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treatment of shock in children

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https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#1
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28972153/pharmacochaperoning-in-a-drosophila-model-system-rescues-human-dopamine-transporter-variants-associated-with-infantile-juvenile-parkinsonism
#2
H M Mazhar Asjad, Ameya Kasture, Ali El-Kasaby, Michael Sackel, Thomas Hummel, Michael Freissmuth, Sonja Sucic
Point mutations in the gene encoding the human dopamine transporter (hDAT, SLC6A3) cause a syndrome of infantile/juvenile dystonia and parkinsonism. To unravel the molecular mechanism underlying these disorders and investigate possible pharmacological therapies, here we examined 13 disease-causing DAT mutants that were retained in the endoplasmic reticulum (ER) when heterologously expressed in HEK293 cells. In three of these mutants - i.e. hDAT-V158F, hDAT-G327R and hDAT-L368Q- the folding deficit was remedied with the pharmacochaperonenoribogaineor the heat shock protein 70 (HSP70)-inhibitor pifithrin-μ such that ER export of and radioligand binding and substrate uptake by these DAT mutants were restored...
September 29, 2017: Journal of Biological Chemistry
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#3
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28941540/adjunctive-steroid-therapy-for-treatment-of-pediatric-septic-shock
#4
REVIEW
Jerry J Zimmerman
Septic shock remains the major cause of childhood morbidity and mortality worldwide. Although early sepsis recognition, fluid resuscitation, timely administration of antimicrobials, and vasoactive-inotropic drug infusions are all key to achieving good sepsis outcomes, therapy using various steroid drug classes remains an attractive adjunctive intervention to minimize the duration of septic shock and transition to multiple organ dysfunction syndrome. All steroid drug classes possess biological plausibility to affect a beneficial clinical effect among children with septic shock, but none has undergone rigorous, prospective assessment in a large, high-quality pediatric interventional trial...
October 2017: Pediatric Clinics of North America
https://www.readbyqxmd.com/read/28905004/gastroenteritis-aggressive-versus-slow-treatment-for-rehydration-gastro-a-pilot-rehydration-study-for-severe-dehydration-who-plan-c-versus-slower-rehydration
#5
Kirsty A Houston, Jack G Gibb, Ayub Mpoya, Nchafatso Obonyo, Peter Olupot-Olupot, Margeret Nakuya, Jennifer A Evans, Elizabeth C George, Diana M Gibb, Kathryn Maitland
BACKGROUND: The World Health Organization (WHO) rehydration management guidelines (Plan C) for children with acute gastroenteritis (AGE) and severe dehydration are widely practiced in resource-poor settings, yet have never been formally evaluated in a clinical trial. A recent audit of outcome of AGE at Kilifi County Hospital, Kenya noted that 10% of children required high dependency care (20% mortality) and a number developed fluid-related complications. The fluid resuscitation trial, FEAST, conducted in African children with severe febrile illness, demonstrated higher mortality with fluid bolus therapy and raised concerns regarding the safety of rapid intravenous rehydration therapy...
2017: Wellcome Open Research
https://www.readbyqxmd.com/read/28881515/-characteristics-of-epidemiology-and-antimicrobial-resistance-of-gram-negative-bacterial-bloodstream-infections-in-children
#6
L Dong, X Y Zhang, C C Li, Z Li, Y Q Xia
Objective: To study the epidemiology and antimicrobial resistance of Gram-negative bacterial bloodstream infections in children, and to guide the choice of antimicrobials and the control of nosocomial infection. Method: Clinical data, bacteriology and antimicrobial susceptibility test results were collected retrospectively in hospitalized children who were diagnosed with gram-negative bacterial bloodstream infections in Yuying Children's Hospital of Wenzhou Medical University from January, 2010 to December, 2015...
September 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28873333/role-of-echocardiography-in-reducing-shock-reversal-time-in-pediatric-septic-shock-a-randomized-controlled-trial
#7
Ahmed A El-Nawawy, Aly M Abdelmohsen, Hadir M Hassouna
OBJECTIVE: To evaluate the role of echocardiography in reducing shock reversal time in pediatric septic shock. METHODS: A prospective study conducted in the pediatric intensive care unit of a tertiary care teaching hospital from September 2013 to May 2016. Ninety septic shock patients were randomized in a 1:1 ratio for comparing the serial echocardiography-guided therapy in the study group with the standard therapy in the control group regarding clinical course, timely treatment, and outcomes...
