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Pediatric Critical Care Medicine

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https://www.readbyqxmd.com/read/28723883/the-2014-american-college-of-critical-care-medicine-clinical-practice-guidelines-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock-executive-summary
#1
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme Maclaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
No abstract text is available yet for this article.
July 18, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28723882/altered-carnitine-homeostasis-in-children-with-increased-pulmonary-blood-flow-due-to-ventricular-septal-defects
#2
Stephen M Black, Aida Field-Ridley, Shruti Sharma, Sanjiv Kumar, Roberta L Keller, Rebecca Kameny, Emin Maltepe, Sanjeev A Datar, Jeffrey R Fineman
OBJECTIVES: Congenital heart disease with increased pulmonary blood flow results in progressive pulmonary vascular endothelial dysfunction and associated increased perioperative morbidity. Using our ovine model of congenital heart disease with increased pulmonary blood flow, we have previously demonstrated progressive endothelial dysfunction associated with disruption in carnitine homeostasis, mitochondrial dysfunction, decreased nitric oxide signaling, and enhanced reactive oxygen species generation...
July 18, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28723881/correlation-between-pao2-fio2-and-peripheral-capillary-oxygenation-fio2-in-burned-children-with-smoke-inhalation-injury
#3
Janos Cambiaso-Daniel, Charles D Voigt, Eric Rivas, Gabriel Hundeshagen, Omar Nunez-Lopez, Lars-Peter Kamolz, Michaela Sljivich, Linda E Sousse, David N Herndon, Oscar E Suman, Michael P Kinsky, Ronald P Mlcak
OBJECTIVES: Determine whether the peripheral capillary oxygenation/FIO2 ratio correlates with the PaO2/FIO2 ratio in burned children with smoke inhalation injury, with the goal of understanding if the peripheral capillary oxygenation/FIO2 ratio can serve as a surrogate for the PaO2/FIO2 ratio for the diagnosis of acute respiratory distress syndrome. DESIGN: Retrospective chart review. SETTING: Shriners Hospitals for Children-Galveston. PATIENTS: All burned children with smoke inhalation injury who were admitted from 1996 to 2014 and had simultaneously obtained peripheral capillary oxygenation, FIO2 and PaO2 measurements...
July 18, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28691936/national-variation-in-the-use-of-tracheostomy-in-patients-with-congenital-heart-disease
#4
Joyce T Johnson, Bradley S Marino, Darren Klugman, Pirouz Shamszad
OBJECTIVES: The postsurgical care of children with congenital heart disease may be complicated by the need for cardiorespiratory support, including tracheostomy. The variation of the use of tracheostomy across multiple pediatric cardiac surgical centers has not been defined. We describe multicenter variation in the use of tracheostomy in children undergoing congenital heart surgery. DESIGN: We retrospectively analyzed a multicenter cohort. SETTING: Pediatric Health Information Systems database retrospective cohort...
