Scholars@Duke
Alexandre Tellechea Rotta

Alexandre Tellechea Rotta

Professor of Pediatrics
Pediatrics, Critical Care Medicine

Selected Publications

Acute Respiratory Distress Syndrome in Children With Lower Respiratory Tract Infection Requiring Invasive Mechanical Ventilation: Post Hoc Analysis of the 2019-2020 Bronchiolitis and Codetection Cohort.

Journal Article Pediatr Crit Care Med · May 1, 2025 OBJECTIVES: Bronchiolitis and other lower respiratory tract infections (LRTIs) are the most common causes of pediatric respiratory failure. There is insufficient evidence characterizing pediatric acute respiratory distress syndrome (PARDS) in young childre ... Full text Link to item Cite

Age-associated differences in mucosal and systemic host responses to SARS-CoV-2 infection.

Journal Article Nat Commun · March 10, 2025 Age is among the strongest risk factors for severe outcomes from SARS-CoV-2 infection. Here we describe upper respiratory tract (URT) and peripheral blood transcriptomes of 202 participants (age range of 1 week to 83 years), including 137 non-hospitalized ... Full text Open Access Link to item Cite

Planning a Phased Guideline Implementation Strategy Across the Multicenter Ventilation Liberation for Kids (VentLib4Kids) Collaborative.

Journal Article Pediatr Crit Care Med · March 1, 2025 OBJECTIVES: To evaluate contextual factors relevant to implementing pediatric ventilator liberation guidelines and to develop an implementation strategy for a multicenter collaborative. DESIGN: Cross-sectional qualitative analysis of a 2023/2024 survey. SE ... Full text Link to item Cite

Noninvasive Ventilation or CPAP in the Initial Treatment Phase of Small Infants With Respiratory Failure.

Journal Article Respir Care · February 2025 Background: Respiratory failure in infants is a common reason for admission to the pediatric ICU (PICU). Although high-flow nasal cannula (HFNC) is the preferred first-line treatment at our institution, some infants require CPAP or noninvasive ventilation ... Full text Link to item Cite

Framework for Research Gaps in Pediatric Ventilator Liberation.

Journal Article Chest · November 2024 BACKGROUND: The 2023 International Pediatric Ventilator Liberation Clinical Practice Guidelines provided evidence-based recommendations to guide pediatric critical care providers on how to perform daily aspects of ventilator liberation. However, because of ... Full text Link to item Cite

Endotracheal Intubation Outside the Operating Room: Year in Review 2023.

Journal Article Respir Care · August 24, 2024 Endotracheal intubation is a common lifesaving procedure that often is performed outside the operating room in a variety of clinical scenarios. Providers who perform intubation outside the operating room have variable degrees of training, skill development ... Full text Link to item Cite

Use of Speckle-Tracking Echocardiography in Septic Cardiomyopathy in Critically Ill Children: A Narrative Review.

Journal Article Crit Care Explor · July 1, 2024 OBJECTIVES: In critically ill children with severe sepsis, septic cardiomyopathy (SCM) denotes the subset of patients who have myocardial dysfunction with poor response to fluid and inotropic support, and higher mortality risk. The objective of this review ... Full text Link to item Cite

Prevalence of Bacterial Codetection and Outcomes for Infants Intubated for Respiratory Infections.

Journal Article Pediatr Crit Care Med · July 1, 2024 OBJECTIVES: To determine the prevalence of respiratory bacterial codetection in children younger than 2 years intubated for acute lower respiratory tract infection (LRTI), primarily viral bronchiolitis, and identify the association of codetection with mech ... Full text Link to item Cite

Immunogenicity of Monovalent mRNA-1273 and BNT162b2 Vaccines in Children <5 Years of Age.

Journal Article Pediatrics · June 1, 2024 BACKGROUND AND OBJECTIVES: The messenger RNA (mRNA)-based coronavirus disease 2019 vaccines approved for use in children <5 years of age have different antigen doses and administration schedules that could affect vaccine immunogenicity and effectiveness. W ... Full text Link to item Cite

Factors Associated With Successful Extubation Readiness Testing in Children With Congenital Heart Disease.

Journal Article Respir Care · March 27, 2024 BACKGROUND: In children with congenital heart disease, extubation readiness testing (ERT) is performed to evaluate the potential for liberation from mechanical ventilation. There is a paucity of data that suggests what mechanical ventilation parameters are ... Full text Link to item Cite

Suicide and Self-Harm in Adolescents During the COVID-19 Pandemic: A U.S. Virtual Pediatric Systems, LLC, Database Study of PICU Admissions, 2016-2021.

Journal Article Pediatr Crit Care Med · February 1, 2024 OBJECTIVES: To characterize the epidemiology of suicide and self-harm among adolescents admitted to PICUs during the first 2 years of the COVID-19 pandemic in the United States. DESIGN: Descriptive analysis of a large, multicenter, quality-controlled datab ... Full text Link to item Cite

The effects of flow settings during high-flow nasal cannula oxygen therapy for neonates and young children.

Journal Article Eur Respir Rev · January 31, 2024 BACKGROUND: During neonatal and paediatric high-flow nasal cannula therapy, optimising the flow setting is crucial for favourable physiological and clinical outcomes. However, considerable variability exists in clinical practice regarding initial flows and ... Full text Link to item Cite

RESPIRATORY DISTRESS

Chapter · January 1, 2024 Full text Cite

Mechanical Ventilation

Chapter · January 1, 2024 Full text Cite

Noninvasive Ventilation or CPAP for Postextubation Support in Small Infants.

Journal Article Respir Care · December 28, 2023 BACKGROUND: Infants with a high risk of extubation failure are often treated with noninvasive ventilation (NIV) or CPAP, but data on the role of these support modalities following extubation are sparse. This report describes our experience using NIV or CPA ... Full text Link to item Cite

Association Between Dead Space to Tidal Volume Ratio and Duration of Respiratory Support After Extubation in Critically Ill Children.

Journal Article Respir Care · November 2023 BACKGROUND: The dead-space-to-tidal-volume ratio (VD/VT) has been used to successfully predict extubation failure in children who are critically ill. However, a singular reliable measure to predict the level and duration of respiratory support after libera ... Full text Link to item Cite

Feasibility of a Multi-Center Respiratory Therapist Endotracheal Intubation Study.

Journal Article Respir Care · August 2023 BACKGROUND: Respiratory therapists (RTs) have historically performed safe and effective intubations, yet there are limited multi-center data assessing their intubation performance. Multi-center data can be used to compare RT intubation performance to that ... Full text Link to item Cite

Association of Extubation Failure Rates With High-Flow Nasal Cannula, Continuous Positive Airway Pressure, and Bilevel Positive Airway Pressure vs Conventional Oxygen Therapy in Infants and Young Children: A Systematic Review and Network Meta-Analysis.

