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Pediatric cardiac arrest

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https://www.readbyqxmd.com/read/29228147/association-of-early-postresuscitation-hypotension-with-survival-to-discharge-after-targeted-temperature-management-for-pediatric-out-of-hospital-cardiac-arrest-secondary-analysis-of-a-randomized-clinical-trial
#1
Alexis A Topjian, Russell Telford, Richard Holubkov, Vinay M Nadkarni, Robert A Berg, J Michael Dean, Frank W Moler
Importance: Out-of-hospital cardiac arrest (OHCA) occurs in more than 6000 children each year in the United States, with survival rates of less than 10% and severe neurologic morbidity in many survivors. Post-cardiac arrest hypotension can occur, but its frequency and association with survival have not been well described during targeted temperature management. Objective: To determine whether hypotension is associated with survival to discharge in children and adolescents after resuscitation from OHCA...
December 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/29226563/fatal-cardiac-arrest-in-pediatric-heart-transplant-recipients-query-of-the-unos-database
#2
Robert W Loar, Susan W Denfield, Shaine A Morris, Hari P Tunuguntla, Antonio G Cabrera, Jack F Price, Wei Zhang, Katherine Hosek, Jeffrey J Kim, William J Dreyer, Aamir Jeewa
The incidence of death by CA after PHTx is unknown. We aimed to determine the incidence and factors for fatal CA after PHTx, and whether a PM affects survival. Retrospective cohort study utilizing the United Network of Organ Sharing registry of patients transplanted ≤18 years. Multivariable analyses in hazard-function domain and Kaplan-Meier analyses were performed for an outcome of death due to CA. There were 7719 PHTx patients queried. CA was the reported cause of death in 11%. Age ≥13 years at time of transplant, presence of a PM, and depressed EF were identified as significant factors for fatal CA...
December 10, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#3
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29210925/frequency-of-desaturation-and-association-with-hemodynamic-adverse-events-during-tracheal-intubations-in-picus
#4
Simon Li, Ting-Chang Hsieh, Kyle J Rehder, Sholeen Nett, Pradip Kamat, Natalie Napolitano, David A Turner, Michelle Adu-Darko, J Dean Jarvis, Conrad Krawiec, Ashley T Derbyshire, Keith Meyer, John S Giuliano, Joana Tala, Keiko Tarquinio, Michael D Ruppe, Ronald C Sanders, Matthew Pinto, Joy D Howell, Margaret M Parker, Gabrielle Nuthall, Michael Shepherd, Guillaume Emeriaud, Yuki Nagai, Osamu Saito, Jan Hau Lee, Dennis W Simon, Alberto Orioles, Karen Walson, Paula Vanderford, Asha Shenoi, Anthony Lee, Geoffrey L Bird, Michael Miksa, Ana Lia Graciano, Jesse Bain, Peter W Skippen, Lee A Polikoff, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: Oxygen desaturation during tracheal intubation is known to be associated with adverse ICU outcomes in critically ill children. We aimed to determine the occurrence and severity of desaturation during tracheal intubations and the association with adverse hemodynamic tracheal intubation-associated events. DESIGN: Retrospective cohort study as a part of the National Emergency Airway Registry for Children Network's quality improvement project from January 2012 to December 2014...
November 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29200138/dispatcher-assisted-cardiopulmonary-resuscitation-program-and-outcomes-after-pediatric-out-of-hospital-cardiac-arrest
#5
Yu Jin Lee, Kyoung Jun Song, Sang Do Shin, Seung Chul Lee, Eui Jung Lee, Young Sun Ro, Ki Ok Ahn
OBJECTIVES: A dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) is expected to influence the outcomes of pediatric out-of-hospital cardiac arrest (OHCA). Our objective was to measure the effect size of a DA-BCPR on survival outcomes according to location of the event. METHODS: All emergency medical service treated OHCA patients younger than 19 years in Korea from January 2012 through December 2013 were analyzed. Patients with OHCA witnessed by emergency medical service providers and those with missing outcome information were excluded...
December 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29192562/cerebral-microcirculatory-alterations-and-the-no-reflow-phenomenon-in%C3%A2-vivo-after-experimental-pediatric-cardiac-arrest
#6
Lingjue Li, Samuel M Poloyac, Simon C Waltkins, Claudette M St Croix, Henry Alexander, Gregory A Gibson, Patricia A Loughran, Levent Kirisci, Robert Sb Clark, Patrick M Kochanek, Alberto L Vazquez, Mioara D Manole
Decreased cerebral blood flow (CBF) after cardiac arrest (CA) contributes to secondary ischemic injury in infants and children. We previously reported cortical hypoperfusion with tissue hypoxia early in a pediatric rat model of asphyxial CA. In order to identify specific alterations as potential therapeutic targets to improve cortical hypoperfusion post-CA, we characterize the CBF alterations at the cortical microvascular level in vivo using multiphoton microscopy. We hypothesize that microvascular constriction and disturbances of capillary red blood cell (RBC) flow contribute to cortical hypoperfusion post-CA...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29190801/comparison-between-manual-and-mechanical-chest-compressions-during-resuscitation-in-a-pediatric-animal-model-of-asphyxial-cardiac-arrest
#7
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Blanca Toledo, Jesús López-Herce
AIMS: Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model. MATERIAL AND METHODS: An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9...
