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Article: Palliative care in the ICU: together we can make a greater difference.

Custer, Joseph R

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2014 Volume 15, Issue 8, Page(s) 784–786

MeSH term(s)	Advisory Committees ; Delivery of Health Care/organization & administration ; Humans ; Intensive Care Units, Pediatric/standards ; Palliative Care/standards
Language	English
Publishing date	2014-10
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000000242
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Article ; Online: The evolution of patient selection criteria and indications for extracorporeal life support in pediatric cardiopulmonary failure: next time, let's not eat the bones.

Custer, Joseph R

Organogenesis

2011 Volume 7, Issue 1, Page(s) 13–22

Abstract: Bill James, baseball statistician and author, tells the story of hungry cavemen sitting about a campfire, waiting for tomatoes to ripen. One has the inspiration to throw an ox on the fire, and the first barbecue ensued and was endured. After eating, the ... ...

Abstract	Bill James, baseball statistician and author, tells the story of hungry cavemen sitting about a campfire, waiting for tomatoes to ripen. One has the inspiration to throw an ox on the fire, and the first barbecue ensued and was endured. After eating, the conversation goes something like this. "There were some good parts." "Yeah, but there were some bad parts." And the smart one says, "This time, let's not eat the bones." The evolution of patient selection criteria for the use of extracorporeal support (ECLS) is a bit like those cavemen and their first barbecued ox. Extracorporeal life support technology and application to patient care is the unique result of a long standing history of ambitious attempt, evaluation, debate, collaboration and extension.
MeSH term(s)	Cardiopulmonary Resuscitation ; Child ; Extracorporeal Membrane Oxygenation ; Heart Failure ; Humans ; Organ Preservation ; Patient Selection ; Respiratory Insufficiency ; Sepsis
Language	English
Publishing date	2011-01-01
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2159583-5
ISSN	1555-8592 ; 1555-8592
ISSN (online)	1555-8592
ISSN	1555-8592
DOI	10.4161/org.7.1.14024
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Article ; Online: Clinical Outcomes of Acute Respiratory Failure Associated With Noninvasive and Invasive Ventilation in a Pediatric ICU.

Kyle, James M / Sturza, Julie M / Dechert, Ronald E / Custer, Joseph R / Dahmer, Mary K / Saba, Thomas G / Flori, Heidi R

Respiratory care

2022 Volume 67, Issue 8, Page(s) 956–966

Abstract: Background: It remains unknown if pediatric patients failing initial noninvasive ventilation (NIV) experience worse clinical outcomes than those successfully treated with NIV or those primarily intubated.: Methods: This was a single-center, ... ...

Abstract	Background: It remains unknown if pediatric patients failing initial noninvasive ventilation (NIV) experience worse clinical outcomes than those successfully treated with NIV or those primarily intubated. Methods: This was a single-center, retrospective review of patients admitted with acute respiratory failure to the University of Michigan pediatric intensive care or cardiothoracic ICUs and receiving NIV or invasive mechanical ventilation as first-line therapy. Results: One hundred seventy subjects met inclusion criteria and were enrolled: 65 NIV success, 55 NIV failure, and 50 invasive mechanical ventilation alone. Of those failing NIV, median time to intubation was 1.8 (interquartile range [IQR] < 1-7) h. On multivariable regression, ICU-free days were significantly different between groups (NIV success: 22.9 ± 6.9 d; NIV failure: 13.0 Conclusions: We demonstrated that critically ill pediatric subjects unsuccessfully trialed on NIV did not experience increased ICU length of stay or fewer ventilator-free days when compared to those on invasive mechanical ventilation alone, including in the pediatric ARDS subgroup. Our findings are predicated on a median time to intubation of < 2 h in the NIV failure group and the provision of adequate monitoring while on NIV.
MeSH term(s)	Child ; Humans ; Intensive Care Units ; Intensive Care Units, Pediatric ; Noninvasive Ventilation ; Respiration, Artificial ; Respiratory Distress Syndrome/therapy ; Respiratory Insufficiency/etiology ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2022-06-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	603252-7
ISSN	1943-3654 ; 0098-9142 ; 0020-1324
ISSN (online)	1943-3654
ISSN	0098-9142 ; 0020-1324
DOI	10.4187/respcare.09348
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Article ; Online: Making a difference to that one, one (documented) patient at a time.

Custer, Joseph R

Critical care medicine

2009 Volume 37, Issue 4, Page(s) 1503–1505

MeSH term(s)	Child ; Extracorporeal Membrane Oxygenation ; Humans ; Life Support Care ; Neoplasms/complications ; Patient Selection ; Respiratory Insufficiency/complications ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2009-04
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e31819d2d79
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Article: A little patience for our patients with lung disease: ECMO... eventually.