Journal Article JAMA Pediatr · August 1, 2023 IMPORTANCE: Extubation failure (EF) has been associated with worse outcomes in critically ill children. The relative efficacy of different modes of noninvasive respiratory support (NRS) to prevent EF is unknown. OBJECTIVE: To study the reported relative ef ... Full text Link to item Cite

Operational Definitions Related to Pediatric Ventilator Liberation.

Journal Article Chest · May 2023 BACKGROUND: Common, operational definitions are crucial to assess interventions and outcomes related to pediatric mechanical ventilation. These definitions can reduce unnecessary variability among research and quality improvement efforts, to ensure finding ... Full text Link to item Cite

Association Between Pressure Support During Extubation Readiness Testing and Time to First Extubation in Children With Congenital Heart Disease.

Journal Article Respir Care · March 2023 BACKGROUND: Extubation readiness testing (ERT) is often performed in children with congenital heart disease prior to liberation from mechanical ventilation. The ideal ERT method in this population is unknown. We recently changed our ERT method from variabl ... Full text Link to item Cite

Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network Document.

Journal Article Am J Respir Crit Care Med · January 1, 2023 Rationale: Pediatric-specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods use ... Full text Link to item Cite

[New morbidity following critical illness in Latin American children under 18 years old with lower respiratory tract infection].

Journal Article Andes Pediatr · January 2023 UNLABELLED: Acquisition of new morbidity (NM) has become a key clinical outcome measure after pediatric critical illness. Data on Latin American children are still scarce. OBJECTIVE: to analyze the development of new morbidities acquired after hospitalizat ... Full text Link to item Cite

Commentary on High-Flow Nasal Cannula and Continuous Positive Airway Pressure Practices After the First-Line Support for Assistance in Breathing in Children Trials.

Journal Article Pediatr Crit Care Med · December 1, 2022 Continuous positive airway pressure (CPAP) and heated humidified high-flow nasal cannula (HFNC) are commonly used to treat children admitted to the PICU who require more respiratory support than simple oxygen therapy. Much has been published on these two t ... Full text Link to item Cite

Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome.

Journal Article Pediatr Crit Care Med · November 1, 2022 OBJECTIVES: To characterize the prevalence of pediatric critical illness from multisystem inflammatory syndrome in children (MIS-C) and to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain on outcomes. DESIGN: Retr ... Full text Link to item Cite

Age-Related Changes in the Nasopharyngeal Microbiome Are Associated With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection and Symptoms Among Children, Adolescents, and Young Adults.

Journal Article Clin Infect Dis · August 24, 2022 BACKGROUND: Children are less susceptible to SARS-CoV-2 infection and typically have milder illness courses than adults, but the factors underlying these age-associated differences are not well understood. The upper respiratory microbiome undergoes substan ... Full text Open Access Link to item Cite

Executive Summary: International Clinical Practice Guidelines for Pediatric Ventilator Liberation, A PALISI Network Document.

Journal Article Am J Respir Crit Care Med · August 15, 2022 RATIONALE: Pediatric specific ventilator liberation guidelines are lacking despite the many studies exploring elements of extubation readiness testing. The lack of clinical practice guidelines has led to significant and unnecessary variation in methods use ... Full text Link to item Cite

A systematic review of clinical study evidence for pulmonary vasodilator therapy following surgery with cardiopulmonary bypass in children with CHD.

Journal Article Cardiol Young · July 20, 2022 OBJECTIVES: Complications from pulmonary hypertension are one of the leading contributors to morbidity and mortality post-cardiopulmonary bypass surgery in children with CHD. Pulmonary vasodilator therapies are commonly used post-operatively, but the optim ... Full text Link to item Cite

School Closures in the United States and Severe Respiratory Illnesses in Children: A Normalized Nationwide Sample.

Journal Article Pediatr Crit Care Med · July 1, 2022 OBJECTIVES: To determine the association between nationwide school closures and prevalence of common admission diagnoses in the pediatric critical care unit. DESIGN: Retrospective cohort study. SETTING: National database evaluation using the Virtual Pediat ... Full text Link to item Cite

A Novel Maneuver to Treat Refractory Atelectasis in Mechanically Ventilated Children.

Journal Article J Pediatr Intensive Care · June 2022 We developed a novel airway clearance and lung recruitment maneuver for children with refractory unilateral atelectasis undergoing invasive mechanical ventilation. In this retrospective, single-center, proof of concept study, we describe the steps involved ... Full text Link to item Cite

Mechanical Ventilation and Respiratory Support in the Pediatric Intensive Care Unit.

Journal Article Pediatr Clin North Am · June 2022 Children admitted to the pediatric intensive care unit often require respiratory support for the treatment of respiratory distress and failure. Respiratory support comprises both noninvasive modalities (ie, heated humidified high-flow nasal cannula, contin ... Full text Link to item Cite

Epidemiology and Outcomes of SARS-CoV-2 Infection or Multisystem Inflammatory Syndrome in Children vs Influenza Among Critically Ill Children.

Journal Article JAMA Netw Open · June 1, 2022 This cohort study compares the epidemiology and outcomes of patients in the pediatric intensive care unit with SARS-CoV-2–related disease during the first 15 months of the COVID-19 pandemic vs children with critical influenza prior to the pandemic. ... Full text Link to item Cite

Guidance for Structuring a Pediatric Intermediate Care Unit.

Journal Article Pediatrics · May 1, 2022 The purpose of this policy statement is to update the 2004 American Academy of Pediatrics clinical report and provide enhanced guidance for institutions, administrators, and providers in the development and operation of a pediatric intermediate care unit ( ... Full text Link to item Cite

A systematic review of the evidence supporting post-operative antithrombotic use following cardiopulmonary bypass in children with CHD.

Journal Article Cardiol Young · January 2022 OBJECTIVES: To determine the optimal antithrombotic agent choice, timing of initiation, dosing and duration of therapy for paediatric patients undergoing cardiac surgery with cardiopulmonary bypass. METHODS: We used PubMed and EMBASE to systematically revi ... Full text Link to item Cite

Derivation and Validation of the Critical Bronchiolitis Score for the PICU.

Journal Article Pediatr Crit Care Med · January 1, 2022 OBJECTIVES: To derive and internally validate a bronchiolitis-specific illness severity score (the Critical Bronchiolitis Score) that out-performs mortality-based illness severity scores (e.g., Pediatric Risk of Mortality) in measuring expected duration of ... Full text Link to item Cite

Suicide and Self-Harm in Children and Adolescents Admitted to PICUs in the United States.

Journal Article Pediatr Crit Care Med · January 1, 2022 OBJECTIVES: To characterize the epidemiology of children and adolescents admitted for deliberate self-harm to PICUs in the United States by examining patient demographics, diagnoses, modes of self-harm, and outcomes. DESIGN: Descriptive analysis of a large ... Full text Link to item Cite

The Temporal Relationship Between Local School Closure and Increased Incidence of Pediatric Diabetic Ketoacidosis.

