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Pediatric Critical Care Medicine

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https://www.readbyqxmd.com/read/28800001/basic-hemodynamic-monitoring-using-ultrasound-or-electrical-cardiometry-during-transportation-of-neonates-and-infants
#1
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
#2
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
https://www.readbyqxmd.com/read/28746169/traditional-long-term-central-venous-catheters-versus-transhepatic-venous-catheters-in-infants-and-young-children
#3
Amanda Marie Marshall, David A Danford, Christopher L Curzon, Venus Anderson, Jeffrey W Delaney
OBJECTIVES: Children with congenital heart disease may require long-term central venous access for intensive care management; however, central venous access must also be preserved for future surgical and catheterization procedures. Transhepatic venous catheters may be an useful alternative. The objective of this study was to compare transhepatic venous catheters with traditional central venous catheters regarding complication rate and duration of catheter service. DESIGN: Retrospective review of 12 congenital heart disease patients from September 2013 to July 2015 who underwent placement of one or more transhepatic venous catheters...
July 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#4
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28742723/supraglottic-atomization-of-surfactant-in-spontaneously-breathing-lambs-receiving-continuous-positive-airway-pressure
#5
Ilaria Milesi, David G Tingay, Anna Lavizzari, Federico Bianco, Emanuela Zannin, Paolo Tagliabue, Fabio Mosca, Maria Luisa Ventura, Anushi Rajapaksa, Elizabeth J Perkins, Don Black, Marco Di Castri, Magdy Sourial, Gerhard Pohlmann, Raffaele L Dellaca'
OBJECTIVES: To determine the short-term tolerance, efficacy, and lung deposition of supraglottic atomized surfactant in spontaneously breathing lambs receiving continuous positive airway pressure. DESIGN: Prospective, randomized animal study. SETTING: Animal research laboratory. SUBJECTS: Twenty-two preterm lambs on continuous positive airway pressure (132 ± 1 d gestational age). INTERVENTIONS: Animals receiving continuous positive airway pressure via binasal prongs at 8 cm H2O were randomized to receive atomized surfactant at approximately 60-minute of life (atom; n = 15) or not (control; n = 7)...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#6
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737599/interhospital-transport-of-children-undergoing-cardiopulmonary-resuscitation-a-practical-and-ethical-dilemma
#7
Corina Noje, Jennifer N Fishe, Philomena M Costabile, Bruce L Klein, Elizabeth A Hunt, Peter J Pronovost
OBJECTIVES: To discuss risks and benefits of interhospital transport of children in cardiac arrest undergoing cardiopulmonary resuscitation. DESIGN: Narrative review. RESULTS: Not applicable. CONCLUSIONS: Transporting children in cardiac arrest with ongoing cardiopulmonary resuscitation between hospitals is potentially lifesaving if it enables access to resources such as extracorporeal support, but may risk transport personnel safety...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737598/epidemiology-and-outcomes-of-cardiac-arrest-in-pediatric-cardiac-icus
#8
Jeffrey A Alten, Darren Klugman, Tia T Raymond, David S Cooper, Janet E Donohue, Wenying Zhang, Sara K Pasquali, Michael G Gaies
OBJECTIVES: In-hospital cardiac arrest occurs in 2.6-6% of children with cardiac disease and is associated with significant morbidity and mortality. Much remains unknown about cardiac arrest in pediatric cardiac ICUs; therefore, we aimed to describe cardiac arrest epidemiology in a contemporary multicenter cardiac ICU cohort. DESIGN: Retrospective analysis within the Pediatric Cardiac Critical Care Consortium clinical registry. SETTING: Cardiac ICUs within 23 North American hospitals...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737597/a-prospective-study-of-the-association-between-clinically-significant-bleeding-in-picu-patients-and-thrombocytopenia-or-prolonged-coagulation-times
#9
Paul C Moorehead, Nicholas J Barrowman, Janelle Cyr, Jamie Ray, Robert Klaassen, Kusum Menon
OBJECTIVE: There are no proven methods to predict the risk of clinically significant bleeding in the PICU. A retrospective study identified platelet count as a risk marker for clinically significant bleeding. We conducted a study to examine any association of platelet count, international normalized ratio, and activated partial thromboplastin time with bleeding risk in PICU patients. DESIGN: Prospective observational cohort study. SETTING: The PICU at the Children's Hospital of Eastern Ontario, a university-affiliated tertiary care pediatric center...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737596/creating-a-controlled-arterio-venous-shunt-by-reversing-the-extracorporeal-membrane-oxygenation-blood-flow-a-strategy-for-weaning-patients-off-veno-arterial-extracorporeal-membrane-oxygenation
#10
Christian Adrian Mattke, Emma Haisz, Nischal Pandya, Anthony Black, Prem Venugopal
OBJECTIVES: To assess whether reversing the veno-arterial extracorporeal membrane oxygenation blood flow (thereby creating a controlled arterio-venous shunt) can be used to wean children off extracorporeal membrane oxygenation. The standard practice for weaning patients off VA extracorporeal membrane oxygenation is to gradually reduce the blood flows delivered through the extracorporeal membrane oxygenation pump to a minimum level followed by either insertion of an "arterio-venous bridge" and clamping of the blood flow to the patient or direct decannulation...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737595/time-of-admission-to-the-picu-and-mortality
#11
Michael C McCrory, Michael C Spaeder, Emily W Gower, Thomas A Nakagawa, Sean L Simpson, Mary A Coleman, Peter E Morris
OBJECTIVES: To evaluate for any association between time of admission to the PICU and mortality. DESIGN: Retrospective cohort study of admissions to PICUs in the Virtual Pediatric Systems (VPS, LLC, Los Angeles, CA) database from 2009 to 2014. SETTING: One hundred and twenty-nine PICUs in the United States. PATIENTS: Patients less than 18 years old admitted to participating PICUs; excluding those post cardiac bypass...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737594/identifying-risk-for-acute-kidney-injury-in-infants-and-children-following-cardiac-arrest
#12
Tara M Neumayr, Jeff Gill, Julie C Fitzgerald, Avihu Z Gazit, Jose A Pineda, Robert A Berg, J Michael Dean, Frank W Moler, Allan Doctor
OBJECTIVES: Our goal was to identify risk factors for acute kidney injury in children surviving cardiac arrest. DESIGN: Retrospective analysis of a public access dataset. SETTING: Fifteen children's hospitals associated with the Pediatric Emergency Care Applied Research Network. PATIENTS: Two hundred ninety-six subjects between 1 day and 18 years old who experienced in-hospital or out-of-hospital cardiac arrest between July 1, 2003, and December 31, 2004...
July 21, 2017: Pediatric Critical Care Medicine
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
#13
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
#14
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
#15
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
#16
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
#17
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/28658198/professional-responsibility-consensus-and-conflict-a-survey-of-physician-decisions-for-the-chronically-critically-ill-in-neonatal-and-pediatric-intensive-care-units
#18
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
#19
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
#20
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
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