ライフサイエンスコーパス: PICU

1 PICU bed availability is variable across U.S. states and

2 PICU bed growth exceeded pediatric population growth ove

3 PICU beds per pediatric population (< 18 yr), PICU bed d

4 PICU clinicians correctly identified multiple organ dysf

5 PICU hospitals contained greater than or equal to 1 PICU

6 PICU hospitals with greater than or equal to 15 beds in

7 PICU length of stay was increased in children with delir

8 PICU mortality for pediatric hematopoietic stem cell tra

9 PICU mortality has dropped from 85% to 44%, but interpre

10 PICU mortality of patients requiring continuous renal re

11 PICU mortality of pediatric cancer and hematopoietic ste

12 PICU mortality varied significantly by center, and a hig

13 PICU mortality was 8% in the reference standard cohort a

14 PICU mortality, length of ventilation, length of PICU st

15 PICU nurses, respiratory therapists, social workers, and

16 PICU patients diagnosed with severe sepsis.

17 PICU practitioners are developing flexible and novel app

18 PICU resource utilization varied by immunocompromised di

19 PICUs also prospectively collected timing of initial reh

20 PICUs from 43 children's hospitals.

21 PICUs in tertiary children's hospitals in United States

22 PICUs were defined as a separate unit, specifically for

23 spitals contained greater than or equal to 1 PICU.

24 ation is reported in approximately one in 10 PICU patients undergoing tracheal intubation.

25 During the study period, there were 151,128 PICU admissions.

26 ed for all initial tracheal intubation in 15 PICUs from July 2010 to December 2011 using the National

27 We analyzed data from 44 cases, 172 PICU controls, and 93 community controls.

28 Eighty-four identified PICUs of 206 PICUs contacted had at least one respondent, with a 40.8

29 d for all initial tracheal intubations in 25 PICUs from July 2010 to March 2014 using National Emerge

30 ith delirium developed it within the first 3 PICU days.

31 Data included 1,157 children from 31 PICUs.

32 ected from 60 patients with septic shock, 40 PICU patients with systemic inflammatory response syndro

33 Among 75 PICUs with regular morbidity and mortality conferences,

34 Across 83 centers, we identified 10,768 PICU admissions with an International Classification of

35 ed had at least one respondent, with a 40.8% PICU-level response rate.

36 Forty-seven of 88 PICU admitted children (53%) were identified as neuropsy

37 Of 1,927 PICU admissions of pediatric cancer and hematopoietic st

38 nical outcomes and ease of surveillance in a PICU.

39 23% to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or communit

40 ere less than 28 days old when admitted to a PICU in Australia or New Zealand between 2007 and 2016.

41 eonates born at "term" who are admitted to a PICU, increasing gestational age at birth is associated

42 We enrolled patients from five academic PICUs between 2008 and 2015.

43 aried widely in structure and process across PICUs in the United States.

44 Functional Status Scale scores at admission, PICU discharge, and hospital discharge were obtained for

45 Admitting PICU site explained 6.5% of the variation in first-line

46 University affiliated PICU.

47 Participants included all PICU patients younger than 18 years.

48 ansplantation patients comprised 0.7% of all PICU admissions (1,782/246,346), which resulted in 16.2%

49 PICU hospitals containing almost half of all PICU beds.

50 During the study period, all PICU patients were prospectively screened daily for seps

51 Seventy-six North American PICUs that participated in the Virtual Pediatric Systems

52 Among PICUs with greater than one respondent, when asked about

53 The readmission rate varied among PICUs (0-3.3%), and acute respiratory (56%), infectious

54 ve fluid overload % throughout admission and PICU day 2 cumulative fluid overload %.

55 Sixty-three adult and PICU teams from both academic and community hospitals in

56 eighted estimate of the population-based and PICU-based incidence of pediatric acute respiratory dist

57 charge POPC/PCPC scores and the baseline and PICU discharge FSS scores, the dispersion of FSS scores

58 ted the association between the baseline and PICU discharge POPC/PCPC scores and the baseline and PIC

59 determined at PICU admission (baseline) and PICU discharge.

