intensive care units from tertiary-care children's hospitals in the Collaborative Pediatric Critical Care Research Network. PATIEN...

CONTEXT The differential allocation of medical resources to adult patients according to characteristics such as race, gender, and insurance status raises the serious concern that such issues apply to critically ill children as well. OBJECTIVE This study examined whether medical resources and outcomes for children admitted to pediatric intensive care units differed according to race, gender, o...

Spiders exist in every place and ecosystem. Spiders in tropical regions are particularly poisonous and can be dangerous to humans. Nearly 20,000 spider species are known, and almost all are venomous, although only 60 species worldwide are poisonous in humans. In our area, eight species are reported as poisonous in humans. Although most cases of spider bite are benign and require no intervention...