Journal Article Front Pediatr · 2022 IMPORTANCE: The incidence of pediatric diabetic ketoacidosis (DKA) increased early in the COVID-19 pandemic, but the relative contribution of behavioral changes and viral-related pathophysiology are unknown. OBJECTIVE: To evaluate the relationship between ... Full text Link to item Cite

The Physiological Basis of High-Frequency Oscillatory Ventilation and Current Evidence in Adults and Children: A Narrative Review.

Journal Article Front Physiol · 2022 High-frequency oscillatory ventilation (HFOV) is a type of invasive mechanical ventilation that employs supra-physiologic respiratory rates and low tidal volumes (VT) that approximate the anatomic deadspace. During HFOV, mean airway pressure is set and gas ... Full text Link to item Cite

Severe Acute Respiratory Syndrome Coronavirus 2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.

Journal Article Clin Infect Dis · November 2, 2021 BACKGROUND: Child with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of SARS-CoV-2-related illnesses that the vi ... Full text Open Access Link to item Cite

Family Presence and Visitation Practices in Latin American PICUs: An International Survey.

Conference Journal of pediatric intensive care · November 2021 Over the last two decades, there has been a worldwide cultural shift toward family-centered intensive care. In this article, we conducted a survey of 47 pediatric intensive care units (PICUs) across 11 Latin American countries to assess visitation practice ... Full text Cite

High-Frequency Jet Ventilation in Infants With Congenital Heart Disease.

Journal Article Respir Care · November 2021 BACKGROUND: High-frequency jet ventilation (HFJV) is primarily used in neonates but may also have a role in the treatment of infants with congenital heart disease and severe respiratory failure. We hypothesized that HFJV would result in improved gas exchan ... Full text Link to item Cite

A narrative review of advanced ventilator modes in the pediatric intensive care unit.

Journal Article Transl Pediatr · October 2021 Respiratory failure is a common reason for pediatric intensive care unit admission. The vast majority of children requiring mechanical ventilation can be supported with conventional mechanical ventilation (CMV) but certain cases with refractory hypoxemia o ... Full text Link to item Cite

Asymptomatic or mild symptomatic SARS-CoV-2 infection elicits durable neutralizing antibody responses in children and adolescents.

Journal Article JCI insight · September 2021 As SARS-CoV-2 continues to spread globally, questions have emerged regarding the strength and durability of immune responses in specific populations. In this study, we evaluated humoral immune responses in 69 children and adolescents with asymptomatic or m ... Full text Cite

Response from the Authors.

Journal Article J Pediatr Intensive Care · September 2021 Full text Link to item Cite

High-Flow Nasal Cannula in Pediatric Critical Asthma.

Journal Article Respir Care · August 2021 BACKGROUND: High-flow nasal cannula (HFNC) has been used in the treatment of pediatric asthma, although high-quality data comparing HFNC to aerosol mask nebulizer are lacking. We hypothesized that HFNC would perform similarly to the aerosol mask for meanin ... Full text Link to item Cite

Changes in Pediatric ICU Utilization and Clinical Trends During the Coronavirus Pandemic.

Journal Article Chest · August 2021 BACKGROUND: Children have been less affected by the COVID-19 pandemic, but its repercussions on pediatric illnesses may have been significant. This study examines the indirect impact of the pandemic on a population of critically ill children in the United ... Full text Link to item Cite

Reduced PICU respiratory admissions during COVID-19.

Journal Article Arch Dis Child · July 19, 2021 BACKGROUND: The COVID-19 pandemic reached the Southern Hemisphere in the autumn of 2020, thus coinciding with its expected annual viral respiratory season. The potential impact of national strategies aimed at mitigating COVID-19 during the pandemic on the ... Full text Link to item Cite

Trends in Head Computed Tomography Utilization in Children Presenting to Emergency Departments After Traumatic Head Injury.

Journal Article Pediatr Emerg Care · July 1, 2021 OBJECTIVES: Although closed head injuries occur commonly in children, most do not have a clinically important traumatic brain injury (ciTBI) and do not require neuroimaging. We sought to determine whether the utilization of computed tomography of the head ... Full text Link to item Cite

A systematic review of the evidence supporting post-operative medication use in congenital heart disease.

Journal Article Cardiol Young · May 2021 BACKGROUND: Targeted drug development efforts in patients with CHD are needed to standardise care, improve outcomes, and limit adverse events in the post-operative period. To identify major gaps in knowledge that can be addressed by drug development effort ... Full text Link to item Cite

A systematic review of the evidence supporting post-operative diuretic use following cardiopulmonary bypass in children with Congenital Heart Disease.

Journal Article Cardiol Young · May 2021 BACKGROUND: Paediatric cardiac surgery on cardiopulmonary bypass induces substantial physiologic changes that contribute to post-operative morbidity and mortality. Fluid overload and oedema are prevalent complications, routinely treated with diuretics. The ... Full text Link to item Cite

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database.

Journal Article Pediatr Crit Care Med · May 1, 2021 OBJECTIVES: High-flow nasal cannula and noninvasive positive pressure ventilation are used to support children following liberation from invasive mechanical ventilation. Evidence comparing extubation failure rates between patients randomized to high-flow n ... Full text Link to item Cite

Asymptomatic or mild symptomatic SARS-CoV-2 infection elicits durable neutralizing antibody responses in children and adolescents.

Journal Article medRxiv · April 20, 2021 As SARS-CoV-2 continues to spread globally, questions have emerged regarding the strength and durability of immune responses in specific populations. In this study, we evaluated humoral immune responses in 69 children and adolescents with asymptomatic or m ... Full text Link to item Cite

Age-related changes in the upper respiratory microbiome are associated with SARS-CoV-2 susceptibility and illness severity.

Journal Article medRxiv · March 23, 2021 UNLABELLED: Children are less susceptible to SARS-CoV-2 and typically have milder illness courses than adults. We studied the nasopharyngeal microbiomes of 274 children, adolescents, and young adults with SARS-CoV-2 exposure using 16S rRNA gene sequencing. ... Full text Open Access Link to item Cite

Severe Acute Respiratory Syndrome-Associated Coronavirus 2 Infection and Organ Dysfunction in the ICU: Opportunities for Translational Research.

Journal Article Crit Care Explor · March 2021 OBJECTIVES: Since the beginning of the coronavirus disease 2019 pandemic, hundreds of thousands of patients have been treated in ICUs across the globe. The severe acute respiratory syndrome-associated coronavirus 2 virus enters cells via the angiotensin-co ... Full text Link to item Cite

Echocardiographic Imaging

Chapter · March 2021 Jerry J. Zimmerman and Alexandre T. Rotta, along with an expert team of editors and contributors from around the world, have carefully updated the 6th Edition of this highly regarded text to bring you the most authoritative and useful ... ... Cite

Variability in care for children with severe acute asthma in Latin America.

