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Pediatric Respiratory Care

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https://www.readbyqxmd.com/read/28099401/vocal-cord-palsy-in-children-with-cancer-a-10-year-analysis-of-uk-pediatric-intensive-care-admissions
#1
Anna Capsomidis, Andrew Hall, Hamid Daya, Jonathan Round, Donna Lancaster, Jessica Bate
Vocal cord palsy (VCP) is a rare but potentially life-threatening complication in children with cancer. This study reviews UK Intensive Care admissions for children with cancer and VCP using data obtained from the Pediatric Intensive Care Audit Network (PICANet) database. 26 children with cancer and VCP were admitted to intensive care from 2002 to 2012. The majority of admissions (23/26) required respiratory intervention (17 invasive ventilation, 8 noninvasive ventilation, and 5 tracheostomy). VCP should be considered early in children with cancer who present with signs of upper airway obstruction, especially in those receiving vinca-alkaloids as VCP is likely to be reversible...
January 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#2
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28093275/reverse-transcription-loop-mediated-isothermal-amplification-for-rapid-detection-of-respiratory-syncytial-virus-directly-from-nasopharyngeal-swabs
#3
Johannes Hoos, Rebecca Marie Peters, Julia Tabatabai, Jürgen Grulich-Henn, Paul Schnitzler, Johannes Pfeil
Respiratory syncytial virus (RSV) is a common cause of lower respiratory tract infection in young infants and a major cause of nosocomial infection in pediatric care. Currently available RSV point-of-care tests are of limited sensitivity and relatively expensive. We developed and evaluated a novel RSV rapid test for use at point-of-care, based on reverse-transcription loop-mediated isothermal amplification (RT-LAMP) for direct testing of nasopharyngeal swab specimens. RT-LAMP can detect RSV within 30min, without the need for RNA extraction...
January 13, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#4
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28088400/hospitalizations-for-respiratory-syncytial-virus-and-vaccine-preventable-infections-in-the-first-2-years-after-pediatric-liver-transplant
#5
Amy G Feldman, Shikha S Sundaram, Brenda L Beaty, Allison Kempe
OBJECTIVES: To examine in liver transplant recipients at centers participating in the Pediatric Health Information System dataset the number of hospitalizations for respiratory syncytial virus (RSV) and vaccine-preventable infections (VPIs) in the first 2 years after transplantation, morbidity and mortality associated with these hospitalizations, and costs associated with these hospitalizations. STUDY DESIGN: A retrospective cohort study of patients <18 years of age who underwent liver transplantation at a Pediatric Health Information System center between January 1, 2004, and December 31, 2012...
January 11, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28078682/population-pharmacokinetics-of-intravenous-clonidine-for-sedation-during-pediatric-extracorporeal-membrane-oxygenation-ecmo-and-continuous-veno-venous-hemofiltration-cvvh
#6
Niina Kleiber, Ron A A Mathôt, Maurice J Ahsman, Enno D Wildschut, Dick Tibboel, Saskia N de Wildt
AIMS: Clonidine is used for sedation in the pediatric intensive care unit. Extracorporeal membrane oxygenation (ECMO) provides temporary support if respiratory and cardiac function is threatened. ECMO influences the pharmacokinetics of drugs. Clonidine during pediatric ECMO cannot be effectively titrated as PK data are lacking. The aim of this study is to describe clonidine PK in a particular ECMO system and propose dosing guidelines for children on this particular ECMO circuit. METHODS: All children below the age of 18 who received clonidine during ECMO were eligible...
