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OBJECTIVE To compare the effectiveness of high-frequency oscillatory ventilation with conventional mechanical ventilation in pediatric patients with respiratory failure. SETTING Five tertiary care pediatric intensive care units. DESIGN A prospective, randomized, clinical study with crossover. PATIENTS Seventy patients with either diffuse alveolar(More)
CONTEXT Ventilator management protocols shorten the time required to wean adult patients from mechanical ventilation. The efficacy of such weaning protocols among children has not been studied. OBJECTIVE To evaluate whether weaning protocols are superior to standard care (no defined protocol) for infants and children with acute illnesses requiring(More)
RATIONALE Minimizing exposure of children to blood products is desirable. OBJECTIVES We aimed to understand anemia development, blood loss, and red blood cell (RBC) transfusions in the pediatric intensive care unit (PICU). METHODS Prospective, multicenter, 6-month observational study in 30 PICUs. Data were collected on consecutive children (<18 yr old)(More)
Designing robust clinical trials in critically ill, mechanically ventilated children requires an understanding of the epidemiology and course of pediatric respiratory failure. As part of a clinical trial, we screened all mechanically ventilated children in nine large pediatric intensive care units (ICUs) across North America for 6 consecutive months. Of(More)
OBJECTIVE The effect of fluid balance on respiratory outcomes for critically ill children has not been evaluated. The only indicator of fluid balance routinely recorded across our intensive care units was estimated fluid intake and output. We sought to determine whether cumulative intake minus output (I-O) at the start of weaning predicted weaning duration(More)
OBJECTIVE The use of high-frequency oscillatory ventilation (HFOV) has increased dramatically in the management of respiratory failure in pediatric patients. We surveyed ten pediatric centers that frequently use high-frequency oscillation to describe current clinical practice and to examine factors related to improved outcomes. DESIGN Retrospective,(More)
OBJECTIVE To assess the safety and efficacy of a recruitment maneuver, the Open Lung Tool, in pediatric patients with acute lung injury and acute respiratory distress syndrome. DESIGN Prospective cohort study using a repeated-measures design. SETTING Pediatric intensive care unit at an urban tertiary children's hospital. PATIENTS Twenty-one ventilated(More)
In summary, most of the available data suggest that pediatric patients should be ventilated with low tidal volumes. The 6-mL/kg IBW tidal volume strategy as used in the ARDSNet studies is a reasonable target, having since been rigorously tested in several large, clinical trials (adult and pediatric). The mortality associated with ALI in these studies has(More)
The advantages of international experiences for engineering students are well documented. With this in mind, we decided to take our 18-year-old, client-based, senior design class " on the road. " This foray into the realm of international projects did not come without some anxieties: • Could we properly manage such a long-distance project? • How much of a(More)
This study explores the use of writing as a tool for metacognition in the engineering classroom. We used the " explain-a-problem " type of assignment in the Engineering Statics course for four terms. The objectives associated with the assignments were grouped under student self-assessment, student communication, and administration. Performance on each of(More)