Custer, Joseph R / Annich, Gail Marie

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2012 Volume 13, Issue 1, Page(s) 94–96

MeSH term(s)	Cause of Death ; Extracorporeal Membrane Oxygenation/methods ; Female ; Humans ; Male ; Registries ; Respiration, Artificial/methods ; Respiratory Insufficiency/mortality ; Respiratory Insufficiency/therapy
Language	English
Publishing date	2012-01
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0b013e3182231237
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Article: A randomized trial of a single dose of oral dexamethasone for mild croup.

Custer, Joseph R

The Journal of pediatrics

2005 Volume 146, Issue 3, Page(s) 434–435

MeSH term(s)	Administration, Oral ; Anti-Inflammatory Agents/administration & dosage ; Anti-Inflammatory Agents/therapeutic use ; Child, Preschool ; Croup/drug therapy ; Dexamethasone/administration & dosage ; Dexamethasone/therapeutic use ; Double-Blind Method ; Humans
Chemical Substances	Anti-Inflammatory Agents ; Dexamethasone (7S5I7G3JQL)
Language	English
Publishing date	2005-03
Publishing country	United States
Document type	Clinical Trial ; Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2005.01.005
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Article: Infections acquired while on extracorporeal membrane oxygenation: navigating the maze.

Odetola, Folafoluwa / Custer, Joseph R

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2011 Volume 12, Issue 3, Page(s) 353–355

MeSH term(s)	Cross Infection/epidemiology ; Cross Infection/etiology ; Extracorporeal Membrane Oxygenation/adverse effects ; Humans
Language	English
Publishing date	2011-05
Publishing country	United States
Document type	Comment ; Editorial
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0b013e3181e8b73c
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Article ; Online: A normal capillary refill time of ≤ 2 seconds is associated with superior vena cava oxygen saturations of ≥ 70%.

Raimer, Patricia L / Han, Yong Y / Weber, Monica S / Annich, Gail M / Custer, Joseph R

The Journal of pediatrics

2011 Volume 158, Issue 6, Page(s) 968–972

Abstract: Objective: To test the hypothesis that a normal capillary refill time (CRT) ≤ 2 seconds is associated with superior vena cava oxygen saturation (ScvO₂) ≥ 70% in critically ill children.: Study design: Two-year, prospective study in a tertiary-level ... ...

Abstract	Objective: To test the hypothesis that a normal capillary refill time (CRT) ≤ 2 seconds is associated with superior vena cava oxygen saturation (ScvO₂) ≥ 70% in critically ill children. Study design: Two-year, prospective study in a tertiary-level pediatric intensive care unit. Whenever ScvO₂ measurements were obtained, central (forehead/sternum) and peripheral (finger/toe) CRTs were concomitantly assessed. Results: Central and peripheral CRTs ≤ 2 seconds were both associated with ScvO₂ ≥ 70% (P < .01). Sensitivity/specificity analyses revealed that central CRT ≤ 2 seconds demonstrated a sensitivity of 84.4%, specificity of 71.4%, positive predictive value of 93.1%, and negative predictive value of 50.0% in predicting ScvO₂ ≥ 70%. Peripheral CRT ≤ 2 seconds had a sensitivity of 71.9%, specificity of 85.7%, positive predictive value of 95.8%, and negative predictive value of 40.0% in predicting ScvO₂ ≥ 70%. Conclusions: A normal CRT ≤ 2 seconds can be predictive of ScvO₂ ≥ 70%. Our study corroborates the recommendations of the Pediatric Advanced Life Support curricula targeting a normal CRT ≤ 2 seconds as a therapeutic endpoint for goal-directed shock resuscitation. This clinical target remains particularly relevant in community hospitals when the ability to obtain central venous catheter access may be limited and ScvO₂ data unavailable.
MeSH term(s)	Blood Gas Analysis ; Capillaries/pathology ; Catheters ; Child ; Child, Preschool ; Critical Illness ; Female ; Humans ; Infant ; Male ; Oxygen/chemistry ; Oxygen/metabolism ; Oxygen Consumption ; Pediatrics ; Predictive Value of Tests ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Vena Cava, Superior/pathology
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2011-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2010.11.062
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Article: A Normal Capillary Refill Time of ≤ 2 Seconds is Associated with Superior Vena Cava Oxygen Saturations of ≥ 70%

Raimer, Patricia L / Han, Yong Y / Weber, Monica S / Annich, Gail M / Custer, Joseph R

journal of pediatrics. 2011 June, v. 158, no. 6

2011

Abstract: OBJECTIVE: To test the hypothesis that a normal capillary refill time (CRT) ≤ 2 seconds is associated with superior vena cava oxygen saturation (ScvO₂) ≥ 70% in critically ill children. STUDY DESIGN: Two-year, prospective study in a tertiary-level ... ...

