Joan S Roberts

Learn More
Efficacy of the Haemophilus influenzae type b (Hib) conjugate vaccine PRP-T (Pasteur-Merieux) was evaluated in a controlled community intervention study in the Oxford region, UK. PRP-T was offered to infants from May 1, 1991 in three of the region's eight districts and from July 1, 1991, in a fourth district. It was given by separate injection in addition(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)
Colloid solutions have been developed and used over the past 70 years as expanders of the intravascular space, based on an understanding of Starling's law. Increasing osmotic pressure with colloidal products has remained an attractive theoretical premise for volume resuscitation. Indeed, colloids have been shown to increase osmotic pressure in clinical(More)
OBJECTIVE Cerebral edema associated with diabetic ketoacidosis is an uncommon but severe complication of insulin-dependent diabetes mellitus with unclear pathophysiology. We sought to determine whether cerebral edema in patients with diabetic ketoacidosis was related to changes in cerebral blood flow, autoregulation, regional cerebral saturation, or S100B.(More)
OBJECTIVE Identify the incidence and risk factors for development of acute, severe central nervous system (CNS) complications of pediatric extracorporeal life support (ECLS). DESIGN Retrospective review of Extracorporeal Life Support Organization (ELSO) registry database. SETTING Pediatric intensive care units of 115 tertiary centers internationally. (More)
OBJECTIVE To describe the efficacy of percutaneous pigtail catheters in evacuating pleural air or fluid in pediatric patients. DESIGN A case series of children with percutaneous pigtail catheters placed in the pediatric ICU between January 1996 and August 1997. SETTING Urban pediatric teaching hospital in Seattle, WA. METHODS A retrospective chart(More)
OBJECTIVE To observe the effects of right carotid artery ligation and variations in extracorporeal life support (ECLS) flow on regional cerebral oxygenation index (rSO2i) measured using near infrared spectroscopy. DESIGN Prospective observational study. SETTING Tertiary children's hospital. PATIENTS Eleven neonatal and pediatric patients requiring(More)
OBJECTIVE To determine differences in therapies and outcomes among pediatric intensive care units for patients with acute severe asthma. DESIGN Retrospective cohort study. SETTING Eleven pediatric intensive care units participating in the Pediatric Intensive Care Evaluations. PATIENTS Patients were 1528 children with a primary diagnosis of asthma. (More)
OBJECTIVE Cerebral edema is a devastating complication of pediatric diabetic ketoacidosis. We aimed to examine blood-brain barrier permeability during treatment of diabetic ketoacidosis in children. DESIGN Prospective observational study. SETTING Seattle Children's Hospital, Seattle, WA. PATIENTS Children admitted with diabetic ketoacidosis (pH <7.3,(More)
BACKGROUND Extracorporeal life support (ECLS) is an advanced form of life-sustaining therapy that creates stressful dilemmas for families. In May 2009, Seattle Children's Hospital (SCH) implemented a policy to involve the Pediatric Advanced Care Team (PACT) in all ECLS cases through automatic referral. OBJECTIVE Our aim was to describe PACT involvement in(More)