2017: PloS One
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#8
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#9
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#10
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29117093/death-of-a-simulated-pediatric-patient-toward-a-more-robust-theoretical-framework
#11
Mary E McBride, Dana Aronson Schinasi, Michael Alice Moga, Shreepada Tripathy, Aaron Calhoun
INTRODUCTION: A theoretical framework was recently proposed that encapsulates learner responses to simulated death due to action or inaction in the pediatric context. This framework, however, was developed at an institution that allows simulated death and thus does not address the experience of those centers at which this technique is not used. To address this, we performed a parallel qualitative study with the intent of augmenting the initial framework. METHODS: We conducted focus groups, using a constructivist grounded theory approach, using physicians and nurses who have experienced a simulated cardiac arrest...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#12
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29114009/2017-american-heart-association-focused-update-on-pediatric-basic-life-support-and-cardiopulmonary-resuscitation-quality-an-update-to-the-american-heart-association-guidelines-for-cardio-pulmonary-resuscitation-and-emergency-cardiovascular-care
#13
REVIEW
Dianne L Atkins, Allan R de Caen, Stuart Berger, Ricardo A Samson, Stephen M Schexnayder, Benny L Joyner, Blair L Bigham, Dana E Niles, Jonathan P Duff, Elizabeth A Hunt, Peter A Meaney
This focused update to the American Heart Association guidelines for cardiopulmonary resuscitation (CPR) and emergency cardiovascular care follows the Pediatric Task Force of the International Liaison Committee on Resuscitation evidence review. It aligns with the International Liaison Committee on Resuscitation's continuous evidence review process, and updates are published when the International Liaison Committee on Resuscitation completes a literature review based on new science. This update provides the evidence review and treatment recommendation for chest compression-only CPR versus CPR using chest compressions with rescue breaths for children <18 years of age...
November 6, 2017: Circulation
https://www.readbyqxmd.com/read/29076969/compatibility-of-zoll-defibrillators-in-simulation-based-training
#14
Jamie Leigh Shoemaker, Olivia T Duty, Kenneth J Martin, Gary L Geis
INTRODUCTION: In response to the need for high-quality cardiopulmonary resuscitation (CPR) during cardiac arrest, our institution recently purchased ZOLL R Series monitor/defibrillators. This defibrillator provides CPR quality metrics and displays a filtered rhythm through compressions. Purchase of this defibrillator resulted in a practice change and heavily impacted our simulation-based training courses by requiring providers to practice CPR and defibrillation in as close to the real environment as possible...
October 25, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29058248/ventilation-during-cardiopulmonary-resuscitation-in-children-a-survey-on-clinical-practice
#15
Rafael González, Lázaro Pascual, Alexandra Sava, Sara Tolón, Javier Urbano, Jesus López-Herce
BACKGROUND: This study aimed to investigate the ventilation practice during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC) in children. METHODS: An online survey of CPR practices was designed and sent to healthcare professionals treating children. RESULTS: A total of 477 healthcare professionals from 46 countries responded to this survey; 92.7% were physicians and 64.2% worked in pediatric intensive care units...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29023307/interrater-agreement-of-eeg-interpretation-after-pediatric-cardiac-arrest-using-standardized-critical-care-eeg-terminology
#16
Nicholas S Abend, Shavonne L Massey, Mark Fitzgerald, France Fung, Natalie J Atkin, Rui Xiao, Alexis A Topjian
PURPOSE: We evaluated interrater agreement of EEG interpretation in a cohort of critically ill children resuscitated after cardiac arrest using standardized EEG terminology. METHODS: Four pediatric electroencephalographers scored 10-minute EEG segments from 72 consecutive children obtained 24 hours after return of circulation using the American Clinical Neurophysiology Society's (ACNS) Standardized Critical Care EEG terminology. The percent of perfect agreement and the kappa coefficient were calculated for each of the standardized EEG variables and a predetermined composite EEG background category...
November 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#17
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28985969/modifiable-factors-associated-with-survival-after-out-of-hospital-cardiac-arrest-in-the-pan-asian-resuscitation-outcomes-study
#18
Hideharu Tanaka, Marcus E H Ong, Fahad J Siddiqui, Matthew H M Ma, Hiroshi Kaneko, Kyung Won Lee, Kentaro Kajino, Chih-Hao Lin, Han Nee Gan, Pairoj Khruekarnchana, Omer Alsakaf, Nik H Rahman, Nausheen E Doctor, Pryseley Assam, Sang Do Shin
STUDY OBJECTIVE: The study aims to identify modifiable factors associated with improved out-of-hospital cardiac arrest survival among communities in the Pan-Asian Resuscitation Outcomes Study (PAROS) Clinical Research Network: Japan, Singapore, South Korea, Malaysia, Taiwan, Thailand, and the United Arab Emirates (Dubai). METHODS: This was a prospective, international, multicenter cohort study of out-of-hospital cardiac arrest in the Asia-Pacific. Arrests caused by trauma, patients who were not transported by emergency medical services (EMS), and pediatric out-of-hospital cardiac arrest cases (<18 years) were excluded from the analysis...
October 3, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28978554/association-of-pediatric-medical-emergency-teams-with-hospital-mortality
#19
Shelby Kutty, Philip G Jones, Quentin Karels, Navya Joseph, John A Spertus, Paul S Chan
Background -Implementation of a medical emergency teams has been identified as a potential strategy to reduce hospital deaths, as these teams respond to patients with acute physiological decline in an effort to prevent in-hospital cardiac arrest. However, prior studies of the association between medical emergency teams and hospital mortality have been limited and typically have not accounted for pre-implementation mortality trends. Methods -Within the Pediatric Health Information System (PHIS) for freestanding pediatric hospitals, annual risk-adjusted mortality rates were calculated for sites between 2000 and 2015...
October 4, 2017: Circulation
https://www.readbyqxmd.com/read/28976463/cardiac-arrest-in-pediatric-cardiac-icus-what-are-the-differences
#20
Jesús López-Herce, Jimena Del Castillo
No abstract text is available yet for this article.
October 2017: Pediatric Critical Care Medicine
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