Abstract	OBJECTIVE: To test the hypothesis that a normal capillary refill time (CRT) ≤ 2 seconds is associated with superior vena cava oxygen saturation (ScvO₂) ≥ 70% in critically ill children. STUDY DESIGN: Two-year, prospective study in a tertiary-level pediatric intensive care unit. Whenever ScvO₂ measurements were obtained, central (forehead/sternum) and peripheral (finger/toe) CRTs were concomitantly assessed. RESULTS: Central and peripheral CRTs ≤ 2 seconds were both associated with ScvO₂ ≥ 70% (P < .01). Sensitivity/specificity analyses revealed that central CRT ≤ 2 seconds demonstrated a sensitivity of 84.4%, specificity of 71.4%, positive predictive value of 93.1%, and negative predictive value of 50.0% in predicting ScvO₂ ≥ 70%. Peripheral CRT ≤ 2 seconds had a sensitivity of 71.9%, specificity of 85.7%, positive predictive value of 95.8%, and negative predictive value of 40.0% in predicting ScvO₂ ≥ 70%. CONCLUSIONS: A normal CRT ≤ 2 seconds can be predictive of ScvO₂ ≥ 70%. Our study corroborates the recommendations of the Pediatric Advanced Life Support curricula targeting a normal CRT ≤ 2 seconds as a therapeutic endpoint for goal-directed shock resuscitation. This clinical target remains particularly relevant in community hospitals when the ability to obtain central venous catheter access may be limited and ScvO₂ data unavailable.
Keywords	children ; hospitals ; oxygen ; prediction ; prospective studies ; sternum ; superior vena cava
Language	English
Dates of publication	2011-06
Size	p. 968-972.
Publishing place	Mosby, Inc.
Document type	Article
ZDB-ID	3102-1
ISSN	1097-6833 ; 0022-3476
ISSN (online)	1097-6833
ISSN	0022-3476
DOI	10.1016/j.jpeds.2010.11.062
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Article ; Online: The Bereaved Parent Needs Assessment: a new instrument to assess the needs of parents whose children died in the pediatric intensive care unit*.

Meert, Kathleen L / Templin, Thomas N / Michelson, Kelly N / Morrison, Wynne E / Hackbarth, Richard / Custer, Joseph R / Schim, Stephanie M / Briller, Sherylyn H / Thurston, Celia S

Critical care medicine

2012 Volume 40, Issue 11, Page(s) 3050–3057

Abstract: Objectives: To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents' needs and need fulfillment around the time of their child's death in the pediatric intensive care unit. We hypothesized ... ...

Abstract	Objectives: To evaluate the reliability and validity of the Bereaved Parent Needs Assessment, a new instrument to measure parents' needs and need fulfillment around the time of their child's death in the pediatric intensive care unit. We hypothesized that need fulfillment would be negatively related to complicated grief and positively related to quality of life during bereavement. Design: Cross-sectional survey. Setting: Five U.S. children's hospital pediatric intensive care units. Subjects: Parents (n = 121) bereaved in a pediatric intensive care unit 6 months earlier. Interventions: Surveys included the 68-item Bereaved Parent Needs Assessment, the Inventory of Complicated Grief, and the abbreviated version of the World Health Organization Quality of Life questionnaire. Each Bereaved Parent Needs Assessment item described a potential need and was rated on two scales: 1) a 5-point rating of importance (1 = not at all important, 5 = very important) and 2) a 5-point rating of fulfillment (1 = not at all met, 5 = completely met). Three composite scales were computed: 1) total importance (percentage of all needs rated ≥4 for importance), 2) total fulfillment (percentage of all needs rated ≥4 for fulfillment), and 3) percent fulfillment (percentage of important needs that were fulfilled). Internal consistency reliability was assessed by Cronbach's α and Spearman-Brown-corrected split-half reliability. Generalized estimating equations were used to test predictions between composite scales and the Inventory of Complicated Grief and World Health Organization Quality of Life questionnaire. Measurements and main results: Two items had mean importance ratings <3, and 55 had mean ratings >4. Reliability of composite scores ranged from 0.92 to 0.94. Total fulfillment was negatively correlated with Inventory of Complicated Grief (r = -.29; p < .01) and positively correlated with World Health Organization Quality of Life questionnaire (r = .21; p < .05). Percent fulfillment was also significantly correlated with both outcomes. Adjusting for parent's age, education, and loss of an only child, percent fulfillment remained significantly correlated with Inventory of Complicated Grief but not with World Health Organization Quality of Life questionnaire. Conclusions: The Bereaved Parent Needs Assessment demonstrated reliability and validity to assess the needs of parents bereaved in the pediatric intensive care unit. Meeting parents' needs around the time of their child's death may promote adjustment to loss.
MeSH term(s)	Adolescent ; Adult ; Bereavement ; Child ; Child, Preschool ; Death ; Female ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units, Pediatric ; Male ; Middle Aged ; Needs Assessment ; Parents/psychology ; Psychometrics ; Surveys and Questionnaires
Language	English
Publishing date	2012-08-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/CCM.0b013e31825fe164
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