July 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28661973/determinants-of-antibiotic-tailoring-in-pediatric-intensive-care-a-national-survey
#5
Patricia S Fontela, Caroline Quach, Mohammad E Karim, Douglas F Willson, Elaine Gilfoyle, James Dayre McNally, Milagros Gonzales, Jesse Papenburg, Steven Reynolds, Jacques Lacroix
OBJECTIVES: To describe the criteria that currently guide empiric antibiotic treatment in children admitted to Canadian PICUs. DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists and pediatric infectious diseases specialists. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used focus groups and literature review to design the survey questions and its four clinical scenarios (sepsis, pneumonia, meningitis, and intra-abdominal infections)...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28661972/continuous-chest-compressions-during-sustained-inflations-in-a-perinatal-asphyxial-cardiac-arrest-lamb-model
#6
Payam Vali, Praveen Chandrasekharan, Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Bobby Mathew, Sara Berkelhamer, Jayasree Nair, Satyan Lakshminrusimha
OBJECTIVE: Continuous chest compressions are more effective during resuscitation in adults. Sustained inflation rapidly establishes functional residual capacity in fluid-filled lungs at birth. We sought to compare the hemodynamics and success in achieving return of spontaneous circulation in an asphyxial cardiac arrest lamb model with transitioning fetal circulation and fluid-filled lungs between subjects receiving continuous chest compressions during sustained inflation and those receiving conventional 3:1 compression-to-ventilation resuscitation...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28658198/professional-responsibility-consensus-and-conflict-a-survey-of-physician-decisions-for-the-chronically-critically-ill-in-neonatal-and-pediatric-intensive-care-units
#7
Miriam C Shapiro, Pamela K Donohue, Sapna R Kudchadkar, Nancy Hutton, Renee D Boss
OBJECTIVE: To describe neonatologist and pediatric intensivist attitudes and practices relevant to high-stakes decisions for children with chronic critical illness, with particular attention to physician perception of professional duty to seek treatment team consensus and to disclose team conflict. DESIGN: Self-administered online survey. SETTING: U.S. neonatal ICUs and PICUs. SUBJECTS: Neonatologists and pediatric intensivists...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28658197/hydrocortisone-therapy-in-catecholamine-resistant-pediatric-septic-shock-a-pragmatic-analysis-of-clinician-practice-and-association-with-outcomes
#8
Blake Nichols, Sherri Kubis, Jennifer Hewlett, Nadir Yehya, Vijay Srinivasan
OBJECTIVES: The 2012 Surviving Sepsis Campaign pediatric guidelines recommend stress dose hydrocortisone in children experiencing catecholamine-dependent septic shock with suspected or proven absolute adrenal insufficiency. We evaluated whether stress dose hydrocortisone therapy in children with catecholamine dependent septic shock correlated with random serum total cortisol levels and was associated with improved outcomes. DESIGN: Retrospective cohort study. SETTING: Non-cardiac PICU...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28658196/late-term-gestation-is-associated-with-improved-survival-in-neonates-with-congenital-heart-disease-following-postoperative-extracorporeal-life-support
#9
Jane M McKenzie, Thomas Scodellaro, Yves d'Udekem, Roberto Chiletti, Warwick Butt, Siva P Namachivayam
OBJECTIVE: Several population-based studies have shown that gestational age 39-40 weeks at birth is associated with superior outcomes in various pediatric settings. A high proportion of births for neonates with congenital heart disease occur before 39 weeks. We aimed to assess the influence of late-term gestation (39-40 wk) on survival in neonates requiring extracorporeal life support following surgery for congenital heart disease. DESIGN: Retrospective cohort study...
June 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654552/severe-upper-airway-obstruction-after-intraoperative-transesophageal-echocardiography-in-pediatric-cardiac-surgery-a-retrospective-analysis
#10
Jörg Michel, Michael Hofbeck, Christian Schineis, Matthias Kumpf, Ellen Heimberg, Harry Magunia, Eckhard Schmid, Christian Schlensak, Gunnar Blumenstock, Felix Neunhoeffer