January 12, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28072745/safety-and-efficacy-of-chloral-hydrate-for-conscious-sedation-of-infants-in-the-pediatric-cardiovascular-intensive-care-unit
#7
Mei-Lian Chen, Qiang Chen, Fan Xu, Jia-Xin Zhang, Xiao-Ying Su, Xiao-Zhen Tu
This study evaluates the safety and efficacy of chloral hydrate administration for the conscious sedation of infants in the pediatric cardiovascular intensive care unit (PCICU).We conducted a retrospective review of the charts of 165 infants with congenital heart disease who received chloral hydrate in our PCICU between January 2014 and December 2014. Chloral hydrate was administered orally or rectally to infants using doses of 50 mg/kg. We collected and analyzed relevant clinical parameters.The overall length of time to achieve sedation was ranged from 5 to 35 min (10...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072737/the-efficacy-of-dexmedetomidine-remifentanil-versus-dexmedetomidine-propofol-in-children-undergoing-flexible-bronchoscopy-a-retrospective-trial
#8
Hongquan Zhang, Baojun Fang, Wenjing Zhou
Flexible bronchoscopy has been more and more used for diagnosis and management diseases of respiratory system in pediatrics. Previous studies have reported that remifentanil (RF) and propofol are safe and effective for flexible bronchoscopy in adults, however, there have no trials evaluate the efficacy of DEX-RF versus dexmedetomidine-propofol in children undergoing flexible bronchoscopy.We divided 123 children undergoing flexible bronchoscopy with DEX-RF or dexmedetomidine-propofol into 2 groups: Group DR (n = 63, DEX infusion at 1...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28063721/point-of-care-lung-ultrasound-of-children-with-acute-asthma-exacerbations-in-the-pediatric-emergency-department
#9
Samantha Dankoff, Patricia Li, Adam J Shapiro, Terry Varshney, Alexander S Dubrovsky
OBJECTIVES: Primary objective was to characterize lung ultrasound findings in children with asthma presenting with respiratory distress to the emergency department (ED). Secondary objectives included correlating these findings with patients' clinical course in the ED. METHODS: Eligible patients 2-17years of age, underwent a lung ultrasound by the study sonographer between November 2014 to December 2015. Positive lung ultrasound was defined as the presence of ≥1 of the following findings: ≥3 B-lines per intercostal space, consolidation and/or pleural abnormalities...
December 26, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28055027/interdisciplinary-onsite-team-based-simulation-training-in-the-neonatal-intensive-care-unit-a-pilot-report
#10
D J W Reed, R L Hermelin, C S Kennedy, J Sharma
OBJECTIVE: Simulation training improves individual clinician confidence, performance and self-efficacy in resuscitation and procedural training experiences. The reality of resuscitation experiences in the neonatal intensive care unit (NICU) is that they are team-accomplished events. However, limited data exist on team-based simulation training (TBST) in the NICU. We report the experience of TBST over a 4-year period. STUDY DESIGN: This is a retrospective report of 65 TBST events in a 71-bed Level IV NICU at a regional subspecialty children's hospital...
January 5, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28052587/pilot-study-of-dornase-alfa-pulmozyme-therapy-for-acquired-ventilator-associated-infection-in-preterm-infants
#11
Melissa Scala, Deborah Hoy, Maria Bautista, Judith Jones Palafoutas, Kabir Abubakar
OBJECTIVE: Evaluate the feasibility, safety, and efficacy of adjunctive treatment with dornase alfa in preterm patients with ventilator-associated pulmonary infection (VAPI) compared to standard care. WORKING HYPOTHESIS: We hypothesize that therapy with dornase alfa will be safe and well tolerated in the preterm population with no worsening of symptoms, oxygen requirement, or need for respiratory support. STUDY DESIGN: Prospective, randomized, blinded, pilot study comparing adjunctive treatment with dornase alfa to sham therapy...
January 3, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28046188/comparative-effectiveness-of-nonsteroidal-anti-inflammatory-drug-treatment-vs-no-treatment-for-patent-ductus-arteriosus-in-preterm-infants
#12
Jonathan L Slaughter, Patricia B Reagan, Thomas B Newman, Mark A Klebanoff
Importance: Patent ductus arteriosus (PDA) is associated with increased mortality and worsened respiratory outcomes, including bronchopulmonary dysplasia (BPD), in preterm infants. Nonsteroidal anti-inflammatory drugs (NSAIDs) are efficacious in closing PDA, but the effectiveness of NSAID-mediated PDA closure in improving mortality and preventing BPD is unclear. Objective: To determine the effectiveness of NSAID treatment for PDA in reducing mortality and moderate/severe BPD at 36 weeks postmenstrual age...
