Debra H. Fiser

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OBJECTIVE Given the current focus on outcomes, there is a crucial need for easily utilized measures that can effectively quantify morbidity or disability after a child's critical illness or injury. The purpose of this study is to significantly extend the research on two such promising measures: the Pediatric Overall Performance Category (POPC) and the(More)
OBJECTIVE This study was undertaken to examine variation in therapies and outcome for pediatric head trauma patients by patient characteristics and by pediatric intensive care unit. Specifically, the study was designed to examine severity of illness on admission to the pediatric intensive care unit, the therapies used during the pediatric intensive care(More)
OBJECTIVES To determine if decomplexification of heart rate dynamics occurs in critically ill and injured pediatric patients. We hypothesized that heart rate power spectra, a measure of heart rate dynamics, would inversely correlate with measures of severity of illness and outcome. DESIGN A prospective clinical study. SETTING A 12-bed pediatric(More)
The pharmacologic effects of dopamine and dobutamine (2 to 32 micrograms/kg.min) were evaluated in 12 1 to 2-month-old piglets. Dopamine increased cardiac output at 16 to 32 micrograms/kg.min (p less than .05) and increased heart rate (HR) at 4 to 32 micrograms/kg.min (p less than .05). Dobutamine produced an increased cardiac output at doses of 16 to 32(More)
OBJECTIVES To compare pediatric intensive care unit (ICU) mortality risk using models from two distinct time periods; and to discuss the implications of changing mortality risk for severity systems and quality-of-care assessment. DATA SOURCES AND SETTING Consecutive admissions (n = 10,833) from 16 pediatric ICUs across the United States that participate(More)
BACKGROUND Cost-effectiveness analysis relies on preference-weighted health outcome measures as they form the basis for quality adjusted life years. Studies of preference-weighted outcomes for children following traumatic brain injury are lacking. OBJECTIVE This study seeks to describe the preference-weighted health outcomes of children following a(More)
OBJECTIVE This study examines the incidence, utilization of procedures, and outcomes for critically ill children hospitalized with traumatic brain injury over the period 1988-1999 to describe the benefits of improved treatment. DESIGN Retrospective analysis of hospital discharges was conducted using data from the Health Care Cost and Utilization Project(More)
Forty-one children and adolescents with a history of breathing difficulty during sleep and morbid obesity, defined as greater than 150% ideal body weight, underwent polysomnography to determine the incidence of sleep-associated breathing disorders. Seventeen patients also performed pulmonary function testing. The mean patient age was 10.3 +/- 4.4 (SD)(More)
Central diabetes insipidus (DI) occurs in patients suffering from overwhelming CNS injuries leading to brain death. The purpose of this study was to describe the clinical presentation of DI in children with brain death. The medical records of 34 patients with a diagnosis of brain death were reviewed. Diuresis was present in 76% of patients; however, DI was(More)