OBJECTIVES: The aim of this study was to evaluate if there is a correlation between the use of intraoperative transesophageal echocardiography and an increased rate of extubation failure and to find other risk factors for severe upper airway obstructions after pediatric cardiac surgery. DESIGN: Retrospective analysis. SETTING: Cardiac PICU. PATIENTS: Patients 24 months old or younger who underwent surgery for congenital heart disease with cardiopulmonary bypass were retrospectively enrolled and divided into two groups depending on whether they received an intraoperative transesophageal echocardiography or not...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654551/assuring-sustainable-gains-in-interdisciplinary-performance-improvement-creating-a-shared-mental-model-during-operating-room-to-cardiac-icu-handoff
#11
Christine M Riley, Amber D Merritt, Justine M Mize, Jennifer J Schuette, John T Berger
OBJECTIVE: To understand sustainability and assure long-term gains in multidisciplinary performance improvement using an operating room to cardiac ICU handoff process focused on creation of a shared mental model. DESIGN: Performance improvement cohort project with pre- and postintervention assessments spanning a 4-year period. SETTING: Twenty-six bed pediatric cardiac ICU in a tertiary care children's hospital. PATIENTS: Cardiac surgery patients admitted to cardiac ICU from the operating room following cardiac surgery...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654550/promoters-and-barriers-to-implementation-of-tracheal-intubation-airway-safety-bundle-a-mixed-method-analysis
#12
Katherine Finn Davis, Natalie Napolitano, Simon Li, Hayley Buffman, Kyle Rehder, Matthew Pinto, Sholeen Nett, J Dean Jarvis, Pradip Kamat, Ronald C Sanders, David A Turner, Janice E Sullivan, Kris Bysani, Anthony Lee, Margaret Parker, Michelle Adu-Darko, John Giuliano, Katherine Biagas, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. DESIGN: Mixed methods. SETTING: Thirteen PICUs of the National Emergency Airway Registry for Children network. INTERVENTION: Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28654549/workload-of-team-leaders-and-team-members-during-a-simulated-sepsis-scenario
#13
Nancy M Tofil, Yiqun Lin, John Zhong, Dawn Taylor Peterson, Marjorie Lee White, Vincent Grant, David J Grant, Ronald Gottesman, Stephanie N Sudikoff, Mark Adler, Kimberly Marohn, Jennifer Davidson, Adam Cheng
OBJECTIVES: Crisis resource management principles dictate appropriate distribution of mental and/or physical workload so as not to overwhelm any one team member. Workload during pediatric emergencies is not well studied. The National Aeronautics and Space Administration-Task Load Index is a multidimensional tool designed to assess workload validated in multiple settings. Low workload is defined as less than 40, moderate 40-60, and greater than 60 signify high workloads. Our hypothesis is that workload among both team leaders and team members is moderate to high during a simulated pediatric sepsis scenario and that team leaders would have a higher workload than team members...
June 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650904/pediatric-procedural-sedation-using-the-combination-of-ketamine-and-propofol-outside-of-the-emergency-department-a-report-from-the-pediatric-sedation-research-consortium
#14
Jocelyn R Grunwell, Curtis Travers, Anne G Stormorken, Patricia D Scherrer, Corrie E Chumpitazi, Jana A Stockwell, Mark G Roback, Joseph Cravero, Pradip P Kamat
OBJECTIVES: Outcomes associated with a sedative regimen comprised ketamine + propofol for pediatric procedural sedation outside of both the pediatric emergency department and operating room are underreported. We used the Pediatric Sedation Research Consortium database to describe a multicenter experience with ketamine + propofol by pediatric sedation providers. DESIGN: Prospective observational study of children receiving IV ketamine + propofol for procedural sedation outside of the operating room and emergency department using data abstracted from the Pediatric Sedation Research Consortium during 2007-2015...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650903/thigh-ultrasound-monitoring-identifies-decreases-in-quadriceps-femoris-thickness-as-a-frequent-observation-in-critically-ill-children
#15
Frederic V Valla, David K Young, Muriel Rabilloud, Uvaraj Periasami, Manoj John, Florent Baudin, Carole Vuillerot, Aurélie Portefaix, Deborah White, Jenna A Ridout, Rosan Meyer, Bénédicte Gaillard Le Roux, Etienne Javouhey, Nazima Pathan
OBJECTIVES: Significant muscle wasting develops in critically ill adults, with subsequent worse outcomes. In the pediatric setting, occurrence and effects of muscle wasting are undescribed; this is in part due to a lack of validated, objective methods for assessing muscle wasting. A single measurement of quadriceps femoris thickness has failed to show consistent reproducibility. We hypothesized that averaging repeated measurements could afford good reproducibility to allow for quadriceps femoris thickness decline detection and monitoring...
