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Pediatric Critical Care Medicine

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https://www.readbyqxmd.com/read/29979331/risk-factors-for-mortality-in-children-admitted-for-suspected-malaria-to-a-pediatric-emergency-ward-in-a-low-resource-setting-a-case-control-study
#1
Francesco Cavallin, Luigi Pisani, Lorenzo Stancari, Vandi Massaquoi, Allieu Sharif, Enzo Pisani, Giovanni Putoto, Daniele Trevisanuto
OBJECTIVES: To identify the risk factors for mortality after admission for suspected malaria in a pediatric emergency ward in Sierra Leone. DESIGN: Retrospective case-control. SETTING: Pujehun Hospital Pediatric Ward in Pujehun, Sierra Leone. PATIENTS: All cases were pediatric deaths after admission for suspected malaria at the Pujehun Hospital Pediatric Ward between January 1, 2015, and May 31, 2016. The case-control ratio was 1:1...
July 2, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29965888/factors-associated-with-mortality-in-children-who-successfully-wean-from-extracorporeal-membrane-oxygenation
#2
Taylor S Howard, Brian T Kalish, Satish K Rajagopal, Kathryn Williams, Jill Zalieckas, Ravi R Thiagarajan, Peta M A Alexander
OBJECTIVES: Extracorporeal membrane oxygenation is an established therapy for cardiac and respiratory failure unresponsive to usual care. Extracorporeal membrane oxygenation mortality remains high, with ongoing risk of death even after successful decannulation. We describe occurrence and factors associated with mortality in children weaned from extracorporeal membrane oxygenation. DESIGN: Retrospective cohort study. SETTING: Two hundred five extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization...
June 29, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29939978/mortality-risk-using-a-pediatric-quick-sequential-sepsis-related-organ-failure-assessment-varies-with-vital-sign-thresholds
#3
Cheryl Peters, Srinivas Murthy, Rollin Brant, Niranjan Kissoon, Matthias Görges
OBJECTIVES: We evaluated adapting the quick Sequential (Sepsis-Related) Organ Failure Assessment score (fast respiratory rate, altered mental status, low blood pressure) for pediatric use by selecting thresholds from three commonly used definitions: Pediatric Logistic Organ Dysfunction 2, Pediatric Advanced Life Support, and International Pediatric Sepsis Consensus Conference. We examined their respective performance in identifying children who had a discharge diagnosis of infection at high risk of mortality using PICU registry data, with additional focus on the influence of age on performance...
June 22, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29933287/leak-compensation-during-volume-guarantee-with-the-dr%C3%A3-ger-babylog-vn500-neonatal-ventilator
#4
Eniko Szakmar, Colin J Morley, Gusztav Belteki
OBJECTIVES: To investigate how compensating for endotracheal tube leaks by targeting the leak-compensated tidal volume affects measured physiologic and ventilator variables during neonatal mechanical ventilation. DESIGN: Retrospective observational study. SETTING: A level III Neonatal ICU. PATIENTS: We enrolled 30 neonates who were ventilated using synchronized intermittent positive pressure mode with volume guarantee and had at least 12 hours of continuous detailed recording of ventilation variables...
June 21, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927880/fosphenytoin-population-pharmacokinetics-in-the-acutely-ill-pediatric-population
#5
Brady S Moffett, Mindl M Weingarten, Lindsay R Schmees, Marianne Galati, Jennifer Erklauer, James J Riviello
OBJECTIVE: The purpose of this study is to describe the pharmacokinetics of phenytoin in pediatric patients receiving fosphenytoin. DESIGN: Retrospective, population pharmacokinetic analysis. SETTING: Emergency department or PICU of a large tertiary care children's hospital. PATIENTS: Patients less than 19 years old who received fosphenytoin in the PICU or emergency center for treatment of seizures from January 2011 to June 2017 were included...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927879/no-requirement-for-targeted-theophylline-levels-for-diuretic-effect-of-aminophylline-in-critically-ill-children
#6
Katie Park, Lindsay C Trout, Cong Xu, Ming Wang, Robert F Tamburro, E Scott Halstead
OBJECTIVES: To determine the relationship between theophylline trough levels and urine output in critically ill children administered aminophylline as adjunctive diuretic therapy. DESIGN: Retrospective cohort study. SETTING: The PICU of a tertiary care children's hospital. PATIENTS: A mixed population of medical/surgical including postoperative cardiothoracic surgery patients less than 18 years old. INTERVENTIONS: Electronic medical records of all PICU patients admitted from July 2010 to June 2015 were reviewed, and patients who received aminophylline as diuretic therapy were identified...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927878/admission-hyperoxia-is-a-risk-factor-for-mortality-in-pediatric-intensive-care
#7
Andrew Numa, Himanshu Aneja, John Awad, Hari Ravindranathan, Puneet Singh, Kevin Swil, Gary Williams
