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Background: Blood pressure variability (BPV), defined as the degree of variation between discrete blood pressure readings, is associated with poor outcomes in acute care settings. Acute kidney injury (AKI) is a common and serious postoperative complication of cardiac surgery with cardiopulmonary bypass (CPB) in children. No studies have yet assessed the association between intraoperative BPV during cardiac surgery with CPB and the development of AKI in children. Methods: A retrospective chart review of children undergoing cardiac surgery with CPB was performed. Intraoperative BPV was calculated using average real variability (ARV) and standard deviation (SD). Multiple regression models were used to examine the association between BPV and outcomes of AKI, hospital and intensive care unit (PICU) length of stay, and length of mechanical ventilation. Results: Among 231 patients (58% males, median age 8.6 months) reviewed, 51.5% developed AKI (47.9% Stage I, 41.2% Stage II, 10.9% Stage III). In adjusted models, systolic and diastolic ARV were associated with development of any stage AKI (OR 1.40, 95% CI 1.08–1.8 and OR 1.4, 95% CI 1.05–1.8, respectively). Greater diastolic SD was associated with longer PICU length of stay (β 0.94, 95% CI 0.62–1.2). When stratified by age, greater systolic ARV and SD were associated with AKI in infants ≤ 12 months, but there was no relationship in children > 12 months. Conclusions: Greater BPV during cardiac surgery with CPB was associated with development of postoperative AKI in infants, suggesting that BPV is a potentially modifiable risk factor for AKI in this high-risk population. [ABSTRACT FROM AUTHOR]

Objective: The goal of the study was to investigate the feasibility and acceptance of an interactive computer assisted asthma education program in the pediatric emergency department (ED) for children with acute asthma exacerbations. Methods: A pre-post non- randomized study was designed for children age 3 to 18 years at the University of Maryland Hospital for Children, Baltimore. An interactive computer-assisted educational program, Patient Education and Motivation Tool (PEMT), was designed using learning theories, to teach children about asthma and its management. Sixty nine children were enrolled during an ED visit for acute asthma between May 2006 and November 2006. Socio-demographic and asthma knowledge information was gathered using questionnaires. An attitudinal survey was used to assess the acceptance of the program. Results: Eighty one percent (n=56) of the children found PEMT very easy to use, and seventy five percent (n=52) agreed to use it in near future. There was a significant thirteen percent improvement in knowledge of asthma after the completion of this computer assisted asthma education program (p=0.01). Conclusion: PEMT is highly acceptable and is an effective way to provide asthma education in an ED setting. [ABSTRACT FROM AUTHOR]