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Pediatric Critical Care Medicine

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https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#1
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922270/decision-making-in-pediatric-transport-team-dispatch-using-script-concordance-testing
#2
Prakadeshwari Rajapreyar, Karen Marcdante, Liyun Zhang, Pippa Simpson, Michael T Meyer
OBJECTIVES: Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. DESIGN: Survey was developed using Script Concordance Testing guidelines...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#3
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922268/early-exercise-in-critically-ill-youth-and-children-a-preliminary-evaluation-the-weecycle-pilot-trial
#4
Karen Choong, Saif Awladthani, Adeeb Khawaji, Heather Clark, Asm Borhan, Ji Cheng, Sam Laskey, Charmaine Neu, Aimee Sarti, Lehana Thabane, Brian W Timmons, Katina Zheng, Samah Al-Harbi
OBJECTIVES: To determine the feasibility of conducting a full trial evaluating the efficacy of early mobilization using in-bed cycling as an adjunct to physiotherapy, on functional outcomes in critically ill children. DESIGN: Single center, pilot, randomized controlled trial. SETTING: Twelve-bed tertiary care, medical-surgical PICU at McMaster Children's Hospital, Hamilton, ON, Canada. PATIENTS: Children 3-17 years old who were limited to bed-rest with an expected PICU stay of at least 48 hours...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922267/the-1-year-follow-up-clinic-for-neonates-and-children-after-respiratory-extracorporeal-membrane-oxygenation-support-a-10-year-single-institution-experience
#5
Suzan Kakat, Maura O'Callaghan, Liz Smith, Raymond Hreiche, Deborah A Ridout, Jo Wray, Timothy Thiruchelvam, Katherine L Brown, Aparna U Hoskote
OBJECTIVES: To establish the effectiveness of a "1-year extracorporeal membrane oxygenation follow-up clinic" and to characterize any neurodevelopmental concerns identified. DESIGN: Single-center retrospective cohort of respiratory extracorporeal membrane oxygenation survivors over 10 years. SETTING: Nationally commissioned center for neonatal and pediatric (> 28 d of life) respiratory extracorporeal membrane oxygenation. PATIENTS: Children attending the follow-up clinic 1 year after receiving respiratory extracorporeal membrane oxygenation between 2003 and 2013...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922266/time-to-asthma-related-readmission-in-children-admitted-to-the-icu-for-asthma
#6
Sze Man Tse, Christian Samson
OBJECTIVES: To compare the time to asthma-related readmissions between children with a previous ICU hospitalization for asthma and those with a non-ICU hospitalization and to explore predictors of time to readmission in children admitted to the ICU. DESIGN: Retrospective cohort study using a pan-Canadian administrative inpatient database from April 1, 2008, to March 31, 2014. SETTING: All adult and pediatric Canadian hospitals. SUBJECTS: Children 2-17 years old with a hospitalization for asthma...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#7
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922264/validation-of-a-portable-coagulometer-for-routine-in-hospital-use-for-newborns
#8
Antonio E Jerez Calero, Dolores Fernández Jiménez, Manuel Molina Oya, Eduardo Narbona López, José Uberos Fernández
OBJECTIVES: To verify the reliability and clinical benefits of the coagulation tests made by a point of care device in newborn admitted to a neonatal unit. DESIGN: We made a statistical comparison between results obtained by the point of care device versus conventional laboratory analysis. SETTING: Level 3 neonatal unit. PATIENTS: Thirty-one infants admitted to the neonatal unit at the San Cecilio University Hospital (Granada, Spain) were recruited to this study...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922263/prospective-side-by-side-comparison-of-outcomes-and-complications-with-a-simple-versus-intensive-anticoagulation-monitoring-strategy-in-pediatric-extracorporeal-life-support-patients
#9
Jane S Yu, Ryan P Barbaro, Donald A Granoski, Mary E Bauman, M Patricia Massicotte, Laurance L Lequier, Gail M Annich, Lindsay M Ryerson
