ライフサイエンスコーパス: PICU

1 PICU length of stay was increased in children with delir

2 PICU mortality for pediatric hematopoietic stem cell tra

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

4 PICU mortality, length of ventilation, length of PICU st

5 PICU patients diagnosed with severe sepsis.

6 PICU practitioners are developing flexible and novel app

7 PICUs from 43 children's hospitals.

8 PICUs in tertiary children's hospitals in United States

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

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

11 The study was conducted in 16 PICUs across the United States that were member institut

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

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

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

15 (<or=16 years) admitted consecutively to 29 PICUs in England and Wales during 4 years (Jan 1, 2005,

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

17 Data included 1,157 children from 31 PICUs.

18 icular or pulmonary artery catheters) in 351 PICU patients were studied.

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

20 Among 75 PICUs with regular morbidity and mortality conferences,

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

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

23 rent at home versus parent in the PICU; 4) a PICU admission does not equate with respite; 5) high sta

24 , and either New York State designation as a PICU or a separate dedicated unit for children.

25 Hospitals were considered to have a PICU if they had a board-certified pediatric intensivist

26 nical outcomes and ease of surveillance in a PICU.

27 eath of some children in hospitals lacking a PICU is expected, the significant regional variation in

28 23% to 96%) less likely to be admitted to a PICU for influenza compared to PICU controls or communit

29 e input of parents of children admitted to a PICU, and it was administered to parents in the PICU.

30 Sixty-six parents of children admitted to a PICU.

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

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

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

34 University affiliated PICU.

35 ciated with an increased risk of death after PICU admission after cardiac arrest.

36 ents were interviewed during, or just after, PICU admission until data saturation was achieved.

37 (PRISM) scores were collected daily for all PICU patient days.

38 Participants included all PICU patients younger than 18 years.

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

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

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

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

43 nonlinear relationship between Pa(O)(2) and PICU mortality.

44 95% confidence interval [CI] 2.8, 24.4) and PICU stay > or =3 days (OR 13.8, CI 5.1, 37.5).

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

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

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

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

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

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

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

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

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

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

55 PICUs can be applied to patients in another PICU remote from where the scoring system was developed

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

57 ity of illness and health status, as well as PICU quality and performance.

58 the risk for Glasgow Coma Scale score <13 at PICU discharge (odds ratio [OR] 9.7, 95% confidence inte

59 Data were collected at PICU discharge, hospital discharge, and 1- and 6-month f

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

61 luded the POPC (at PICU discharge), PCPC (at PICU discharge), Stanford-Binet Intelligence Scale, four

62 Measures utilized included the POPC (at PICU discharge), PCPC (at PICU discharge), Stanford-Bine

63 edictor of lower Glasgow Coma Scale score at PICU discharge (OR 4.7, CI 1.4, 15.6) and longer PICU le

64 The outcome was vital status at PICU discharge.

65 omized design was used; children in a 23-bed PICU with solid organ transplantation were enrolled into

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

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

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

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

70 Tertiary care PICU.

71 Urban academic tertiary care PICU.

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

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

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

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

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

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

78 Each PICU had similar organizational and staffing structures.

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

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

81 The total cost for PICU care was $16,983,323.

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

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

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

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

86 mortality up to 90 days after discharge from PICU.

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

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

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

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

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

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

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

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

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

96 Of 1875 patients, 735 (39%) died in PICU.

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

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

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

100 agnosis of septic shock and its mortality in PICU.

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

102 mary outcome measures were mortality rate in PICU and length of stay in PICU.

103 mortality rate in PICU and length of stay in PICU.

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

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

106 0.04), and this difference was attenuated in PICUs with in-hospital attending coverage (adjusted odds

107 l intubation-associated events are common in PICUs.

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

109 ity 6% [4-10] vs 4% [2-7]), stayed longer in PICUs (75 h [33-153] vs 43 h [18-116]), and had higher c

110 the most commonly restricted medications in PICUs internationally.

111 cterize the extubation failure population in PICUs.

112 6-1.38), the risk-adjusted mortality rate in PICUs was lower than among children admitted from within

113 of sleep promotion and delirium screening in PICUs worldwide.

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

115 Demographic data including PICU resource utilization and outcome were recorded.

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

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

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

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

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

121 Tertiary-level PICU.

122 s, 107.9 hrs, SD +/- 171.3; p <.001), longer PICU length of stay (17.5 days, SD +/- 15.6 vs. 7.6 days

123 in children were associated with 18% longer PICU stays after controlling for other patient and insti

124 discharge (OR 4.7, CI 1.4, 15.6) and longer PICU length of stay (OR 8.5, CI 2.8, 25.6).

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

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

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

128 For survivors, median PICU LOS was 2 days, although 25% had LOS >6 days.

129 s; and patients transferred to their nearest PICU and those who were not.

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

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

132 Non-PICU hospital pediatric death rates were compared for he

133 opulation (8.04 vs. 2.00), and per 1,000 non-PICU hospital discharges (2.25 vs. 1.18), respectively (

134 New York City non-PICU hospital death rates also were higher than in the r

135 Forty percent of New York City non-PICU hospitals experienced a pediatric inpatient death c

136 ight regions in pediatric death rates in non-PICU hospitals (p < .05).