September 3, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28868586/the-correlation-between-inferior-vena-cava-diameter-measured-by-ultrasonography-and-central-venous-pressure
#8
Hans Vaish, Virendra Kumar, Rama Anand, Viswas Chhapola, Sandeep Kumar Kanwal
OBJECTIVE: To find a correlation between inferior vena cava (IVC) diameters, IVC compressibility index (CI) and central venous pressure (CVP). METHODS: Prospective observational study was done at pediatric intensive care unit (PICU) of Kalawati Saran Children's Hospital (KSCH). Fifty children aged 5-18 y, presenting with shock were enrolled for the study. IVC diameters, CI and relevant clinical data were noted at enrollment, 30 min, 1 h, 6 h, and 12 h. Central line was placed at the time of admission...
September 4, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28841792/-importance-of-the-forensic-autopsy-in-the-diagnosis-of-septic-shock-a-case-report
#9
A Sibón-Olano, E Sánchez-Rodríguez, M Payá, E Barrera-Pérez, M Salguero-Villadiego, A Fernández-Rodríguez
Septic shock sometimes starts with unspecific symptoms that hamper the clinical diagnosis and, therefore an appropriate treatment. When the septic shock follows a fulminating course with a fatal outcome, the etiological diagnosis has to be conducted post-mortem. Sudden unexpected deaths in children and young adults are frequently the object of medico-legal autopsies. Some sudden unexpected deaths have an infectious origin, which requires further analyses, including microbiology, to establish the cause of death...
August 25, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28795054/sepsis-in-the-burn-patient-a-different-problem-than-sepsis-in-the-general-population
#10
REVIEW
David G Greenhalgh
Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28768513/clinical-and-laboratory-predictors-of-death-in-african-children-with-features-of-severe-malaria-a-systematic-review-and-meta-analysis
#11
Paulina Sypniewska, Jose F Duda, Isabella Locatelli, Clotilde Rambaud Althaus, Fabrice Althaus, Blaise Genton
BACKGROUND: The criteria for defining severe malaria have evolved over the last 20 years. We aimed to assess the strength of association of death with features currently characterizing severe malaria through a systematic review and meta-analysis. METHOD: Electronic databases (Medline, Embase, Cochrane Database of Systematic Reviews, Thomson Reuters Web of Knowledge) were searched to identify publications including African children with severe malaria. PRISMA guidelines were followed...
August 3, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28756458/comparison-of-intermediate-and-low-frequency-shock-wave-lithotripsy-for-pediatric-kidney-stones
#12
Onur Kaygısız, Hakan Kılıçarslan, Ahmet Mert, Burhan Coşkun, Yakup Kordan
The aim of the study to compare low and intermediate shock wave frequency rates in terms of success and complications for treating pediatric kidney stones. This retrospective study was performed on 58 consecutive pediatric patients (24 girls, 34 boys) who underwent shock wave lithotripsy (SWL) for kidney stones with an electrohydraulic lithotripter between April 2014 and March 2016. In the first year, all children underwent SWL with a frequency of 90 SWs/min as an intermediate frequency (Group 90), and in the second year all children were treated by SWL using 60 SWs/min as a low frequency (Group 60)...
July 29, 2017: Urolithiasis
https://www.readbyqxmd.com/read/28739652/in-hospital-quality-of-care-measures-for-pediatric-sepsis-syndrome
#13
Folafoluwa O Odetola, Gary Freed, Caroline Shevrin, Brian Madden, Julie McCormick, Kevin Dombkowski
BACKGROUND AND OBJECTIVES: Sepsis syndrome, comprising sepsis, severe sepsis, and septic shock, is a leading cause of child mortality and morbidity, for which the delivery of time-sensitive care leads to improved survival. We aimed to describe the development and testing of quality measures for in-hospital care of pediatric sepsis syndrome. METHODS: Seven measures of quality of care for children hospitalized with sepsis syndrome were developed by using an iterative process including literature review, development of concepts and candidate measures, and selection of measures for feasibility and importance by 2 panels of experts...
July 24, 2017: Pediatrics
https://www.readbyqxmd.com/read/28617763/short-term-peripheral-vasoactive-infusions-in-pediatrics-where-is-the-harm
#14
Jason T Patregnani, Anthony A Sochet, Darren Klugman
OBJECTIVE: Pediatric shock represents a major cause of morbidity and mortality in the United States. Standardization of treatment such as volume resuscitation and vasoactive administration has resulted in improved patient outcomes. Vasoactives have been anecdotally associated with peripheral IV infiltration and extravasation. There is a paucity of evidence in pediatrics to determine the ideal route of vasoactive infusions and what, if any, risk factors and harm are associated with peripheral IV infiltration and extravasation...