OBJECTIVES: A continuous infusion of unfractionated heparin is the most common anticoagulant used for pediatric patients on extracorporeal life support. The objective of this study was to compare extracorporeal life support complications and outcomes between two large-volume pediatric extracorporeal life support centers that use different anticoagulation strategies. DESIGN: Prospective, observational cohort study. SETTING: The University of Michigan used simple anticoagulation monitoring, whereas the University of Alberta used an intensive anticoagulation monitoring strategy...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28914722/factors-associated-with-pediatric-ventilator-associated-conditions-in-six-u-s-hospitals-a-nested-case-control-study
#10
Noelle M Cocoros, Gregory Priebe, James E Gray, Philip Toltzis, Gitte Y Larsen, Latania K Logan, Susan Coffin, Julia S Sammons, Kathleen Deakins, Kelly Horan, Matthew Lakoma, Jessica Young, Michael Burton, Michael Klompas, Grace M Lee
OBJECTIVES: A newly proposed surveillance definition for ventilator-associated conditions among neonatal and pediatric patients has been associated with increased morbidity and mortality among ventilated patients in cardiac ICU, neonatal ICU, and PICU. This study aimed to identify potential risk factors associated with pediatric ventilator-associated conditions. DESIGN: Retrospective cohort. SETTING: Six U.S. hospitals PATIENTS:: Children less than or equal to 18 years old ventilated for greater than or equal to 1 day...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28914721/sepsis-in-children-global-implications-of-the-world-health-assembly-resolution-on-sepsis
#11
Niranjan Kissoon, Konrad Reinhart, Ron Daniels, Machado Flavia R Machado, Raymond D Schachter, Simon Finfer
BACKGROUND: Sepsis, worldwide the leading cause of death in children, has now been recognized as the global health emergency it is. On May 26, 2017, the World Health Assembly, the decision-making body of the World Health Organization, adopted a resolution proposed by the Global Sepsis Alliance to improve the prevention, diagnosis, and management of sepsis. OBJECTIVE: To discuss the implications of this resolution for children worldwide. CONCLUSIONS: The resolution highlights sepsis as a global threat and urges the 194 United Nations member states to take specific actions and implement appropriate measures to reduce its human and health economic burden...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906423/empowering-parents-of-australian-infants-and-children-in-hospital-translation-cultural-adaptation-and-validation-of-the-empowerment-of-parents-in-the-intensive-care-30-aus-questionnaire
#12
Fenella J Gill, Sally Wilson, Laurene Aydon, Gavin D Leslie, Jos M Latour
OBJECTIVES: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. DESIGN: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. SETTINGS: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906422/increased-risk-of-acute-kidney-injury-in-critically-ill-children-treated-with-vancomycin-and-piperacillin-tazobactam
#13
Maya R Holsen, Calvin J Meaney, Amanda B Hassinger, Nicholas M Fusco
OBJECTIVES: Compare the rates of acute kidney injury in critically ill children treated with vancomycin and piperacillin-tazobactam versus vancomycin and ceftriaxone. DESIGN: Retrospective cohort study. SETTING: A large tertiary care children's hospital in an urban setting. PATIENTS: Children greater than or equal to 2 months old admitted to the PICU who received greater than or equal to 48 consecutive hours of vancomycin and piperacillin-tazobactam or vancomycin and ceftriaxone...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906421/the-relationship-between-remoteness-and-outcomes-in-critically-ill-children
#14
Megan Sample, Anand Acharya, Katharine O'Hearn, Shane Livingstone, Kusum Menon
OBJECTIVE: A significant number of children live in remote geographic areas without direct access to tertiary care PICU. Our objective was to explore the relationship between remoteness and outcomes of critically ill children in Canada. DESIGN: Retrospective cohort study of patients admitted to the PICU from February 1, 2015, to January 31, 2016. SETTING: Pediatric tertiary care PICU in Canada. PATIENTS: All children admitted to PICU during the study period...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28817508/end-tidal-co2-guided-chest-compression-delivery-improves-survival-in-a-neonatal-asphyxial-cardiac-arrest-model