Journal Article Pediatr Pulmonol · February 2021 BACKGROUND: Care variability for children with severe acute asthma has been well documented in high-income countries, yet data from low- and middle-income regions are lacking. We sought to characterize the magnitude of practice variability in the care of L ... Full text Link to item Cite

High-Frequency Jet Ventilation in Pediatric Acute Respiratory Failure.

Journal Article Respir Care · February 2021 BACKGROUND: High-frequency jet ventilation (HFJV) is primarily used in premature neonates; however, its use in pediatric patients with acute respiratory failure has been reported. The objective of this study was to evaluate HFJV use in the pediatric critic ... Full text Link to item Cite

Newborn Circumcision Techniques and Medical Ethics.

Journal Article Am Fam Physician · January 15, 2021 Link to item Cite

HIGH-FLOW NASAL CANNULA IN PEDIATRIC CRITICAL ASTHMA

Conference CRITICAL CARE MEDICINE · 2021 Cite

High-Flow Nasal Cannula versus Continuous Positive Airway Pressure in Critical Bronchiolitis: A Randomized Controlled Pilot.

Journal Article J Pediatr Intensive Care · December 2020 Featured Publication We conducted a randomized controlled pilot study in infants with critical bronchiolitis ( n  = 63) comparing high-flow nasal cannula (HFNC, n  = 35) to continuous positive airway pressure (CPAP, n  = 28). The primary outcome was treatment failure, defined ... Full text Open Access Link to item Cite

Randomized pilot trial of ipratropium versus placebo in children with critical asthma.

Journal Article Pediatr Pulmonol · December 2020 OBJECTIVE: To test the effects of inhaled ipratropium on clinical outcomes of critical asthma in the first randomized trial of this adjunctive therapy in critically ill children. DESIGN: Pilot, placebo-controlled, double-blinded, and randomized-controlled ... Full text Link to item Cite

Impact of multidisciplinary engagement in a quality improvement blood conservation protocol for craniosynostosis.

Journal Article J Neurosurg Pediatr · October 1, 2020 OBJECTIVE: Patients undergoing open cranial vault remodeling for craniosynostosis frequently experience substantial blood loss requiring blood transfusion. Multiple reports in the literature have evaluated the impact of individual blood conservation techni ... Full text Open Access Link to item Cite

SARS-CoV-2 Infections Among Children in the Biospecimens from Respiratory Virus-Exposed Kids (BRAVE Kids) Study.

Journal Article medRxiv · September 1, 2020 BACKGROUND: Children with SARS-CoV-2 infection typically have mild symptoms that do not require medical attention, leaving a gap in our understanding of the spectrum of illnesses that the virus causes in children. METHODS: We conducted a prospective cohort ... Full text Open Access Link to item Cite

Emergency room endotracheal intubation in children with bronchiolitis: A cohort study using a multicenter database.

Journal Article Health Sci Rep · September 2020 BACKGROUND AND AIMS: Bronchiolitis and asthma have a clinical overlap, and it has been shown that pediatric intensive care unit (PICU) patients with asthma undergoing endotracheal intubation in a community hospital emergency room (ER) have a shorter durati ... Full text Link to item Cite

Palliative extubation: five‐year experience in a pediatric hospital

Journal Article Jornal de Pediatria (Versão em Português) · September 2020 Full text Cite

The Impact of an Emergency Department Upgrade to Level I Trauma Status on the Timeliness of Nontrauma Computed Tomography Scans.

Journal Article J Emerg Med · August 2020 BACKGROUND: Resources such as computed tomography (CT) scanners are sometimes shared when separate adult and pediatric emergency departments (EDs) exist in proximity. OBJECTIVES: To assess the impact of American College of Surgeons Level I trauma verificat ... Full text Open Access Link to item Cite

The Effects of Furosemide on Oxygenation in Mechanically Ventilated Children with Bronchiolitis.

Conference J Pediatr Intensive Care · June 2020 Fluid balance management, including diuretic administration, may influence outcomes among mechanically ventilated children. We retrospectively compared oxygenation saturation index (OSI) before and after the initial furosemide bolus among 65 mechanically v ... Full text Open Access Link to item Cite

Characterization of In-Flight Medical Events Involving Children on Commercial Airline Flights.

Journal Article Ann Emerg Med · January 2020 STUDY OBJECTIVE: More than 4 billion passengers travel on commercial airline flights yearly. Although in-flight medical events involving adult passengers have been well characterized, data describing those affecting children are lacking. This study seeks t ... Full text Open Access Link to item Cite

Palliative extubation: five-year experience in a pediatric hospital.

Journal Article J Pediatr (Rio J) · 2020 OBJECTIVE: To present the characteristics of pediatric patients with chronic and irreversible diseases submitted to palliative extubation. METHOD: This is a descriptive analysis of a series of patients admitted to a public pediatric hospital, with chronic ... Full text Link to item Cite

In-Flight Injuries Involving Children on Commercial Airline Flights.

Journal Article Pediatr Emerg Care · October 2019 BACKGROUND: More than 3 billion passengers are transported every year on commercial airline flights worldwide, many of whom are children. The incidence of in-flight medical events (IFMEs) affecting children is largely unknown. This study seeks to character ... Full text Link to item Cite

The authors reply.

Journal Article Pediatr Crit Care Med · August 2019 Full text Link to item Cite

Outcomes of Children With Bronchiolitis Treated With High-Flow Nasal Cannula or Noninvasive Positive Pressure Ventilation.

Journal Article Pediatr Crit Care Med · February 2019 OBJECTIVES: Initial respiratory support with noninvasive positive pressure ventilation or high-flow nasal cannula may prevent the need for invasive mechanical ventilation in PICU patients with bronchiolitis. However, it is not clear whether the initial cho ... Full text Link to item Cite

Outcomes of Children With Critical Bronchiolitis Meeting at Risk for Pediatric Acute Respiratory Distress Syndrome Criteria.

Journal Article Pediatr Crit Care Med · February 2019 OBJECTIVES: New definitions of pediatric acute respiratory distress syndrome include criteria to identify a subset of children "at risk for pediatric acute respiratory distress syndrome." We hypothesized that, among PICU patients with bronchiolitis not imm ... Full text Link to item Cite

Characterization of Suicide and Deliberate Self-Harm Among Children in the United States.

Journal Article Clin Pediatr (Phila) · January 2019 We analyzed data from the Nationwide Emergency Department Sample (NEDS) database for the years 2008 to 2013 to characterize deliberate self-harm among children and adolescents presenting to an emergency department (ED) in the United States. All ED visits f ... Full text Link to item Cite

Factors Associated With Early Deaths Following Neonatal Male Circumcision in the United States, 2001 to 2010.