August 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28615900/predictors-of-outcome-in-children-with-status-epilepticus-during-resuscitation-in-pediatric-emergency-department-a-retrospective-observational-study
#15
Indumathy Santhanam, Sangeetha Yoganathan, V Akila Sivakumar, Rubini Ramakrishnamurugan, Sharada Sathish, Murali Thandavarayan
OBJECTIVES: To study the clinical profile and predictors of outcome in children with status epilepticus (SE) during resuscitation in pediatric emergency department. MATERIALS AND METHODS: This retrospective study was carried out in a tertiary care teaching hospital. Admission and resuscitation data of children, aged between 1 month and 12 years, treated for SE, between September 2013 and August 2014, were extracted using a standard data collection form. Our SE management protocol had employed a modified pediatric assessment triangle to recognize and treat acute respiratory failure, cardiovascular dysfunction (CD), and subtle SE until all parameters resolved...
April 2017: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/28601903/can-complications-in-febrile-neutropenia-be-predicted-report-from-a-developing-country
#16
Sapna Oberoi, Anirban Das, Amita Trehan, Pallab Ray, Deepak Bansal
PURPOSE: Febrile neutropenia (FN) is an important cause of morbidity and mortality in children with acute lymphoblastic leukemia (ALL). We aimed to look at complications in febrile neutropenia and to derive a risk model for developing complications from the variables predicting complications. METHODS: Children on treatment for ALL, presenting with FN, were prospectively enrolled over a period of 1 year. Their clinical presentation, course during hospital stay, and outcomes were recorded...
June 11, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28599461/sparc-overexpression-suppresses-radiation-induced-hsp27-and-induces-the-collapse-of-mitochondrial-%C3%AE-%C3%AF-in-neuroblastoma-cells
#17
Smita Tanpure, Jerusha Boyineini, Manu Gnanamony, Reuben Antony, Karen S Fernández, Jaime Libes, Julian Lin, David Pinson, Pushpa A Joseph, Christopher S Gondi
Neuroblastoma is the cause of >15% of cancer-associated mortality in children in the USA. Despite aggressive treatment regimens, the long-term survival rate for these children remains at <40%. The current study demonstrates that secreted protein acidic and rich in cysteine (SPARC) suppresses radiation-induced expression of heat shock protein 27 (HSP27) in vivo and suppresses mitochondrial membrane potential (Δψ) in neuroblastoma cells. In the present study, the overexpression of SPARC in SK-N-BE(2) and NB1691 neuroblastoma cell lines suppresses radiation-induced G2M cell cycle arrest, proliferation, HSP27 expression (in vitro and in vivo) and induces the collapse of the mitochondrial Δψ...
June 2017: Oncology Letters
https://www.readbyqxmd.com/read/28598976/the-dynamic-role-of-autophagy-and-mapk-signaling-in-determining-cell-fate-under-cisplatin-stress-in-osteosarcoma-cells
#18
Sudeshna Mukherjee, Subhra Dash, K Lohitesh, Rajdeep Chowdhury
Osteosarcoma (OS) is an aggressive bone malignancy commonly observed in children and adolescents. Sub-optimal therapy for years has irretrievably compromised the chances of OS patient survival; also, lack of extensive research on this rare disease has hindered therapeutic development. Cisplatin, a common anti-tumor drug, is currently an integral part of treatment regime for OS along with methotrexate and doxorubicin. However, toxicity issues associated with combination module impede OS therapy. Also, despite the proven benefits of cisplatin, acquisition of resistance remains a concern with cisplatin-based therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28596655/a-correlation-of-the-platelet-count-with-d-dimer-levels-as-an-indicator-for-component-therapy-in-children-with-dengue-hemorrhagic-fever
#19
Arthi Sridhar, B M Sunil Kumar, Aarathi Rau, A T K Rau
Dengue Fever (DF) may evolve into two life threatening forms-Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). DHF is associated with increased vascular permeability and plasma leakage causing thrombocytopenia and loss of clotting factors into the third space and may result in bleeding initially due to thrombocytopenia and later due to disseminated intravascular coagulation (DIC), often as a terminal event. Prompt recognition and treatment of minor bleeds in DF children with incipient DIC with component therapy may be associated with improved survival while failure to do so is usually catastrophic...
June 2017: Indian Journal of Hematology & Blood Transfusion
https://www.readbyqxmd.com/read/28584508/childhood-pyogenic-septic-arthritis-as-seen-in-a-teaching-hospital-south-east-nigeria
#20
Njoku Isaac Omoke, Akputa Aja Obasi
BACKGROUND: Childhood pyogenic septic arthritis and its associated musculoskeletal morbidity is an important health concern in developing countries. Its pattern of presentation that varies from and within subregions has implications on the early recognition, treatment, and outcome. The aim of this study was to determine the pattern and outcome of childhood septic arthritis in our environment. MATERIALS AND METHODS: This was a retrospective study of all the children seen with pyogenic septic arthritis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015...
January 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
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