June 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28650363/population-pharmacokinetics-and-pharmacodynamic-target-attainment-of-vancomycin-in-neonates-on-extracorporeal-life-support
#16
Jeffrey J Cies, Wayne S Moore, Kristen Nichols, Chad A Knoderer, Dominick M Carella, Arun Chopra
OBJECTIVES: To evaluate the population pharmacokinetics and pharmacodynamic target attainment of vancomycin in neonates with a contemporary ¼-inch extracorporeal life support circuit with a Quadrox-iD Pediatric oxygenator (Maquet Cardiovascular, LLC, Wayne, NJ). DESIGN: Retrospective medical record review. SETTING: Two free-standing tertiary/quaternary pediatric children's hospitals. PATIENTS: Neonates receiving either veno-arterial or veno-venous extracorporeal life support and vancomycin for empiric or definitive therapy with resulting serum concentrations...
June 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28640009/augmented-renal-clearance-using-population-based-pharmacokinetic-modeling-in-critically-ill-pediatric-patients
#17
Sean N Avedissian, Erin Bradley, Diana Zhang, John S Bradley, Lama H Nazer, Tri M Tran, Austin Nguyen, Jennifer Le
OBJECTIVES: The objectives of this study were to: 1) evaluate the prevalence of augmented renal clearance in critically ill pediatric patients using vancomycin clearance; 2) derive the pharmacokinetic model that best describes vancomycin clearance in critically ill pediatric patients; and 3) correlate vancomycin clearance with creatinine clearance estimated by modified Schwartz or Cockcroft-Gault. DESIGN: Retrospective, two-center, cohort study from 2003 to 2016...
June 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28628546/the-impact-of-multiple-viral-respiratory-infections-on-outcomes-for-critically-ill-children
#18
Jigar C Chauhan, Nicholas B Slamon
OBJECTIVE: Advances in molecular diagnosis have led to increased testing for single and multiviral respiratory infection in routine clinical practice. This study compares outcomes between single and multiviral respiratory infections in children younger than 5 years old admitted to the PICU with respiratory failure. DESIGN: Retrospective, single-center, cohort study. SETTING: Tertiary-care, freestanding children's hospital. PATIENTS: Children younger than 5 years old admitted to the PICU with respiratory failure and positive respiratory molecular panel...
June 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28622280/elevated-central-venous-to-arterial-co2-difference-is-not-associated-with-poor-clinical-outcomes-after-cardiac-surgery-with-cardiopulmonary-bypass-in-children
#19
Takaaki Akamatsu, Yu Inata, Kazuya Tachibana, Takeshi Hatachi, Muneyuki Takeuchi
OBJECTIVE: To investigate whether elevated central venous to arterial CO2 difference is associated with delayed extubation and prolonged ICU stay in children after cardiac surgery with cardiopulmonary bypass. DESIGN: Retrospective review of medical records. SETTING: PICU in a tertiary children's hospital. PATIENTS: Pediatric patients younger than 18 years old who underwent cardiac surgery with cardiopulmonary bypass between January 2014 and December 2014...
June 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28622279/hydrogen-sulphide-in-exhaled-gases-from-ventilated-septic-neonates-and-children-a-preliminary-report
#20
Natalie Bee, Ruth White, Andy J Petros
OBJECTIVES: There is increasing interest in hydrogen sulphide as a marker of pathologic conditions or predictors of outcome. We speculate that as hydrogen sulphide is a diffusible molecule, if there is an increase in plasma hydrogen sulphide in sepsis, it may accumulate in the alveolar space and be detected in exhaled gas. "We wished to determine whether we could detect hydrogen sulphide in exhaled gases of ventilated children and neonates and if the levels changed in sepsis." DESIGN: Prospective, observational study...
June 15, 2017: Pediatric Critical Care Medicine
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