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CONTEXT Despite evidence that patients with acute lung injury (ALI) have pulmonary surfactant dysfunction, trials of several surfactant preparations to treat adults with ALI have not been successful. Preliminary studies in children with ALI have shown that instillation of a natural lung surfactant (calfactant) containing high levels of surfactant-specific(More)
The onset of symptomatic hypoglycemia in children with ingestions of second-generation sulfonylureas has never been documented to be later than 21 hours post-ingestion. We report a case with the longest known interval, 45 hours, between ingestion of a sulfonylurea and the onset of hypoglycemia requiring medical intervention. The hypoglycemia was severe and(More)
OBJECTIVES To determine the current mortality rates for pediatric patients with septic shock and the frequency and outcome of associated multiple organ system failure. DESIGN Retrospective chart review. SETTING Multidisciplinary pediatric intensive care unit. PATIENTS Children age 1 month to 21 yrs admitted to the pediatric intensive care unit from(More)
OBJECTIVE To determine the relationship of demographic and clinical variables to cost, to revenue based on diagnosis-related groups, and to profit in patients in a pediatric intensive care unit (PICU). DESIGN Prospective collection of clinical and demographic data of patients sampled. Detailed financial data for all patients discharged from the hospital(More)
This article details how computers have changed life for those of us in pediatric intensive care. A week of clinical activity is described, with a focus on the interactions with computer systems that have become an integral part of patient-care activities for many of us. It becomes clear that the boundaries between personal computers, hospital systems, and(More)
The treatment of complex parapneumonic effusions in children remains controversial, with some advocating less invasive, strictly medical management and others supporting a more aggressive approach of thoracotomy with or without decortication. Recent advances, including video-assisted thoracoscopic surgery and intrapleural fibrinolytic therapy, offer new(More)
OBJECTIVE To evaluate the intraoperative and postoperative care of children following thoracoabdominal resection of neuroblastoma. DESIGN Retrospective chart review. SETTING Pediatric intensive care unit (PICU) of major pediatric cancer center. PATIENTS Eighty-eight patients undergoing thoracoabdominal resection of neuroblastoma over a 6-year period.(More)
Highly specialized pediatric critical care centers have matured significantly over the past two decades; however, access to this care is limited to tertiary care facilities and constrained by geography. With the advances of transport medicine, great distances can be spanned to bring critical care to the patient and provide effective treatment and safe(More)