60 % to greater than 73.6 million children, and PICU hospitals decreased 0.9% from 347 to 344 (58 closed

61 ng for age, gender, severity of illness, and PICU length of stay, delirium was associated with an 85%

62 c testing in a case series from the NICU and PICU of a large children's hospital between Nov 11, 2011

63 e sequencing (STATseq) in a level 4 NICU and PICU to assess the rate and types of molecular diagnoses

64 r precision medicine for infants in NICU and PICU who are diagnosed with genetic diseases to improve

65 nd paediatric intensive care units (NICU and PICU) is not sufficiently timely to guide acute clinical

66 pilot clinical studies in both the NICU and PICU.

67 Prophylactic antibiotic regimens and PICU patients demonstrated a statistically significant r

68 CU bed distribution by state and region, and PICU characteristics and their relationship with PICU be

69 The PICU core outcome set and PICU core outcome set-extended are multistakeholder-reco

70 nts, initial VLs were comparable in ward and PICU patients, and preceded the peak CDSS.

71 nd pediatric intensive-care units (NICUs and PICUs, respectively) involves continuous monitoring of v

72 dmission weight (kg) x 100] and expressed as PICU peak cumulative fluid overload % throughout admissi

73 tus Scale and POPC/PCPC scores determined at PICU admission (baseline) and PICU discharge.

74 acquired impairment" (acquired impairment at PICU discharge persisting to hospital discharge), and "n

75 acquired impairment" (acquired impairment at PICU discharge recovering by hospital discharge), "persi

76 diatric Logistic Organ Dysfunction scores at PICU admission were 11.0 (6.0-17.0) and 9.0 (6.0-11.0);

77 The outcome was vital status at PICU discharge.

78 IL-10 concentrations were comparable between PICU and floor patients, but higher than in healthy cont

79 oodstream infection rates within and between PICUs over a 10-year period, during which time infection

80 ian age, 2.6 months) with RSV bronchiolitis (PICU, n = 20; floor, n = 46) and healthy matched control

81 adults (>/=19 years) varied considerably by PICU (range, 0%-9.2%).

82 rates from these participants (the so-called PICU cohort) between Sept 10, 2013, and Sept 4, 2016.

83 Tertiary care PICU.

84 Urban academic tertiary care PICU.

85 ry for Children was feasible to characterize PICU tracheal intubation procedural process of care and

86 These data establish that contemporary PICU cardiopulmonary resuscitation, including long durat

87 In contrast, PICU bed numbers increased 43% (4,135 to 5,908 beds); th

88 Control PICUs (14 sites; n = 1224 patients) managed sedation per

89 and generalized estimating equations (daily PICU cumulative fluid overload % and oxygenation index r

90 mostatic assays, transfusion volumes, 90-day PICU-free days, and mortality were collected prospective

91 ; 95% CI, 1.05-1.97; p = 0.02) and decreased PICU-free days (beta coefficient, -4.2; 95% CI, -7.7 to

92 [AUC] 0.69, 95% CI 0.62-0.76) discriminates PICU mortality better than severity at PARDS diagnosis (

93 ource utilization data were collected during PICU admission.

94 Fluid accumulation occurs commonly during PICU course and is associated with considerable mortalit

95 ity of physician-family communication during PICU family meetings is poor overall.

96 utilization data were collected daily during PICU admission.

97 ic Logistic Organ Dysfunction-2 score during PICU stay up to eight time points: days 1, 2, 5, 8, 12,

98 Each PICU had similar organizational and staffing structures.

99 In 2016, there were eight PICU beds per 100,000 U.S. children (5.7 in 2001), with

100 There were 476 eligible PICU admissions, for whom 1,218 surveys were completed.

101 ot important" and were included in the final PICU core outcome set: four Global Domains (Cognitive, E

102 educed neuropsychological function following PICU admission in the critical illnesses under study.