Journal Article Clin Pediatr (Phila) · November 2018 We sought to quantify early deaths following neonatal circumcision (same hospital admission) and to identify factors associated with such mortality. We performed a retrospective analysis of all infants who underwent circumcision in an inpatient hospital se ... Full text Link to item Cite

Outcomes of Children With Critical Bronchiolitis Living in Poor Communities.

Journal Article Clin Pediatr (Phila) · August 2018 There are established associations between adverse health outcomes and poverty, but little is known regarding these associations in critically ill children. We hypothesized that living in poorer communities would be associated with unfavorable outcomes in ... Full text Link to item Cite

Temporal Changes in Prescription of Neuropharmacologic Drugs and Utilization of Resources Related to Neurologic Morbidity in Mechanically Ventilated Children With Bronchiolitis.

Journal Article Pediatr Crit Care Med · December 2017 OBJECTIVES: Critically ill children with bronchiolitis may require neuropharmacologic medications and support for neuro-functional sequelae, but current practices are not well described. We aimed to describe recent trends in neuropharmacology and utilizati ... Full text Link to item Cite

Neurologic and Functional Morbidity in Critically Ill Children With Bronchiolitis.

Journal Article Pediatr Crit Care Med · December 2017 OBJECTIVES: Neurologic and functional morbidity occurs in ~30% of PICU survivors, and young children may be at particular risk. Bronchiolitis is a common indication for PICU admission among children less than 2 years old. Two single-center studies suggest ... Full text Link to item Cite

Abstract: Striving for Transfusion-Free Open Cranial Vault Remodeling: A Novel Protocol

Journal Article Plastic and reconstructive surgery. Global open · September 2017 Cite

Corticosteroid Therapy During Acute Bronchiolitis in Patients Who Later Develop Asthma.

Journal Article Hospital pediatrics · July 2017 Background and objectiveMeta-analyses show that corticosteroids are not effective in patients with bronchiolitis. However, risk factors for asthma such as eczema or familial atopy prompt some practitioners to prescribe corticosteroids for bronchio ... Full text Cite

Hyponatremia and Hypotonic Intravenous Fluids Are Associated With Unfavorable Outcomes of Bronchiolitis Admissions.

Journal Article Hosp Pediatr · May 2017 OBJECTIVES: Hyponatremia has been associated with unfavorable outcomes when present at admission in children with bronchiolitis. Delayed hyponatremia may be a modifiable risk factor for severe disease that is influenced by intravenous fluid (IVF) tonicity. ... Full text Link to item Cite

The impact of septicemia occurring during hospitalization for renal transplantation procedures on outcomes in adults in United States.

Journal Article PLoS One · 2017 INTRODUCTION: Immediate success rates of renal transplantation (RT) procedures are generally very high. National estimates of the impact of post-operative complications, specifically, septicemia occurring during hospitalization for RT's on outcomes is uncl ... Full text Link to item Cite

The use of high-flow nasal cannula in the pediatric emergency department.

Journal Article J Pediatr (Rio J) · 2017 OBJECTIVES: To summarize the current literature describing high-flow nasal cannula use in children, the components and mechanisms of action of a high-flow nasal cannula system, the appropriate clinical applications, and its role in the pediatric emergency ... Full text Link to item Cite

Predictors of Complications of Tonsillectomy With or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study.

Journal Article Clin Pediatr (Phila) · June 2016 Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and ... Full text Link to item Cite

Contemporary treatment of children with critical and near-fatal asthma.

Journal Article Rev Bras Ter Intensiva · June 2016 Asthma is the most common chronic illness in childhood. Although the vast majority of children with acute asthma exacerbations do not require critical care, some fail to respond to standard treatment and require escalation of support. Children with critica ... Full text Link to item Cite

Validation of a pediatric bedside tool to predict time to death after withdrawal of life support.

Journal Article World J Clin Pediatr · February 8, 2016 AIM: To evaluate the accuracy of a tool developed to predict timing of death following withdrawal of life support in children. METHODS: Pertinent variables for all pediatric deaths (age ≤ 21 years) from 1/2009 to 6/2014 in our pediatric intensive care unit ... Full text Link to item Cite

DEATH IN THE PEDIATRIC INTENSIVE CARE UNIT: A TALE OF TWO CITIES

Conference CRITICAL CARE MEDICINE · December 1, 2015 Link to item Cite

Immediate Effects of Use of Recombinant Bone Morphogenetic Protein in Children Having Spinal Fusion and Refusion Procedures in United States.

Journal Article Spine (Phila Pa 1976) · November 2015 STUDY DESIGN: Retrospective study of Nationwide Inpatient Sample (NIS). OBJECTIVE: The objective of this study is to estimate the prevalence of complications in children who had insertion of recombinant human bone morphogenetic protein (rhBMP) at the time ... Full text Link to item Cite

Prevalence, predictors, and outcomes of methicillin-resistant Staphylococcus aureus infections in patients undergoing major surgical procedures in the United States: a population-based study.

Journal Article Am J Surg · July 2015 BACKGROUND: National estimates of methicillin-resistant Staphylococcus aureus (MRSA) infection rates in hospitalized surgical patients and outcomes are lacking. We sought to estimate the prevalence, identify the predictors, and describe the outcomes of MRS ... Full text Link to item Cite

Implementation of a diuretic stewardship program in a pediatric cardiovascular intensive care unit to reduce medication expenditures.

Journal Article Am J Health Syst Pharm · June 15, 2015 PURPOSE: The implementation of a diuretic stewardship program in a pediatric cardiovascular intensive care unit (ICU) is described. METHODS: This retrospective study compared the use of i.v. chlorothiazide and i.v. ethacrynic acid in pediatric cardiovascul ... Full text Link to item Cite

Pediatric acute respiratory distress syndrome: much more than little acute respiratory distress syndrome.

Journal Article Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · June 2015 Full text Cite

Outcomes of invasive mechanical ventilation in children and adolescents hospitalized due to status asthmaticus in United States: a population based study.

Journal Article J Asthma · May 2015 OBJECTIVE: Current national estimates of and outcomes of Invasive Mechanical Ventilation (MV) in status asthmaticus (SA) are unclear. The objective of this study is to estimate the incidence and outcomes of MV in hospitalized SA children and adolescents. M ... Full text Link to item Cite

Prevalence and Predictors of Gastrostomy Tube and Tracheostomy Placement in Anoxic/Hypoxic Ischemic Encephalopathic Survivors of In-Hospital Cardiopulmonary Resuscitation in the United States.

Journal Article PLoS One · 2015 INTRODUCTION: Current prevalence estimates of gastrostomy tube (GT)/tracheostomy placement in hospitalized patients with anoxic/hypoxic ischemic encephalopathic injury (AHIE) post cardiopulmonary resuscitation (CPR) are unknown. We sought, to estimate the ... Full text Link to item Cite

Progress and perspectives in pediatric acute respiratory distress syndrome.

