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Pediatric Critical Care Medicine

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https://www.readbyqxmd.com/read/29329165/repeat-rapid-response-events-in-children-characteristics-and-outcomes
#1
Kristen M Meulmester, Nancy Jaimon, Aarti C Bavare
OBJECTIVE: We describe the characteristics and outcomes of pediatric repeat rapid response events within a single hospitalization. We hypothesized that triggers for repeat rapid response and initial rapid response events are similar, and repeat rapid response events are associated with high prevalence of medical complexity and worse outcomes. DESIGN: A 3-year retrospective study. SETTING: High-volume tertiary academic pediatric hospital. PATIENTS: All rapid response events were reviewed to identify repeat rapid response events...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29329164/a-systematic-review-of-risk-factors-associated-with-cognitive-impairment-after-pediatric-critical-illness
#2
Alicia G Kachmar, Sharon Y Irving, Cynthia A Connolly, Martha A Q Curley
OBJECTIVES: To identify risk factors associated with cognitive impairment as assessed by neuropsychologic tests in neurotypical children after critical illness. DATA SOURCES: For this systematic review, we searched the Cochrane Library, Scopus, PubMed, Ovid, Embase, and CINAHL databases from January 1960 to March 2017. STUDY SELECTION: Included were studies with subjects 3-18 years old at the time of post PICU follow-up evaluation and use of an objective standardized neuropsychologic test with at least one cognitive functioning dimension...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29329163/the-importance-of-parental-connectedness-and-relationships-with-healthcare-professionals-in-end-of-life-care-in-the-picu
#3
Jeannette L Falkenburg, Dick Tibboel, Ruard R Ganzevoort, Saskia J Gischler, Monique van Dijk
OBJECTIVES: Support from healthcare professionals in a PICU is highly valuable for parents of dying children. The way they care for the patients and their families affects the parents' initial mourning process. This study explores what interaction with hospital staff is meaningful to parents in existential distress when their child is dying in the PICU. DESIGN: Qualitative interview study. SETTING: Level 3 PICU in the Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, and the Netherlands...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29329162/reorganizing-care-with-the-implementation-of-electronic-medical-records-a-time-motion-study-in-the-picu
#4
Nadia Roumeliotis, Geneviève Parisien, Sylvie Charette, Elizabeth Arpin, Fabrice Brunet, Philippe Jouvet
OBJECTIVES: To assess caregivers' patient care time before and after the implementation of a reorganization of care plan with electronic medical records. DESIGN: A prospective, observational, time-motion study. SETTING: A level 3 PICU. PARTICIPANTS: Nurses and orderlies caring for intubated patients during an 8-hour work shift before (2008-2009) and after (2016) implementation of reorganization of care in 2013. INTERVENTIONS: The reorganization plan included improved telecommunication for healthcare workers, increased tasks delegated to orderlies, and an ICU-specific electronic medical record (Intellispace Critical Care and Anesthesia information system, Philips Healthcare)...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319635/low-dose-epinephrine-boluses-for-acute-hypotension-in-the-picu
#5
Pamela D Reiter, Jennifer Roth, Beth Wathen, Jaime LaVelle, Leslie A Ridall
OBJECTIVES: To describe the use of low-dose bolus epinephrine in critically ill children during an acute hypotensive episode or prearrest condition. DESIGN: Institutional Review Board approved, single-center, retrospective medical chart review. SETTING: Large medical-surgical PICU within a freestanding, tertiary care children's hospital. PATIENTS: Patients admitted to the PICU between June 1, 2015, and June 1, 2016, who received low-dose (≤ 5 µg/kg) IV bolus epinephrine...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319634/hyperoxia-and-hypocapnia-during-pediatric-extracorporeal-membrane-oxygenation-associations-with-complications-mortality-and-functional-status-among-survivors
#6
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Robert Tamburro, Kathleen L Meert
OBJECTIVES: To determine the frequency of hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation and their relationships to complications, mortality, and functional status among survivors. DESIGN: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network. SETTING: Eight Collaborative Pediatric Critical Care Research Network-affiliated hospitals. PATIENTS: Age less than 19 years and treated with extracorporeal membrane oxygenation...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319633/risk-factors-for-healthcare-associated-infections-after-pediatric-cardiac-surgery
#7
Takeshi Hatachi, Kazuya Tachibana, Yu Inata, Yuji Tominaga, Aiko Hirano, Miyako Kyogoku, Kazue Moon, Yoshiyuki Shimizu, Kanako Isaka, Muneyuki Takeuchi
OBJECTIVES: Healthcare-associated infections after pediatric cardiac surgery are significant causes of morbidity and mortality. We aimed to identify the risk factors for the occurrence of healthcare-associated infections after pediatric cardiac surgery. DESIGN: Retrospective, single-center observational study. SETTING: PICU at a tertiary children's hospital. PATIENTS: Consecutive pediatric patients less than or equal to 18 years old admitted to the PICU after cardiac surgery, between January 2013 and December 2015...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29319632/extracorporeal-membrane-oxygenation-for-pertussis-predictors-of-outcome-including-pulmonary-hypertension-and-leukodepletion
#8
Michele Domico, Deborah Ridout, Graeme MacLaren, Ryan Barbaro, Gail Annich, Luregn J Schlapbach, Katherine L Brown
OBJECTIVE: The recent increase of pertussis cases worldwide has generated questions regarding the utility of extracorporeal membrane oxygenation for children with pertussis. We aimed to evaluate factors associated with extracorporeal membrane oxygenation outcome. DESIGN: The study was designed in two parts: a retrospective analysis of the Extracorporeal Life Support Organization Registry to identify factors independently linked to outcome, and an expanded dataset from individual institutions to examine the association of WBC count, pulmonary hypertension, and leukodepletion with survival...