OBJECTIVES: To determine whether the association between hyperoxia and increased risk-adjusted mortality in adult intensive care patients is also observed in a pediatric intensive care population. DESIGN: Single-center retrospective analysis of admissions to ICU over a 5-year period commencing January 1, 2012, examining the relationship between PaO2 measured within the first hour of admission and risk-adjusted mortality. Standardized mortality rates were calculated using the Pediatric Index of Mortality-3, and patients were grouped into 50 mm Hg (6...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927877/platelet-transfusions-in-the-picu-does-disease-severity-matter
#8
Arun Saini, Alina N West, Camden Harrell, Tamekia L Jones, Marianne E Nellis, Ashwini D Joshi, Krista M Cowan, Connor W Gatewood, Alex B Ryder, Ulrike M Reiss
OBJECTIVES: Pediatric intensivists frequently prescribe platelet transfusions to critically ill children, but there are limited data on platelet transfusion practice and platelet transfusion-related outcomes in the PICU. In this study, we evaluated the current platelet transfusion practice and platelet transfusion-related outcomes in the PICU. DESIGN: Institutional review board-approved, retrospective cohort study from January 2010 to March 2016. SETTING: Tertiary-level PICU...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923942/safety-and-efficacy-of-iv-lidocaine-in-the-treatment-of-children-and-adolescents-with-status-migraine
#9
Marco Antonio Ayulo, Keri Ellen Phillips, Sandeep Tripathi
OBJECTIVES: To evaluate the safety and efficacy of IV lidocaine in treating children and adolescents with status migraine. DESIGN: Retrospective observational study. SETTING: Single center PICU. PATIENTS: Children and adolescents admitted with status migraine. INTERVENTION: IV lidocaine. MEASUREMENT AND MAIN RESULTS: Thirty-three lidocaine infusions were administered to 28 patients with status migraine...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923941/intensive-care-mortality-prognostic-model-for-pediatric-pulmonary-hypertension
#10
Emily Morell Balkin, Matt S Zinter, Satish K Rajagopal, Roberta L Keller, Jeffrey R Fineman, Martina A Steurer
OBJECTIVES: The disease burden and mortality of children with pulmonary hypertension are significantly higher than for the general PICU population. We aimed to develop a risk-adjustment tool predicting PICU mortality for pediatric pulmonary hypertension patients: the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score. DESIGN: Retrospective analysis of prospectively collected multicenter pediatric critical care data. SETTING: One-hundred forty-three centers submitting data to Virtual Pediatric Systems database between January 1, 2009, and December 31, 2015...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923940/factors-associated-with-mechanical-ventilation-use-in-children-with-sickle-cell-disease-and-acute-chest-syndrome
#11
Takuto Takahashi, Yusuke Okubo, Maria A Pereda, Atsuhiko Handa, Scott Miller
OBJECTIVES: Acute chest syndrome is the leading cause of death in children with sickle cell disease and is generally due to respiratory failure. Epidemiologic factors for a need for mechanical ventilation in children with acute chest syndrome require further clarification. DESIGN: Retrospective observational study. SETTING: Nationally representative pediatric inpatient records in the United States by using the Kids' Inpatient Database for the years 2003, 2006, 2009, and 2012...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923939/picu-provider-supply-and-demand-a-national-survey
#12
Kristin H Gigli, Mary S Dietrich, Peter I Buerhaus, Ann F Minnick
OBJECTIVES: To describe physicians' and nurse practitioners' perceptions of the national and local PICU physician and other provider supply in institutions that employ PICU nurse practitioners, assess for differences in perceptions of supply, and evaluate the intent of institutions to hire additional nurse practitioners to work in PICUs. DESIGN: National, quantitative, cross-sectional descriptive study via a postal mail survey from October 2016 to January 2017. SETTING: Institutions (n = 140) identified in the 2015 American Hospital Association Annual Survey with a PICU who employ PICU nurse practitioners...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923938/predictive-factors-for-central-line-associated-bloodstream-infections-in-pediatric-cardiac-surgery-patients-with-chylothorax
#13
Stephanie G Waterhouse, Jeffrey E Vergales, Mark R Conaway, Laura Lee
OBJECTIVES: To assess the prevalence of central line-associated bloodstream infections in pediatric patients with and without chylothorax after cardiac surgery and identify risk factors that predict those patients at highest risk for developing a central line-associated bloodstream infection. DESIGN: Retrospective single-center cohort study. SETTING: A PICU located within a tertiary-care academic pediatric hospital. PATIENTS: All pediatric patients admitted to the PICU after cardiac surgery between 2008 and 2014...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923937/pulmonary-functions-in-children-ventilated-for-acute-hypoxemic-respiratory-failure