Journal Article Rev Bras Ter Intensiva · 2015 Acute respiratory distress syndrome is a disease of acute onset characterized by hypoxemia and infiltrates on chest radiographs that affects both adults and children of all ages. It is an important cause of respiratory failure in pediatric intensive care u ... Full text Link to item Cite

INJURIES DUE TO LEGAL INTERVENTION AND EMERGENCY DEPARTMENT VISITS.

Conference CRITICAL CARE MEDICINE · December 1, 2014 Link to item Cite

Outcomes of stem cell transplant patients with acute respiratory failure requiring mechanical ventilation in the United States.

Journal Article Bone Marrow Transplant · October 2014 SCT indications and procedures are increasing worldwide. We sought to estimate the prevalence of acute respiratory failure (ARF) of any cause in hospitalized SCT patients, and assess the impact of invasive mechanical ventilation (IMV) on outcomes. We hypot ... Full text Link to item Cite

Fatalities above 30,000 feet: characterizing pediatric deaths on commercial airline flights worldwide.

Journal Article Pediatr Crit Care Med · October 2014 OBJECTIVES: We conducted this study to characterize in-flight pediatric fatalities onboard commercial airline flights worldwide and identify patterns that would have been unnoticed through single case analysis of these relative rare events. DESIGN: Retrosp ... Full text Link to item Cite

Primary and secondary immunodeficiencies

Chapter · February 1, 2014 Primary immunodeficiencies are rare disorders that are frequently considered in critically-ill children that are admitted to the intensive care unit with recurrent life-threatening infections. In this chapter, we have briefly reviewed the primary and secon ... Full text Cite

Outcomes of acute chest syndrome in adult patients with sickle cell disease: predictors of mortality.

Journal Article PLoS One · 2014 UNLABELLED: Adults with sickle cell disease(SCD) are a growing population. Recent national estimates of outcomes in acute chest syndrome(ACS) among adults with SCD are lacking. We describe the incidence, outcomes and predictors of mortality in ACS in adult ... Full text Link to item Cite

Hospital based emergency department visits attributed to child physical abuse in United States: predictors of in-hospital mortality.

Journal Article PLoS One · 2014 OBJECTIVES: To describe nationally representative outcomes of physical abuse injuries in children necessitating Emergency Department (ED) visits in United States. The impact of various injuries on mortality is examined. We hypothesize that physical abuse r ... Full text Link to item Cite

Partial and total anomalous pulmonary venous connections and associated defects

Chapter · January 1, 2014 Anomalous pulmonary venous return is a relatively rare congenital cardiac malformation in which the pulmonary veins do not return to the left atrium. If all four pulmonary veins drain anomalously, the designation of total anomalous pulmonary venous return ... Full text Cite

Safety of warfarin dosing in the intensive care unit following the Fontan procedure.

Journal Article Congenit Heart Dis · 2014 OBJECTIVE: To determine the incidence of supratherapeutic international normalized ratio (INR) values in patients initiated on warfarin in the pediatric intensive care unit after the Fontan procedure. DESIGN: Retrospective chart review. SETTING: Pediatric ... Full text Link to item Cite

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Mechanical ventilation following cardiac surgery in children

Journal Article Current Respiratory Medicine Reviews · February 1, 2012 The application of positive pressure mechanical ventilation can result in complex changes in pulmonary and cardiovascular physiology. These cardiopulmonary interactions are particularly important in pediatric patients undergoing surgery for repair or palli ... Full text Cite

Critical illness hyperglycemia in pediatric cardiac surgery.

Conference J Diabetes Sci Technol · January 1, 2012 Critical illness hyperglycemia (CIH) is common in pediatric and adult intensive care units (ICUs). Children undergoing surgical repair or palliation of congenital cardiac defects are particularly at risk for CIH and its occurrence has been associated with ... Full text Link to item Cite

Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study.

Journal Article PLoS One · 2012 BACKGROUND: Kawasaki disease is recognized as the most common cause of acquired heart disease in children in the developed world. Clinical, epidemiologic, and pathologic evidence supports an infectious agent, likely entering through the lung. Pathologic st ... Full text Link to item Cite

Asthma

Chapter · December 1, 2011 Full text Cite

Ventilator-Induced Lung Injury

Chapter · December 1, 2011 Full text Cite

Asthma

Chapter · April 14, 2011 Full text Cite

High-dose dexmedetomidine sedation for pediatric MRI.

Journal Article Paediatr Anaesth · February 2011 OBJECTIVES: To test the hypothesis that high-dose dexmedetomidine can be successfully used for pediatric magnetic resonance imaging (MRI) sedation without significant hemodynamic compromise. BACKGROUND: The dexmedetomidine dose required to achieve optimal ... Full text Link to item Cite

HIGH DOSE DEXMEDETOMIDINE SEDATION FOR PEDIATRIC MRI

Conference CRITICAL CARE MEDICINE · December 1, 2009 Link to item Cite

Fulminant pertussis: a multi-center study with new insights into the clinico-pathological mechanisms.

Journal Article Pediatr Pulmonol · October 2009 Pertussis carries a high risk of mortality in very young infants. The mechanism of refractory cardio-respiratory failure is complex and not clearly delineated. We aimed to examine the clinico-pathological features and suggest how they may be related to out ... Full text Link to item Cite

Strict glycemic targets need not be so strict: a more permissive glycemic range for critically ill children.

Journal Article Pediatrics · October 2008 ObjectiveThe goal was to determine whether a more permissive glycemic target would be associated with a decreased incidence of hypoglycemia but not increased mortality rates in critically ill pediatric patients.MethodsThis retrospective s ... Full text Cite

Mechanical ventilation strategies in children

Journal Article Pediatric Health · June 1, 2008 The last decade has been marked by major advances in the management of pediatric respiratory failure. We now know that the choice of mechanical ventilation strategy can influence the subsequent course of lung injury. As such, mechanical ventilation can no ... Full text Cite

Impact of postoperative hyperglycemia following surgical repair of congenital cardiac defects.

Journal Article Pediatr Cardiol · May 2008 The objective of this study was to determine the prevalence of postoperative hyperglycemia in pediatric patients following surgery for congenital cardiac defects and its impact on morbidity and mortality. It was designed as a retrospective cohort study in ... Full text Link to item Cite

Conventional mechanical ventilation in pediatrics.

Journal Article J Pediatr (Rio J) · May 2007 OBJECTIVE: To review the various challenges of providing mechanical ventilation to pediatric patients with diseases of increased airway resistance, diseases of abnormal lung compliance or normal lungs. SOURCES: Original data from our pediatric intensive ca ... Full text Link to item Cite

Ventilator-Induced Lung Injury

Chapter · December 1, 2006 Full text Cite

Asthma

Chapter · December 1, 2006 Full text Cite

Combining lung-protective strategies in experimental acute lung injury: The impact of high-frequency partial liquid ventilation.