January 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#9
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29315136/renal-replacement-therapy-in-the-critically-ill-child
#10
Claire A Westrope, Sarah Fleming, Melpo Kapetanstrataki, Roger C Parslow, Kevin P Morris
OBJECTIVES: Although renal replacement therapy is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated outcomes, in critically ill children across the United Kingdom in the largest cohort study of this patient group. DESIGN: A retrospective observational study using prospectively collected data. SETTING: Data from the Pediatric Intensive Care Audit Network database which collects data on all children admitted to U...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29252866/latin-american-consensus-for-pediatric-cardiopulmonary-resuscitation-2017-latin-american-pediatric-critical-care-society-pediatric-cardiopulmonary-resuscitation-committee
#11
Jesús López-Herce, Enma Almonte, Manuel Alvarado, Norma Beatriz Bogado, Mariana Cyunel, Raffo Escalante, Christiane Finardi, Gustavo Guzmán, Juan C Jaramillo-Bustamante, Claudia C Madrid, Martha Matamoros, Luis Augusto Moya, Grania Obando, Gaspar Reboredo, Lissette R López, Christian Scheu, Alejandro Valenzuela, Rocío Yerovi, Adriana Yock-Corrales
OBJECTIVES: To develop a Latin American Consensus about Pediatric Cardiopulmonary Resuscitation. To clarify, reinforce, and adapt some specific recommendations for pediatric patients and to stimulate the implementation of these recommendations in clinical practice. DESIGN: Expert consensus recommendations with Delphi methodology. SETTING: Latin American countries. SUBJECTS: Experts in pediatric cardiopulmonary resuscitation from 19 Latin American countries...
December 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29252865/effect-of-location-on-tracheal-intubation-safety-in-cardiac-disease-are-cardiac-icus-safer
#12
Eleanor A Gradidge, Adnan Bakar, David Tellez, Michael Ruppe, Sarah Tallent, Geoffrey Bird, Natasha Lavin, Anthony Lee, Michelle Adu-Darko, Jesse Bain, Katherine Biagas, Aline Branca, Ryan K Breuer, Calvin Brown, G Kris Bysani, Ira M Cheifitz, Guillaume Emeriaud, Sandeep Gangadharan, John S Giuliano, Joy D Howell, Conrad Krawiec, Jan Hau Lee, Simon Li, Keith Meyer, Michael Miksa, Natalie Napolitano, Sholeen Nett, Gabrielle Nuthall, Alberto Orioles, Erin B Owen, Margaret M Parker, Simon Parsons, Lee A Polikoff, Kyle Rehder, Osamu Saito, Ronald C Sanders, Asha N Shenoi, Dennis W Simon, Peter W Skippen, Keiko Tarquinio, Anne Thompson, Iris Toedt-Pingel, Paula Vanderford, Karen Walson, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Evaluate differences in tracheal intubation-associated events and process variances (i.e., multiple intubation attempts and oxygen desaturation) between pediatric cardiac ICUs and noncardiac PICUs in children with underlying cardiac disease. DESIGN: Retrospective cohort study using a multicenter tracheal intubation quality improvement database (National Emergency Airway Registry for Children). SETTING: Thirty-six PICUs (five cardiac ICUs, 31 noncardiac ICUs) from July 2012 to March 2016...