#15
Justin T Hamrick, Jennifer L Hamrick, Utpal Bhalala, Jillian S Armstrong, Jeong-Hoo Lee, Ewa Kulikowicz, Jennifer K Lee, Sapna R Kudchadkar, Raymond C Koehler, Elizabeth A Hunt, Donald H Shaffner
OBJECTIVES: To determine whether end-tidal CO2-guided chest compression delivery improves survival over standard cardiopulmonary resuscitation after prolonged asphyxial arrest. DESIGN: Preclinical randomized controlled study. SETTING: University animal research laboratory. SUBJECTS: 1-2-week-old swine. INTERVENTIONS: After undergoing a 20-minute asphyxial arrest, animals received either standard or end-tidal CO2-guided cardiopulmonary resuscitation...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28817507/comparison-of-consent-models-in-a-randomized-trial-of-corticosteroids-in-pediatric-septic-shock
#16
Kusum Menon, Katharine O'Hearn, James Dayre McNally, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVES: To describe the use of deferred and prior informed consent models in the context of a low additional risk to standard of care, placebo-controlled randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: An observational substudy of consent processes in a randomized controlled trial of hydrocortisone versus placebo. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years inclusive admitted to PICU with suspected septic shock between July 2014 and March 2016...
August 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28816920/similar-metabolic-innate-immunity-and-adipokine-profiles-in-adult-and-pediatric-sepsis-versus-systemic-inflammatory-response-syndrome-a-pilot-study
#17
Theonymfi Tavladaki, Anna Maria Spanaki, Helen Dimitriou, Efmorfia Kondili, Christianna Choulaki, Dimitris Georgopoulos, George Briassoulis
OBJECTIVES: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28816919/enteral-nutrition-practices-in-critically-ill-children-requiring-noninvasive-positive-pressure-ventilation
#18
Matthew K Leroue, Ryan J Good, Heather E Skillman, Angela S Czaja
OBJECTIVES: Evaluate the practice of providing enteral nutrition in critically ill children requiring noninvasive positive pressure ventilation. DESIGN: Retrospective cohort study. SETTING: PICU within a quaternary care children's hospital. PATIENTS: PICU patients older than 30 days requiring noninvasive positive pressure ventilation for greater than or equal to 24 hours from August 2014 to June 2015. Invasive mechanical ventilation prior to noninvasive positive pressure ventilation and inability to receive enteral nutrition at baseline were additional exclusionary criteria...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28800001/basic-hemodynamic-monitoring-using-ultrasound-or-electrical-cardiometry-during-transportation-of-neonates-and-infants
#19
Angele Boet, Gilles Jourdain, Serge Demontoux, Sebastien Hascoet, Pierre Tissieres, Catherine Rucker-Martin, Daniele De Luca
OBJECTIVES: Electrical cardiometry and heart ultrasound might allow hemodynamic evaluation during transportation of critically ill patients. Our aims were 1) to test feasibility of stroke volume monitoring using electrical cardiometry or ultrasound during transportation and 2) to investigate if transportation impacts on electrical cardiometry and ultrasound reliability. DESIGN: Prospective, pragmatic, feasibility cohort study. SETTING: Mobile ICUs specialized for neonatal and pediatric transportation...
August 9, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28777139/fluid-bolus-over-15-20-versus-5-10-minutes-each-in-the-first-hour-of-resuscitation-in-children-with-septic-shock-a-randomized-controlled-trial
#20
Jhuma Sankar, Javed Ismail, M Jeeva Sankar, Suresh C P, Rameshwar S Meena
OBJECTIVES: To compare the effect of administration of 40-60 mL/kg of fluids as fluid boluses in aliquots of 20 mL/kg each over 15-20 minutes with that over 5-10 minutes each on the composite outcome of need for mechanical ventilation and/or impaired oxygenation-increase in oxygenation index by 5 from baseline in the initial 6 and 24 hours in children with septic shock. DESIGN: Randomized controlled trial. SETTING: Pediatric emergency and ICU of a tertiary care institute...
August 2, 2017: Pediatric Critical Care Medicine
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