Peter W. Skippen

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BACKGROUND The Institute of Medicine calls for the use of clinical guidelines and practice parameters to promote "best practices" and to improve patient outcomes. OBJECTIVE 2007 update of the 2002 American College of Critical Care Medicine Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock. PARTICIPANTS Society of(More)
OBJECTIVE To investigate the incidence, implicating factors and outcome of acute renal failure after cardiopulmonary bypass in patients admitted to a paediatric intensive care unit. DESIGN Prospective observational pilot study. SETTING A 14 bed paediatric intensive care unit in a university affiliated, tertiary care referral children's hospital. (More)
BACKGROUND Hypothermia therapy improves survival and the neurologic outcome in animal models of traumatic brain injury. However, the effect of hypothermia therapy on the neurologic outcome and mortality among children who have severe traumatic brain injury is unknown. METHODS In a multicenter, international trial, we randomly assigned children with severe(More)
BACKGROUND The development of standardized acute kidney injury (AKI) definitions has allowed for a better understanding of AKI epidemiology, but the long-term renal outcomes of AKI in the pediatric critical care setting have not been well established. This study was designed to: (1) determine the incidence of chronic kidney disease (CKD) in children 1-3(More)
Regional citrate anticoagulation has become a common alternative to systemic heparinization in adult continuous venovenous hemofiltration (CVVH) practice. We report our experience with the technique in critically ill children. We carried out a retrospective chart review of a 22-bed pediatric intensive care unit. CVVH with pre-filter citrate and systemic(More)
OBJECTIVE To develop pediatric guidelines for the use of citrate as a regional anticoagulant for continuous renal replacement therapy (CRRT) using a neonatal piglet model. DESIGN Prospective observational study. SETTING Animal laboratory in the research center of a tertiary-level children's hospital. SUBJECTS Ten neonatal piglets. INTERVENTIONS AND(More)
OBJECTIVES To study cerebral blood flow and cerebral oxygen consumption in severe head-injured children and also to assess the effect of hyperventilation on regional cerebral blood flow. DESIGN Prospective cohort study. SETTING Pediatric intensive care unit at a tertiary-level university children's hospital. PATIENTS Twenty-three children with(More)
OBJECTIVE To describe characteristics, treatment, and outcomes of critically ill children with influenza A/pandemic influenza A virus (pH1N1) infection in Canada. DESIGN An observational study of critically ill children with influenza A/pH1N1 infection in pediatric intensive care units (PICUs). SETTING Nine Canadian PICUs. PATIENTS A total of 57(More)
BACKGROUND AND OBJECTIVES The prescription and delivery of renal replacement therapy for acute kidney injury is subject to a wide variation and is conditioned by a multiplicity of factors. A variety of renal replacement therapy modalities are now available to treat acute kidney injury; however, there are no standards for the dosage, choice of modality, and(More)
OBJECTIVE To compare the readings from a modified pediatric central venous oximetry (Scvo2) catheter with co-oximetry saturations of blood samples from critically ill children. DESIGN Prospective descriptive study. INTERVENTION None. SETTING A pediatric intensive care unit at a tertiary care children's hospital. MEASUREMENTS AND MAIN RESULTS(More)