103 At 1, 3, 6, and 12 months following PICU admission for the septic shock event, 8%, 11%, 12%,

104 7 days, and 1, 3, 6, and 12 months following PICU admission utilizing the Pediatric Quality of Life I

105 highly significant even after adjusting for PICU length of stay (p < 0.0001).

106 for severity of illness, the odds ratio for PICU mortality increased to 4.84 (95% CI, 1.45-16.2) and

107 propriate antimicrobials, the odds ratio for PICU mortality was 3.92 (95% CI, 1.27-12.06) and 3.59 (9

108 Four PICUs with only one respondent were excluded due to poor

109 .005), and neurodisability at discharge from PICU (53.3% vs. 82.9%; relative risk = 0.37; 95% CI, 0.1

110 on and up to 2 days following discharge from PICU.

111 mortality up to 90 days after discharge from PICU.

112 domly selected and intensively followed from PICU admission to hospital discharge in the Collaborativ

113 te continuous renal replacement therapy from PICU admission was lower in survivors compared to nonsur

114 fluid overload % was associated with greater PICU mortality (odds ratio, 1.05; 95% CI, 1.02-1.09; p =

115 Readmissions had significantly higher PICU mortality and longer PICU length of stay, compared

116 Mott Children's Hospital PICU.

117 or family-centered care in the neonatal ICU, PICU, and adult ICU, we developed an innovative adaptati

118 Pediatric ICUs (PICUs) often provide EOL care to children who die in the

119 Eighty-four identified PICUs of 206 PICUs contacted had at least one respondent

120 In PICU survivors, baseline body mass and composition may p

121 Thirty-two children died (3.1%) in PICU.

122 tion capacity was significantly decreased in PICU compared with both floor patients and healthy contr

123 analyses showed that VL decay was delayed in PICU patients, especially in those treated with steroids

124 ntly needed for the detection of delirium in PICU settings.

125 associated events and oxygen desaturation in PICU patients.

126 No differences in PICU or hospital stay were observed across the groups.

127 Significant variation exists in PICU mortality among centers despite adjustment for immu

128 irium was associated with an 85% increase in PICU costs (p < 0.0001).

129 irium is associated with a major increase in PICU costs.

130 agnosis of septic shock and its mortality in PICU.

131 ansfusion-associated circulatory overload in PICU and adult ICU.

132 Participants in PICU family meetings, including medical staff, family me

133 In a cohort of children recovering in PICU after having undergone cardiac surgery, we found th

134 n = 111) on day 10 among those remaining in PICU.

135 mentation of infection control strategies in PICU captured through a survey of clinicians.

136 In PICUs, two studies (345 patients) reported 0 cases, and

137 the main cause of death in adult ICUs and in PICUs.

138 0.04), and this difference was attenuated in PICUs with in-hospital attending coverage (adjusted odds

139 l intubation-associated events are common in PICUs.

140 risk of underdiagnosis of this condition in PICUs.

141 many morbidity and mortality conferences in PICUs across the United States conform to key elements o

142 the most commonly restricted medications in PICUs internationally.

143 With decreasing mortality in PICUs, a growing number of survivors experience long-las

144 logies leading to morbidity and mortality in PICUs.

145 but little is known about the prevalence in PICUs.

146 of sleep promotion and delirium screening in PICUs worldwide.

147 Most respondents worked in PICUs with sedation scoring systems (70%), although only

148 Intervention PICUs (17 sites; n = 1225 patients) used a protocol that

149 medical incident analysis, 62-68% had intra-PICU disagreement among respondents.

150 greater than one respondent (41%) had intra-PICU disagreement on all three key elements.

151 For emergent intubations, PICUs with home-call attending coverage had a significan

152 arter of children admitted to United Kingdom PICUs with pediatric inflammatory multisystem syndrome t

153 navirus-2 were admitted to 15 United Kingdom PICUs.

