Jeremy M. Loberger
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View article: Automated spontaneous breathing trial performance tool is associated with improved outcomes following pediatric cardiac surgery: A single-center retrospective study from Alabama, USA
Automated spontaneous breathing trial performance tool is associated with improved outcomes following pediatric cardiac surgery: A single-center retrospective study from Alabama, USA Open
Background: Extubation failure is associated with significant morbidity, including prolonged time on ventilator and longer hospital length of stay (LOS). Extubation readiness is assessed with a variety of tools. Using algorithmic analysis,…
View article: Planning a Phased Guideline Implementation Strategy Across the Multicenter Ventilation Liberation for Kids (VentLib4Kids) Collaborative
Planning a Phased Guideline Implementation Strategy Across the Multicenter Ventilation Liberation for Kids (VentLib4Kids) Collaborative Open
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 202…
View article: Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis
Sociodemographic Factors are Associated with Care Delivery and Outcomes in Pediatric Severe Sepsis Open
IMPORTANCE: Sepsis is a leading cause of morbidity and mortality in the United States and disparate outcomes exist between racial/ethnic groups despite improvements in sepsis management. These observed differences are often related to soci…
View article: Implementing the Pediatric Ventilator Liberation Guidelines Using the Most Current Evidence
Implementing the Pediatric Ventilator Liberation Guidelines Using the Most Current Evidence Open
Invasive mechanical ventilation is prevalent and associated with considerable morbidity. Pediatric critical care teams must identify the best timing and approach to liberating (extubating) children from this supportive care modality. Unsur…
View article: Cardiac dysfunction in severe pediatric acute respiratory distress syndrome: the right ventricle in search of the right therapy
Cardiac dysfunction in severe pediatric acute respiratory distress syndrome: the right ventricle in search of the right therapy Open
Severe acute respiratory distress syndrome in children, or PARDS, carries a high risk of morbidity and mortality that is not fully explained by PARDS severity alone. Right ventricular (RV) dysfunction can be an insidious and often under-re…
View article: Predicting Duration of Invasive Mechanical Ventilation in the Pediatric ICU
Predicting Duration of Invasive Mechanical Ventilation in the Pediatric ICU Open
We derived and validated a model to predict the duration of invasive mechanical ventilation that performed well in aggregated predictions at the PICU and the cohort level. This model could be beneficial in quality improvement and instituti…
View article: Pediatric Ventilator Liberation: One-Hour Versus Two-Hour Spontaneous Breathing Trials in a Single Center
Pediatric Ventilator Liberation: One-Hour Versus Two-Hour Spontaneous Breathing Trials in a Single Center Open
A 1-h SBT may be a viable alternative to a 2-h version for the average child who is critically ill. Further, a 1-h SBT may better balance extubation outcomes and duration of invasive ventilation for the general pediatric ICU population.
View article: Prevalence, Risk Factors, and Outcomes of Airway Versus Non-Airway Pediatric Extubation Failure
Prevalence, Risk Factors, and Outcomes of Airway Versus Non-Airway Pediatric Extubation Failure Open
Airway extubation failure prevalence was 1.5 times higher than non-airway failure. Potential risk factors for airway failure were identified. These findings are hypothesis generating for future study focused on key evidence gaps and pragma…
View article: Unique Complications of MIS-C and Its Treatment: Encephalopathy in a Child with MIS-C Who Developed Life-Threatening Gastrointestinal Hemorrhage
Unique Complications of MIS-C and Its Treatment: Encephalopathy in a Child with MIS-C Who Developed Life-Threatening Gastrointestinal Hemorrhage Open
In this case report, we describe a previously healthy eleven-year-old male diagnosed with multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019. The patient presented with shock and neurologic sympt…
View article: Pediatric Ventilation Liberation: A Survey of International Practice Among 555 Pediatric Intensivists
Pediatric Ventilation Liberation: A Survey of International Practice Among 555 Pediatric Intensivists Open
IMPORTANCE: Pediatric ventilation liberation has limited evidence, likely resulting in wide practice variation. To inform future work, practice patterns must first be described. OBJECTIVES: Describe international pediatric ventilation libe…
View article: Pediatric Ventilation Liberation: Bundled Extubation Readiness and Analgosedation Pathways Decrease Mechanical Ventilation Duration and Benzodiazepine Exposure
Pediatric Ventilation Liberation: Bundled Extubation Readiness and Analgosedation Pathways Decrease Mechanical Ventilation Duration and Benzodiazepine Exposure Open
A multidisciplinary, bundled benzodiazepine-sparing analgosedation and extubation readiness testing approach resulted in a reduction in mechanical ventilation duration and benzodiazepine exposure without impacting key balancing measures. E…
View article: Ventilation Liberation Practices Among 380 International PICUs
Ventilation Liberation Practices Among 380 International PICUs Open
OBJECTIVES: 1) Characterize the prevalence of ventilator liberation protocol use in international PICUs, 2) identify the most commonly used protocol elements, and 3) estimate an international extubation failure rate and use of postextubati…
View article: Unit-based Scorecards Result in Improved Bundled Resuscitation for Septic Patients in a Single Freestanding Children’s Hospital
Unit-based Scorecards Result in Improved Bundled Resuscitation for Septic Patients in a Single Freestanding Children’s Hospital Open
The Children’s Hospital Association’s Improving Pediatric Sepsis Outcomes (IPSO) collaborative is a multi-center quality improvement (QI) learning collaborative of 61 U.S. children’s hospitals that seeks to improve sepsis outcomes through …
View article: Leukoerythroblastosis with dyserythropoiesis in an adolescent with SARS-CoV-2-associated macrophage activation syndrome
Leukoerythroblastosis with dyserythropoiesis in an adolescent with SARS-CoV-2-associated macrophage activation syndrome Open
View article: Diurnal Variation and Nursing Perspectives in Analgesic and Sedation Medication Administration to Mechanically Ventilated Children in a Single Pediatric ICU
Diurnal Variation and Nursing Perspectives in Analgesic and Sedation Medication Administration to Mechanically Ventilated Children in a Single Pediatric ICU Open
The primary objective of this study was to determine whether there was diurnal variation in the amount of analgesic and sedation medication administered to mechanically ventilated children in a single pediatric intensive care unit (PICU). …
View article: Exploration of Sepsis-Associated Coagulopathy Severity and Pediatric Septic Shock Outcomes
Exploration of Sepsis-Associated Coagulopathy Severity and Pediatric Septic Shock Outcomes Open
The objective of this study was to explore correlations between sepsis-associated coagulopathy (SAC) in pediatric septic shock and clinical outcomes. This was a retrospective cohort study of all children admitted to a single, academic pedi…