Journal Article Pediatr Crit Care Med · November 2006 OBJECTIVE: To evaluate the independent and combined effects of high-frequency oscillatory ventilation (HFOV) and partial liquid ventilation (PLV) on gas exchange, pulmonary histopathology, inflammation, and oxidative tissue damage in an animal model of acu ... Full text Link to item Cite

Is permissive hypercapnia a beneficial strategy for pediatric acute lung injury?

Journal Article Respiratory care clinics of North America · September 2006 It is clear that mechanical ventilation strategies influence the course of lung disease, and the choice of a ventilation strategy that avoids volutrauma and atelectrauma is firmly based on experimental literature and clinical experience. The application of ... Full text Cite

Effect of low-bias flow oscillation with partial liquid ventilation on fluoroscopic image analysis, gas exchange, and lung injury.

Journal Article Pediatr Crit Care Med · November 2005 OBJECTIVE: To evaluate the effect of low-bias flow oscillation (LBFO) with partial liquid ventilation (PLV) on perfluorochemical evaporation, histopathology, and oxidative tissue damage in an animal model of acute lung injury. DESIGN: Prospective, randomiz ... Full text Link to item Cite

Acute lung injury: Etiologies and basic features

Chapter · January 1, 2005 Acute lung injury is characterized by the rapid onset of a severe inflammatory response that contributes to cell and tissue injury, abnormal lung compliance, and impaired gas exchange. This chapter describes the multiple etiologies and clinical relevance o ... Cite

Low bias flow oscillation with heliox in oleic acid-induced lung injury.

Journal Article Pediatr Crit Care Med · January 2005 OBJECTIVE: To evaluate Co(2) clearance in oleic acid-induced lung injury in rabbits receiving high-frequency oscillatory ventilation with helium-oxygen mixtures through a low bias flow oscillation system designed to conserve expensive gases. DESIGN: A pros ... Full text Link to item Cite

Ventilator-Induced Lung Injury

Chapter · January 1, 2005 Full text Cite

Asthma

Chapter · January 1, 2005 Full text Cite

High versus low PEEP in ARDS.

Journal Article N Engl J Med · November 11, 2004 Link to item Cite

Gastric acid and particulate aspiration injury inhibits pulmonary bacterial clearance.

Journal Article Crit Care Med · March 2004 OBJECTIVE: To establish a model of secondary bacterial pneumonia following gastric aspiration and to identify possible mechanisms involved in the suppressed antibacterial defenses following the initial pulmonary insult. DESIGN: A controlled, in vivo labora ... Full text Link to item Cite

[The impact of mechanical ventilation strategies that minimize atelectrauma in an experimental model of acute lung injury].

Journal Article J Pediatr (Rio J) · 2004 OBJECTIVE: To evaluate whether ventilation strategies that target alveolar stabilization and prevention of atelectrauma would be associated with more favorable physiologic outcomes in a combined model of acute lung injury. METHODS: Thirty-nine rabbits were ... Link to item Cite

[Management of the acute respiratory distress syndrome].

Journal Article J Pediatr (Rio J) · November 2003 OBJECTIVE: To review the current support and treatment strategies of the acute respiratory distress syndrome. DATA SOURCES: Original data from our research laboratory and from representative scientific articles on acute respiratory distress syndrome and ac ... Full text Link to item Cite

Perfluorooctyl bromide (perflubron) attenuates oxidative injury to biological and nonbiological systems.

Journal Article Pediatr Crit Care Med · April 2003 OBJECTIVE: To examine whether perfluorooctyl bromide (perflubron) is capable of protecting biological and nonbiological systems against oxidative damage through a mechanism independent of its known anti-inflammatory property. DESIGN: A controlled, in vitro ... Full text Link to item Cite

Respiratory emergencies in children.

Conference Respir Care · March 2003 Acute obstructive respiratory emergencies in children are a common cause of emergency department visits. The severity of these conditions ranges from mild, self-limited disease to life-threatening forms of rapidly progressive airway obstruction. A high ind ... Link to item Cite

Heliox enhances carbon dioxide clearance from lungs of normal rabbits during low bias flow oscillation.

Conference Pediatr Crit Care Med · January 2003 OBJECTIVES: To evaluate carbon dioxide clearance in normal rabbits during high-frequency oscillatory ventilation with helium-oxygen mixtures by using a low bias flow oscillation (LBFO) system designed to conserve expensive gas. DESIGN: A prospective, paire ... Full text Link to item Cite

Comparison of lung protective ventilation strategies in a rabbit model of acute lung injury.

Journal Article Crit Care Med · November 2001 OBJECTIVE: To determine the impact of different protective and nonprotective mechanical ventilation strategies on the degree of pulmonary inflammation, oxidative damage, and hemodynamic stability in a saline lavage model of acute lung injury. DESIGN: A pro ... Full text Link to item Cite

Use of a physiologic scoring system during interhospital transport of pediatric patients.

Journal Article Air Med J · 2001 OBJECTIVE: To determine the incidence of physiologic deterioration in critically ill and injured pediatric patients during interhospital transport with air and ground ambulance DESIGN: Prospective, descriptive study SETTING: All children were treated in re ... Link to item Cite

Partial liquid ventilation with perflubron attenuates in vivo oxidative damage to proteins and lipids.

Journal Article Crit Care Med · January 2000 OBJECTIVE: To determine the impact of partial liquid ventilation on the degree of pulmonary damage by reactive oxygen species in a model of acute lung injury caused by systemic endotoxemia. DESIGN: A prospective, controlled, in vivo, animal laboratory stud ... Full text Link to item Cite

The role of liquid perflubron (PFOB) in the oxidative process in vitro: Interaction with peroxyl radicals

Journal Article Critical Care Medicine · December 1, 1999 Introduction: Experimental models of acute lung injury treated with PFOB exhibit attenuation in tissue damage and inflammation. We have previously demonstrated an attenuation in oxidative injury to the lung in animals treated with PLV1. Since oxidative dam ... Cite

Partial liquid ventilation: A multifaceted approach to acute respiratory distress syndrome

Journal Article New Horizons: Science and Practice of Acute Medicine · November 17, 1999 In partial liquid ventilation (PLV), a liquid perfluorochemical is instilled into the lungs and ventilation is supported using a conventional respirator. PLV is under development as a treatment for acute respiratory distress syndrome and other forms of acu ... Cite

Pathophysiology of cardiac extracorporeal membrane oxygenation.

Conference Artif Organs · November 1999 The treatment of cardiogenic shock using inotropic agents and vascular volume expansion places an added burden on the heart. The resultant increase in cardiac work may cause myocardial ischemia and lead to cardiac arrest. Extracorporeal membrane oxygenatio ... Full text Link to item Cite

Partial liquid ventilation influences pulmonary histopathology in an animal model of acute lung injury.