154 pyloric route, shorter interruptions, larger PICU size, and a dedicated dietitian in the PICU were as

155 Tertiary-level PICU.

156 gnificantly higher PICU mortality and longer PICU length of stay, compared with index admissions (4.0

157 significantly higher severity scores, longer PICU and hospital length of stay, longer duration of mec

158 ute kidney injury was associated with longer PICU stay (median 5 days [interquartile range, 4-7 d] vs

159 month in a center was associated with lower PICU mortality (adjusted odds ratio, 0.94; 95% CI, 0.90-

160 x admissions, readmissions had longer median PICU length of stay (3.1 vs 1.7 d, p < 0.001) and higher

161 munocompromised patients have shorter median PICU length of stay compared with patients without immun

162 reased 43% (4,135 to 5,908 beds); the median PICU beds per PICU hospital rose from 9 to 12 (interquar

163 Presbyterian Hospital-Weill Cornell Medicine PICU physician group continued to lead this unit.

164 nal study using verbatim transcripts of nine PICU family meetings conducted with in-person, hospital-

165 ty-three thousand three hundred seventy-nine PICU patients discharged between 2009 and 2010.

166 Eighteen percent of cases, 31% of PICU controls, and 51% of community controls were fully

167 ee PICU hospitals (18%) accounted for 47% of PICU beds.

168 ated cardiac arrests occurred during 1.7% of PICU tracheal intubations.

169 All cases of PICU chronic critical illness with length of stay more t

170 ntilator-associated pneumonia in a cohort of PICU patients.

171 deserves further study in larger cohorts of PICU children.

172 receive mechanical ventilation on the day of PICU admission were excluded.

173 and 8.0 days (5.0-14.0 d); and durations of PICU and hospital stay were 9.4 days (5.6-15.4 d) and 15

174 1] vs 7 [4-9], p < 0.001), shorter length of PICU stay (13 d [10.8-15.2 d] vs. 18 d [14.5-21.5 d], p

175 95% CI, 0.24-1.36; p = 0.005), and length of PICU stay (B coefficient, 0.38; 95% CI, 0.11-0.66; p = 0

176 95% CI, 0.54-0.77; p < 0.001), and length of PICU stay (B coefficient, 0.52; 95% CI, 0.46-0.58; p < 0

177 by 1.6 days (95% CI, 1.0-2.3), and length of PICU stay by 2.1 days (95% CI, 1.3-3.0), as well as an i

178 mortality, length of ventilation, length of PICU stay, and ventilator-free days at day 28.

179 core at 72 hours after enrollment, length of PICU stay, duration of mechanical ventilation, and heari

180 if fluid overload predicts longer length of PICU stay, prolonged mechanical ventilation (length of v

181 admissions occurred in a sizable minority of PICU patients.

182 (95% CI, 1.3-3.2; P = .004) greater odds of PICU mortality compared with adolescent patients, after

183 ndently associated with an increased odds of PICU mortality in children with severe sepsis or septic

184 8) were associated with an increased odds of PICU mortality.

185 1) were associated with an increased odds of PICU mortality.

186 years with a relatively small percentage of PICU hospitals containing almost half of all PICU beds.

187 the most important and earliest predictor of PICU mortality.

188 ey injury and impact on functional status of PICU survivors are unknown.

189 Our population-based study of PICUs in England and Wales demonstrates a steady decline

190 Fluid overload peaked on PICU day 2.

191 Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of w

192 red the management of infants in the NICU or PICU.

193 icles reporting study data on population- or PICU-based incidence and mortality of acute respiratory

194 In the coronavirus disease 2019 pandemic, PICU physicians are well poised to care for adult patien

195 ars old admitted to one of the participating PICUs in the Virtual PICU Systems, LLC database were inc

196 280 patients were admitted to participating PICUs, of whom 744 (3.2%) were identified as having PARD

197 135 to 5,908 beds); the median PICU beds per PICU hospital rose from 9 to 12 (interquartile range 8,

198 oints: days 1, 2, 5, 8, 12, 16, and 18, plus PICU discharge.

