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In This Issue of JAMA Pediatrics |

In This Issue of JAMA Pediatrics FREE

JAMA Pediatr. 2013;167(5):408. doi:10.1001/jamapediatrics.2013.67.
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Mussman et al studied suctioning in infants hospitalized with bronchiolitis and found that the use of deep suctioning in the first 24 hours after admission and lapses greater than 4 hours between suctioning events were associated with longer length of stay.

In a retrospective cohort study testing the hypothesis that using an observation unit and home oxygen therapy for bronchiolitis would decrease hospital length of stay, Sandweiss et al found that implementation of such a protocol safely reduced hospital length of stay with significant cost savings.

Jumani et al conducted a cohort study to identify risk factors for complications necessitating removal of peripherally inserted central venous catheters (PICCs) in children. Noncentral PICC tip locations, younger age, and pediatric intensive care unit exposure were independent risk factors for complications necessitating PICC removal.

In a cross-sectional analysis, Edwards et al found that the proportion of adults admitted to pediatric intensive care units (PICUs) varied considerably by PICU (range, 0%-9.2%). As age increased, the proportion of adult patients who had a complex chronic condition and planned or perioperative admissions increased.

In a retrospective cohort study investigating the adequacy of neonatal intensive care unit (NICU) nurse staffing, Rogowski et al found that hospitals understaffed 31% of their NICU infants and 68% of high-acuity infants relative to national guidelines.

Payne et al evaluated neurodevelopmental outcomes of extremely low-birth-weight infants with low-grade periventricular-intraventricular hemorrhage vs those of infants with either no hemorrhage or severe hemorrhage. At 18 to 22 months, the neurodevelopmental outcomes of extremely low-gestational-age infants with low-grade periventricular-intraventricular hemorrhage were not significantly different.

Lyon et al examined the efficacy of family-centered advance care planning, and they found that it enabled families to understand and honor their adolescents' wishes. Intervention dyads were more likely than control subjects to limit treatments.

McAteer et al reviewed 63 studies regarding surgeon or hospital experience and its influence on outcomes in children's surgery. Forty-nine studies (78%) showed positive correlation between experience and most primary outcomes. Hospital-level factors tended to correlate with outcomes for high-complexity procedures, whereas surgeon-level factors correlated more with outcomes of common procedures.

Bechard et al reviewed existing literature concerning the impact of obesity on clinical outcomes in hospitalized children. Childhood obesity may be a risk factor for higher mortality in hospitalized children with critical illness, oncologic diagnoses, or transplants.

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