Journal Article J Crit Care · June 1999 PURPOSE: The aim of this study was to assess the effect of partial liquid ventilation (PLV) and conventional mechanical ventilation (CMV) in the pattern of distribution of lung injury in a rabbit model of acute lung injury. MATERIALS AND METHODS: Animals ( ... Full text Link to item Cite

Liquid ventilation attenuates pulmonary oxidative damage.

Journal Article J Crit Care · March 1999 PURPOSE: Liquid perfluorochemicals reduce the production of reaction oxygen species by alveolar macrophages. We sought to determine whether the use of liquid perfluorochemicals in vivo during liquid ventilation would attenuate oxidative damage to the lung. ... Full text Link to item Cite

Liquid perflubron (PFOB) does not solubilize malondialdehyde (MDA) in vitro

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Experimental models of acute lung injury treated with partial liquid ventilation (PLV) exhibit attenuation in tissue damage and inflammation. We have previously shown a decrease in free radical release by alveolar macrophages1 exposed to PFOB ... Full text Cite

Perflubron (PFOB) protects against fatty acid oxidation in a non-biological, in vitro model

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Oxidative stress is one of the basic mechanisms of tissue injury, having been implicated in various processes such as aging, cancer, sepsis, inflammation, as well as cardiovascular and respiratory diseases. In view of the fact that PFOB atten ... Full text Cite

Lipid peroxidation during initiation of extracorporeal membrane oxygenation after hypoxia in endotoxemic rabbits.

Journal Article Perfusion · January 1999 Initiation of extracorporeal membrane oxygenation (ECMO) in septic children with severe respiratory failure often improves oxygenation but not pulmonary function. The factors affecting pulmonary function following onset of ECMO are not completely understoo ... Full text Link to item Cite

Mechanical ventilation strategies induce pulmonary cytokine response

Journal Article Critical Care Medicine · January 1, 1999 Introduction: The choice of ventilation strategy influences the progression of lung injury. Strategies that avoid closure and overdistension of alveoli such as high frequency oscillatory ventilation (HFOV) are associated with improved oxygenation and atten ... Full text Cite

Hyperbaric oxygen exposure does not result in oxidative damage to rabbit lung tissue

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Hyperbaric oxygen has several accepted medical indications. The advantages of high oxygen partial pressure must be weighed against the toxic effects of oxygen, primarily to the brain and lung. The objective of this study was to determine the ... Full text Cite

Mechanical ventilation strategies influence pulmonary mechanics in atelectasis-prone rabbits

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Ventilation strategies can modify the course of acute lung injury. Strategies that permit alveolar de-recruitment and cyclic overdistension, such as conventional mechanical ventilation with low PEEP (CMV-LP) can induce progressive injury, whe ... Full text Cite

The effect of lung-recruiting ventilatory strategies in acutely injured atelectasis-prone rabbits

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Ventilation strategies play an important role in the development of lung injury. Strategies that permit alveolar de-recruitment and cyclic overdistension, such as conventional mechanical ventilation with low PEEP (CMV-LP) can induce progressi ... Full text Cite

Ventilation strategies do not affect apoptosis in early acute lung injury (ALI)

Journal Article Critical Care Medicine · January 1, 1999 Introduction: We have shown that the mode of ventilation, e.g. high vs. low PEEP vs. HFOV, etc, affects early histologic and biochemical markers of ALI. If these early markers of lung injury translate into a decreased severity of ALI with an associated bet ... Full text Cite

Perflubron (PFOB) protects cell monolayers against direct in vitro oxidative injury

Journal Article Critical Care Medicine · January 1, 1999 Introduction: Oxidative stress is often implicated in the genesis of injury to living tissues, even though intact cells generally possess sophisticated antioxidant systems. PFOB attenuates oxidative lung injury in vivo, at least in part due to a decrease i ... Full text Cite

Partial liquid ventilation (FLV) attenuates oxidative damage to the lung in a model of acute lung injury (AU)

Journal Article Critical Care Medicine · December 1, 1998 Introd-ctioa: Several experimental models of AU treated with PLV exhibit attenuation in tissue damage and inflammation. We have previously demonstrated a reduction in pulmonary leukostasis during PLV1 and a decrease in free radical release by alveolar macr ... Cite

Partial liquid ventilation reduces pulmonary neutrophil accumulation in an experimental model of systemic endotoxemia and acute lung injury.

Journal Article Crit Care Med · October 1998 OBJECTIVE: To determine whether pulmonary neutrophil sequestration and lung injury are affected by partial liquid ventilation with perfluorocarbon in a model of acute lung injury (ALI). DESIGN: A prospective, controlled, in vivo animal laboratory study. SE ... Full text Link to item Cite

Purine nucleotides contribute to pulmonary vasodilâtion caused by birth-related stimuli in the ovine fetus

Journal Article American Journal of Physiology - Heart and Circulatory Physiology · December 1, 1997 We investi-gated the hypothesis that the purine nucleotides ATP and adenosine mediate the pulmonary vasodilation that occurs at birth in fetal lambs. We instrumented 44 fetal lambs to measure left pulmonary arterial pressure and flow. In control studies, w ... Cite

Purine nucleotides contribute to pulmonary vasodilation caused by birth-related stimuli in the ovine fetus.

Journal Article Am J Physiol · May 1997 We investigated the hypothesis that the purine nucleotides ATP and adenosine mediate the pulmonary vasodilation that occurs at birth in fetal lambs. We instrumented 44 fetal lambs to measure left pulmonary arterial pressure and flow. In control studies, we ... Full text Link to item Cite

Purine nucleotides contribute to pulmonary vasodilation caused by birth-related stimuli in the ovine fetus

Journal Article AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY · May 1, 1997 Link to item Cite

Liquid ventilation.

Conference Acta Anaesthesiol Scand Suppl · 1997 Link to item Cite

Shock of birth. Evaluation of neurologic status of term newborn in the first 48 hours of life.

Journal Article Arq Neuropsiquiatr · September 1996 The shock of birth is a transient depression of muscle tone and deep tendon reflexes seen in newborn babies shortly after birth. We evaluated the shock of birth in a sample of 313 consecutive term newborns at 4, 24 and 48 hours of life. We correlated neuro ... Full text Link to item Cite

Povidone-iodine to prevent ophthalmia neonatorum.

Journal Article N Engl J Med · July 13, 1995 Full text Link to item Cite

Index of suspicion. Case 2. Diagnosis: urinary lithiasis.

Journal Article Pediatrics in review · December 1994 Cite

Moraxella catarrhalis bacteremia and preseptal cellulitis.

Journal Article South Med J · April 1994 Invasive disease due to Moraxella catarrhalis is rare and has been associated mostly with immune deficiency conditions. We describe the first case of M catarrhalis bacteremia and preseptal cellulitis in an immunocompetent infant. This organism may be evolv ... Full text Link to item Cite