199 Fluid overload is associated with poor PICU outcomes in different populations.

200 iac surgery and is associated with prolonged PICU length of stay and ventilation.

201 Raw PICU mortality was 11.2% (216/1,972 admissions).

202 ited States each year, and up to 35% require PICU support for life-threatening complications.

203 Forty-two (36%) patients required PICU admission.

204 e ward had higher VLs than infants requiring PICU care (P < .001).

205 stem cell transplantation patients requiring PICU admission.

206 ing was not practiced in 71% of respondent's PICUs, and only 2% reported routine screening at least t

207 less commonly receive rehabilitation in U.S. PICUs, and early rehabilitation consultation is infreque

208 ion have succeeded in reducing rates in U.S. PICUs, but there is a lack of evidence for the impact of

209 anned readmissions within 1 year to the same PICU; 3.4% had two or more readmissions.

210 Pediatric Logistic Organ Dysfunction scores, PICU and hospital durations of stay, maximum and cumulat

211 Fifteen of thirty-seven PICUs with greater than one respondent (41%) had intra-P

212 Seventeen PICUs in the intervention arm.

213 Seventy PICUs had 67 629 admissions; 1954 admissions (2.7%) were

214 after adjustment for disease severity, site, PICU days, and energy intake.

215 but high-risk proportion of patients in some PICUs, suggesting that these PICUs should have plans and

216 Specialized PICUs were available in 59 hospitals (17.2%), 48 were ca

217 Children consecutively admitted to study PICUs.

218 echanical ventilation, neurological testing, PICU and hospital lengths of stay, in-hospital mortality

219 The PICU core outcome set and PICU core outcome set-extended

220 tage of the prescribed daily goal during the PICU stay </=10 d.

221 nfant-Toddler Quality of Life scores for the PICU cohort overall were consistently lower than age-rel

222 atients who died prior to discharge from the PICU.

223 29 patients were enrolled in the PICU cohort.

224 t meet consensus, which were included in the PICU core outcome set-extended.

225 All patients less than 18 years old in the PICU during the study dates and times were included in t

226 For children who were in the PICU for 6 or more days, delirium prevalence rate was 38

227 In the PICU group, multivariable linear regression revealed tha

228 The mode of death in the PICU is proportionally similar to that reported over the

229 PICU size, and a dedicated dietitian in the PICU were associated with higher enteral protein deliver

230 who died beyond 1-week length of stay in the PICU were more likely to have preexisting diagnoses, to

231 f multiple organ dysfunction syndrome in the PICU with a continuous scale.

232 ight enhance enteral protein delivery in the PICU with a potential for improved outcomes.

233 device types and these complications in the PICU.

234 c Delirium completed by nursing staff in the PICU.

235 atric Delirium) throughout their stay in the PICU.

236 s of increased use of this technology in the PICU.

237 continuous renal replacement therapy in the PICU.

238 Data were collected on the PICU characteristics, patient demographics, and elements

239 ng in the unit waiting for a bed outside the PICU or 2) receiving therapeutic anticoagulation.

240 c categorical residents rotating through the PICU for the first time.

241 Of 7,459 patients admitted to the PICU during the study period, 401 met consensus criteria

242 aged 6 months to 5 years and admitted to the PICU regardless of admission diagnosis were enrolled.

243 nd fecal samples in children admitted to the PICU.

244 venous catheters in children admitted to the PICU.

245 Within 1 week, the PICU at New York Presbyterian Hospital-Weill Cornell Med

246 The PICUs had a mean of three respondents (SD, 2.5; range, 1

247 All children admitted to the PICUs were daily evaluated for the presence of acute res

248 ildren (27%) developed delirium during their PICU stay.

249 ers, and child life specialists joined their PICU physician colleagues to care for these critically i

250 assessed for delirium daily throughout their PICU stay.