January 3, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28040841/incidence-of-bradycardia-in-pediatric-patients-receiving-dexmedetomidine-anesthesia-a-meta-analysis
#13
Maowei Gong, Yuanyuan Man, Qiang Fu
Background Dexmedetomidine, an α2-receptor agonist, provides potent sedation, analgesia, and anxiolysis without respiratory depression and is used in a variety of surgical and procedural situations. Aim of the review The aim of this study was to estimate the incidence of bradycardia in pediatric patients who received dexmedetomidine as a sole agent for any procedural, intensive care or surgical sedation. Method Literature was searched in electronic databases and studies were selected by following pre-determined eligibility criteria...
December 31, 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28040689/burden-of-healthcare-associated-viral-respiratory-infections-in-children-s-hospitals
#14
Caroline Quach, Rita Shah, Lorry G Rubin
OBJECTIVE: Although healthcare-associated (HA) viral respiratory infections (VRIs) are common in pediatrics, no benchmark for comparison exists. We aimed to determine, compare, and assess determinants of unit-specific HA-VRI incidence rates in 2 children's hospitals. METHODS: This study was a retrospective comparison of prospective cohorts. The Montreal Children's Hospital and the Cohen Children's Medical Center of New York perform prospective surveillance for HA-VRI using standardized definitions that require the presence of symptoms compatible with VRI and virus detection...
December 30, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28038764/is-all-cause-readmission-an-appropriate-performance-measure-for-pediatric-surgeons-a-case-study-in-pyloromyotomy
#15
Isobel H Marks, David C Chang, Peter T Masiakos, Cassandra M Kelleher
INTRODUCTION: All cause readmissions are used as a surrogate metric for quality of care for both hospitals and physicians, and are considered in pay for performance initiatives. However, the integrity of using all cause readmissions as a benchmark for surgical outcomes has received little attention. Pyloromyotomy for hypertrophic pyloric stenosis is considered a safe pediatric surgical procedure with few complications or readmissions. The incidence of in hospital complications has been reported, however the rate of readmissions and specifically the proportion of readmissions related to surgical complications have not been previously reported...
December 20, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28031377/urine-cotinine-screening-detect-nearly-ubiquitous-tobacco-smoke-exposure-in-urban-adolescents
#16
Neal L Benowitz, Shonul Jain, Delia A Dempsey, Natalie Nardone, Gideon St Helen, Peyton Jacob
INTRODUCTION: Routine biochemical assessment of tobacco smoke exposure could lead to more effective interventions to reduce or prevent secondhand smoke (SHS)-related disease in adolescents. Our aim was to determine using urine cotinine (major nicotine metabolite) measurement the prevalence of tobacco smoke exposure among adolescents receiving outpatient care at an urban public hospital. METHODS: Surplus urine was collected in 466 adolescents attending pediatric or urgent care clinics at San Francisco General Hospital, serving families with lower levels of income and education, in 2013-14...
December 28, 2016: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28029754/pulmonary-hemorrhage-as-a-complication-of-respiratory-syncyntial-virus-rsv-bronchiolitis
#17
Audrey K S Soo, David P Inwald
Respiratory Syncytial Virus (RSV) is a common cause of bronchiolitis. Although there are a number of recognized complications, pulmonary hemorrhage has not been reported previously. A retrospective case notes review was performed through an electronic search of a Pediatric Intensive Care Unit's medical records. Seven patients with RSV infection and pulmonary hemorrhage were identified and included in this case series. Six of the seven patients were born prematurely (30-36 weeks gestation). All patients required blood transfusion...
December 28, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#18
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#19
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28012527/improving-access-to-school-based-education-for-south-african-children-in-rural-areas-who-have-a-tracheostomy-a-case-series-and-recommendations
#20
Chengetai Mahomva, Sue Harris, Narvanie Seebran, Bridget Mudge, Brian Catlin, Louise Davies
OBJECTIVES: Currently few children with tracheostomies attend rural mainstreams schools in South Africa limiting their ability to gain an education. We sought to document the current school experience for the few children attending school who have tracheostomies and devise educational tools for teachers and administrators that will facilitate greater acceptance and safety in classrooms for this population. METHODS: The four patients that are currently attending school with a tracheostomy were identified from the patient records of a tertiary hospital with a pediatric tracheostomy home based care service...
January 2017: International Journal of Pediatric Otorhinolaryngology
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