137 York City inpatient deaths occurring in non-PICU hospitals significantly exceeded the 43 of 256 (17%

138 ic hospital inpatient deaths occurred in non-PICU hospitals.

139 in hospitals lacking specialized units (non-PICU hospitals) were postulated to represent possible PI

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

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

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

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

144 al blood gas analysis taken within 1 hour of PICU admission were included.

145 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

146 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

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

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

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

150 admissions occurred in a sizable minority of PICU patients.

151 (95% CI, 1.3-3.2; P = .004) greater odds of PICU mortality compared with adolescent patients, after

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

153 tcome scoring system created in one group of PICUs can be applied to patients in another PICU remote

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

155 Fluid overload peaked on PICU day 2.

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

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

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

159 The need for other PICU resources, including vasopressors, were similar.

160 change in radiology ordering practice in our PICU.

161 The infection rate in the overall PICU population did not change significantly from the ye

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

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

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

165 itals) were postulated to represent possible PICU utilization failures.

166 ars with documented cardiac arrest preceding PICU admission and arterial blood gas analysis taken wit

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

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

169 matic brain injury serious enough to require PICU admission.

170 stem cell transplantation patients requiring PICU admission.

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

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

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

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

175 Seventeen PICUs in the intervention arm.

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

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

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

179 Children consecutively admitted to study PICUs.

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

181 spital for Sick Children, and the Pan Thames PICU Commissioning Consortium.

182 The PICU was 86% efficient.

183 s from wards within the same hospital as the PICU and from other hospitals; interhospital transfers b

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

185 analyzed and developed specifically for the PICU setting.

186 ned all direct and indirect expenses for the PICU.

187 atients who died prior to discharge from the PICU.

188 assessed at baseline and discharge from the PICU.

189 s were associated with length of stay in the PICU and with predicted risk of mortality (p < .01).

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

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

192 In the PICU group, multivariable linear regression revealed tha

193 pite an increased mean length of stay in the PICU in the gown and glove group (p =.014), there was a

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

195 ependency, and withdrawal in children in the PICU population were selected.

196 the use of sedative/analgesic agents in the PICU population.

197 agent used for sedation and analgesia in the PICU population.

198 We found little difference in the PICU room cost when calculated by adding direct and indi

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

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

201 Nurses and physicians in the PICU were very similar to each other in the types of sup

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

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

204 care nurses, 11 physicians attending in the PICU, 10 critical care and anesthesia fellows, and 24 an

205 age, operative status, length of stay in the PICU, and diagnoses.

206 c Delirium completed by nursing staff in the PICU.

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

208 improving the care of children dying in the PICU.

209 U, and it was administered to parents in the PICU.

210 role of parent at home versus parent in the PICU; 4) a PICU admission does not equate with respite;

211 The cost because of the PICU location (room cost) was 52.1% of all costs, and co

212 y of care to the current patient base of the PICU.

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

214 All children admitted to the PICU immediately after solid organ transplantation, excl

215 +/- 1.0 months; p < .001), readmitted to the PICU more often during the same hospitalization (11.1% v

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

217 ation, and at subsequent readmissions to the PICU were eligible for the study.

218 ccurred in 29.9% of patients admitted to the PICU with traumatic brain injury.

219 during the first 24 hrs of admission to the PICU.

220 th period, 503 patients were admitted to the PICU.

221 ce the endotracheal tube on admission to the PICU; and the use of racemic epinephrine, steroids, heli

222 primary outcome measure was death within the PICU.

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

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

225 assessed for delirium daily throughout their PICU stay.

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

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

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

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

230 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

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

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

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

234 intensive care unit (PICU) discharge and to PICU length of stay in head-injured children.

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

236 al performance category from preadmission to PICU discharge.

237 anically ventilated children on admission to PICUs worldwide.

238 There were 57 997 admissions to PICUs during the study.

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

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

241 children transferred from local hospitals to PICUs.

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

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

244 mitted to the pediatric intensive care unit (PICU) after cardiac arrest.

245 tcomes in the pediatric intensive care unit (PICU) by using multi-institutional data.

246 gic status at pediatric intensive care unit (PICU) discharge and to PICU length of stay in head-injur

247 e care in the pediatric intensive care unit (PICU) has been performed.

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

249 f stay in the pediatric intensive care unit (PICU) is a reflection of patient severity of illness and

250 survival and pediatric intensive care unit (PICU) length of stay (LOS) for children with severe trau

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

252 andwashing in pediatric intensive care unit (PICU) patients with solid organ transplantation.

253 tilation on Paediatric Intensive Care Units (PICU).

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

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

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

257 of regional paediatric intensive care units (PICUs), specialist retrieval teams were set up to transp

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

259 Unplanned PICU readmission within 48 hours of index discharge was

260 Unplanned PICU readmissions were relatively uncommon, but were ass

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

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

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

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

265 oint was survival; secondary end points were PICU LOS, cost, and day at which Glasgow Coma Scale scor

266 mate the independent association of age with PICU mortality.

267 he following terms: sedation, analgesia with PICU, children, physical dependency, withdrawal; toleran

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

269 -6 concentrations, inversely correlated with PICU-free days at 28 days.

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