#14
Stanzen Chakdour, Pankaj C Vaidya, Suresh Kumar Angurana, Jayashree Muralidharan, Meenu Singh, Sunit C Singhi
OBJECTIVE: To assess pulmonary functions of children who received mechanical ventilation for acute hypoxemic respiratory failure. DESIGN: Longitudinal study. SETTING: PICU and Pediatric Pulmonology Clinic of a tertiary care teaching hospital in North India. PATIENTS: All children, 5-12 years old, ventilated for acute hypoxemic respiratory failure in PICU from July 2012 to June 2013 and survived. INTERVENTIONS: The baseline admission variables recorded were as follows: age, sex, duration of illness, primary diagnosis at admission, Pediatric Risk of Mortality III score, lung injury score, mechanical ventilation parameters, oxygenation indices, and duration of PICU stay...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923936/multiple-micronutrient-plasma-level-changes-are-related-to-oxidative-stress-intensity-in-critically-ill-children
#15
Frédéric V Valla, Muriel Bost, Sylvain Roche, Marion Pitance, Charlotte Cuerq, Jenna Ridout, René Ecochard, Tiphanie Ginhoux, Amandine Bellon, Carole Ford-Chessel, Aurélie Portefaix, Etienne Javouhey, Emilie Blond
OBJECTIVES: Micronutrient supplementation in critically ill adults remains controversial. In the pediatric setting, the impact of oxidative stress on the overall micronutrient status has been poorly explored, due to the limited number of studies and to confounding factors (i.e., malnutrition or extra losses). In order to better understand this phenomenon, we aim to describe micronutrient status, focusing on seven micronutrients, in well-nourished critically ill children presenting with severe oxidative stress...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29923935/comparison-of-pediatric-cardiopulmonary-resuscitation-quality-in-classic-cardiopulmonary-resuscitation-and-extracorporeal-cardiopulmonary-resuscitation-events-using-video-review
#16
Mahsheed Taeb, Amanda B Levin, Michael C Spaeder, Jamie M Schwartz
OBJECTIVES: To assess differences in cardiopulmonary resuscitation quality in classic cardiopulmonary resuscitation versus extracorporeal cardiopulmonary resuscitation events using video recordings of actual pediatric cardiac arrest events. DESIGN: Single-center, prospective, observational trial. SETTING: Tertiary-care pediatric teaching hospital, cardiac ICU. PATIENTS: All patients admitted to the pediatric cardiac ICU with cardiopulmonary resuscitation events lasting greater than 2 minutes captured on video...
June 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912813/an-observational-cohort-feasibility-study-to-identify-microvesicle-and-micro-rna-biomarkers-of-acute-kidney-injury-following-pediatric-cardiac-surgery
#17
Nikol Sullo, Silvia Mariani, Maria JnTala, Tracy Kumar, Marcin J Woźniak, Dawn Smallwood, Paolo Pais, Claire Westrope, Attilio Lotto, Gavin J Murphy
OBJECTIVES: Micro-RNA, small noncoding RNA fragments involved in gene regulation, and microvesicles, membrane-bound particles less than 1 μm known to regulate cellular processes including responses to injury, may serve as disease-specific biomarkers of acute kidney injury. We evaluated the feasibility of measuring these signals as well as other known acute kidney injury biomarkers in a mixed pediatric cardiac surgery population. DESIGN: Single center prospective cohort feasibility study...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912812/multicenter-review-of-current-practices-associated-with-venous-thromboembolism-prophylaxis-in-pediatric-patients-after-trauma
#18
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
June 15, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912070/the-impact-of-massage-and-reading-on-children-s-pain-and-anxiety-after-cardiovascular-surgery-a-pilot-study
#19
Sandra L Staveski, Karen Boulanger, Lee Erman, Li Lin, Christina Almgren, Chloe Journel, Stephen J Roth, Brenda Golianu
OBJECTIVES: The purpose of this pilot study was three-fold: 1) to evaluate the safety and feasibility of instituting massage therapy in the immediate postoperative period after congenital heart surgery, 2) to examine the preliminary results on effects of massage therapy versus standard of care plus three reading visits on postoperative pain and anxiety, and 3) to evaluate preliminary effects of opioid and benzodiazepine exposure in patients receiving massage therapy compared with reading controls...
June 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29912069/the-impact-of-critical-care-nursing-certification-on-pediatric-patient-outcomes
#20
Patricia A Hickey, Kimberlee Gauvreau, Courtney Porter, Jean A Connor
OBJECTIVES: To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States. DESIGN: A cross-sectional descriptive survey of nursing and organizational characteristics was sent electronically. SETTING: Free-standing children's hospitals in the United States...
June 14, 2018: Pediatric Critical Care Medicine
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