December 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239980/derivation-and-internal-validation-of-a-mortality-prediction-tool-for-initial-survivors-of-pediatric-in-hospital-cardiac-arrest
#13
Mathias J Holmberg, Ari Moskowitz, Tia T Raymond, Robert A Berg, Vinay M Nadkarni, Alexis A Topjian, Anne V Grossestreuer, Michael W Donnino, Lars W Andersen
OBJECTIVES: To develop a clinical prediction score for predicting mortality in children following return of spontaneous circulation after in-hospital cardiac arrest. DESIGN: Observational study using prospectively collected data. SETTING: This was an analysis using data from the Get With The Guidelines-Resuscitation registry between January 2000 and December 2015. PATIENTS: Pediatric patients (< 18 yr old) who achieved return of spontaneous circulation...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239979/monitoring-haloperidol-plasma-concentration-and-associated-adverse-events-in-critically-ill-children-with-delirium-first-results-of-a-clinical-protocol-aimed-to-monitor-efficacy-and-safety
#14
Valerie D Slooff, Desley K van den Dungen, Babette S van Beusekom, Naomi Jessurun, Erwin Ista, Dick Tibboel, Saskia N de Wildt
OBJECTIVES: As delirium in critically ill children is increasingly recognized, more children are treated with the antipsychotic drug haloperidol, while current dosing guidelines are lacking solid evidence and appear to be associated with a high risk of adverse events. We aim to report on the safety and efficacy of a recently implemented clinical dose-titration protocol with active monitoring of adverse events. DESIGN: From July 2014 until June 2015, when a potential delirium was identified by regular delirium scores and confirmed by a child psychiatrist, haloperidol was prescribed according to the Dutch Pediatric Formulary...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29239978/picu-length-of-stay-factors-associated-with-bed-utilization-and-development-of-a-benchmarking-model
#15
Murray M Pollack, Richard Holubkov, Ron Reeder, J Michael Dean, Kathleen L Meert, Robert A Berg, Christopher J L Newth, John T Berger, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, Tammara L Jenkins, Robert Tamburro
OBJECTIVES: ICU length of stay is an important measure of resource use and economic performance. Our primary aims were to characterize the utilization of PICU beds and to develop a new model for PICU length of stay. DESIGN: Prospective cohort. The main outcomes were factors associated with PICU length of stay and the performance of a regression model for length of stay. SETTING: Eight PICUs. PATIENTS: Randomly selected patients (newborn to 18 yr) from eight PICUs were enrolled from December 4, 2011, to April 7, 2013...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29227437/reducing-childhood-admissions-to-the-picu-for-poisoning-recap2-by-predicting-unnecessary-picu-admissions-after-acute-intoxication
#16
Meral M Patel, Curtis D Travers, Jana A Stockwell, Ezaldeen A Numur, Robert J Geller, Pradip P Kamat, Jocelyn R Grunwell
OBJECTIVE: To derive and validate clinical prediction models to identify children at low risk of clinically significant intoxications for whom intensive care admission is unnecessary. DESIGN: Retrospective review of data in the National Poison Data Systems from 2011 to 2014 and Georgia Poison Center cases from July to December 2016. SETTING: United States PICUs and poison centers participating in the American Association of Poison Control Centers from 2011 to 2016...
December 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29227436/the-effect-of-acetaminophen-on-temperature-in-critically-ill-children-a-retrospective-analysis-of-over-50-000-doses
#17
Samiran Ray, Libby Rogers, Katherine L Brown, Mark J Peters
OBJECTIVES: Acetaminophen is widely used in PICUs. Although randomized controlled trials suggest that acetaminophen significantly reduces body temperature in adults, the effect of acetaminophen on temperature in critically ill children has not been previously quantified. DESIGN: Retrospective observational cohort study. SETTING: Single-center general and cardiac PICU in a specialist children's hospital. PATIENTS: All children who received acetaminophen or had a fever (temperature ≥ 38°C) while on the ICU over a 40-month period (September 2012 to December 2015)...
December 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29215400/five-year-survival-and-causes-of-death-in-children-after-intensive-care-a-national-registry-study
#18
Elina Kyösti, Janne H Liisanantti, Outi Peltoniemi, Pasi Ohtonen, Paula Rautiainen, Janne Kataja, Tero Ala-Kokko
OBJECTIVES: The aim of the study was to compare long-term mortality and causes of death in children post admission to an ICU with a control population of same age. DESIGN: Longitudinal follow-up study. SETTING: Registry study of a national ICU register and hospital registries. PATIENTS: Children admitted to an ICU in the years 2009 and 2010. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The mortality and causes of death following ICU discharge were analyzed retrospectively...
December 6, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206731/enteral-feeding-practices-in-infants-with-congenital-heart-disease-across-european-picus-a-european-society-of-pediatric-and-neonatal-intensive-care-survey
#19
Lyvonne N Tume, Reinis Balmaks, Eduardo da Cruz, Lynne Latten, Sascha Verbruggen, Frédéric V Valla
OBJECTIVES: To describe enteral feeding practices in pre and postoperative infants with congenital heart disease in European PICUs. DESIGN: Cross-sectional electronic survey. SETTING: European PICUs that admit infants with congenital heart disease pre- and postoperatively. PARTICIPANTS: One senior PICU physician or designated person per unit. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Fifty-nine PICUs from 18 European countries responded to the survey...
December 4, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29206730/understanding-the-impact-of-fluid-restriction-on-growth-outcomes-in-infants-following-cardiac-surgery
#20
Melissa Li, Adriana Campa, Fatma G Huffman, Anthony F Rossi
OBJECTIVE: Fluid restriction is reported to be a barrier in providing adequate nutrition following cardiac surgery. The specific aim of this study was to evaluate the adequacy of nutritional intake during the postoperative period using anthropometrics by comparing preoperative weight status, as measured by weight-for-age z scores, to weight status at discharge home. DESIGN: Prospective cohort study. SETTING: Cardiac ICU at Miami Children's Hospital...
December 4, 2017: Pediatric Critical Care Medicine
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