251 atients in some PICUs, suggesting that these PICUs should have plans and protocols specifically focus

252 Sixty-three PICU hospitals (18%) accounted for 47% of PICU beds.

253 Forty-nine of eighty-three PICUs (59%) had fellowship training programs.

254 Five of eighty-three PICUs (6%) had no regular morbidity and mortality confer

255 rtality were recorded from admission through PICU death or discharge.

256 Survival was 81.4% (95% CI, 78.6-83.9) to PICU discharge, 70% (95% CI, 66.7-72.8) at 1 year, and 6

257 undred twenty-four children were admitted to PICU for longer than 28 days on 1,056 occasions, account

258 ation in critically ill children admitted to PICU in an unplanned fashion may be associated with sign

259 Of 764 children admitted to PICU with traumatic brain injury, 92 (12%) were eligible

260 .1-7.3; P = .04) were more often admitted to PICU.

261 admitted to a PICU for influenza compared to PICU controls or community controls, respectively.

262 al performance category from preadmission to PICU discharge.

263 anically ventilated children on admission to PICUs worldwide.

264 failure is a common reason for admission to PICUs.

265 r term-born neonates (>= 37 wk') admitted to PICUs in Australia and New Zealand.

266 ing for covariates, the children admitted to PICUs significantly underperformed on neuropsychological

267 Teachers deemed more children admitted to PICUs than controls as performing educationally worse an

268 occurrence rate of unplanned readmissions to PICUs within 1 year and examine risk factors associated

269 Median total PICU costs were higher in patients with delirium than in

270 admission to pediatric intensive care unit (PICU) and length of hospital stay (LOS).

271 itted to the paediatric intensive care unit (PICU) at Wilhelmina Children's Hospital (Utrecht, Nether

272 ission to the pediatric intensive care unit (PICU) have no risk factors for severe disease.

273 opular in the pediatric intensive care unit (PICU) over the last decade.

274 ts vs ward vs pediatric intensive care unit [PICU]), and a clinical disease severity score (CDSS).

275 tilation on Paediatric Intensive Care Units (PICU).

276 included 59 pediatric intensive care units (PICUs) from 15 countries, we enrolled consecutive childr

277 study, 145 paediatric intensive care units (PICUs) from 27 countries were recruited, and over a cont

278 rdiovascular pediatric intensive care units (PICUs) in the Collaborative Pediatric Critical Care Rese

279 ted to 21 US pediatric intensive care units (PICUs) with acute severe respiratory illness and testing

280 ted in 31 US pediatric intensive care units (PICUs).

281 Unplanned PICU readmission within 48 hours of index discharge was

282 Unplanned PICU readmissions were relatively uncommon, but were ass

283 tion aged 1 month to 18 years in the Virtual PICU System database from January 1, 2009, through Decem

284 selected nonelective cases from the Virtual PICU Systems database were used to estimate each patient

285 ne of the participating PICUs in the Virtual PICU Systems, LLC database were included (2009-2014).

286 The primary outcome was PICU mortality.

287 as cases; children who tested negative were PICU controls.

288 had significant bed growth by 2016, whereas PICU hospitals with less than 15 beds experienced little

289 mate the independent association of age with PICU mortality.

290 te of fluid accumulation was associated with PICU mortality (odds ratio, 1.15; 95% CI, 1.01-1.31; p =

291 icrobial administration were associated with PICU mortality (primary outcome); ventilator-free, vasoa

292 enters and determine factors associated with PICU mortality, we used mixed-effect logistic regression

293 nal replacement therapy were associated with PICU mortality.

294 p was no longer significant in children with PICU stay greater than 2 days.

295 -6 concentrations, inversely correlated with PICU-free days at 28 days.

296 hospital intensivist staffing increased with PICU beds per hospital.

297 characteristics and their relationship with PICU beds were measured.

298 Hospitals with PICUs were identified from prior surveys, databases, onl

299 clonidine, two sedatives widely used within PICUs neither of which being licensed for that use.

300 ICU beds per pediatric population (< 18 yr), PICU bed distribution by state and region, and PICU char