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Pediatric cardiac arrest

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https://www.readbyqxmd.com/read/29454009/24-vs-72-hours-of-hypothermia-for-pediatric-cardiac-arrest-a-pilot-randomized-controlled-trial
#1
Ericka L Fink, Robert S B Clark, Rachel P Berger, Anthony Fabio, Derek C Angus, R Scott Watson, John J Gianakas, Ashok Panigrahy, Clifton W Callaway, Michael J Bell, Patrick M Kochaneka
AIM: Children surviving cardiac arrest (CA) lack proven neuroprotective therapies. The role of biomarkers in assessing response to interventions is unknown. We hypothesized that 72 versus 24 h of hypothermia (HT) would produce more favorable biomarker profiles after pediatric CA. METHODS: This single center pilot randomized trial tested HT (33 ± 1 °C) for 24 vs. 72 h in 34 children with CA. Children comatose after return of circulation aged 1 week to 17 years and treated with HT by their physician were eligible...
February 14, 2018: Resuscitation
https://www.readbyqxmd.com/read/29445066/epidemiology-of-pediatric-out-of-hospital-cardiac-arrest-at-school-an-investigation-of-a-nationwide-registry-in-japan
#2
Kosuke Kiyohara, Junya Sado, Tetsuhisa Kitamura, Mamoru Ayusawa, Masahiko Nitta, Taku Iwami, Ken Nakata, Yasuto Sato, Noriko Kojimahara, Naohito Yamaguchi, Tomotaka Sobue, Yuri Kitamura
BACKGROUND: A better understanding of the epidemiology of pediatric out-of-hospital cardiac arrest (OHCA) occurring in school settings is important to establish an evidence-based strategy for prevention and better prognosis.Methods and Results:The Stop and Prevent cardIac aRrest, Injury, and Trauma in Schools (SPIRITS) is a nationwide prospective observational study linking databases from 2 nationally representative registries, the Injury and the Accident Mutual Aid Benefit System of The Japan Sport Council and the All-Japan Utstein Registry of the Fire and Disaster Management Agency...
February 15, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29443794/stability-of-early-eeg-background-patterns-after-pediatric-cardiac-arrest
#3
Nicholas S Abend, Rui Xiao, Sudha Kilaru Kessler, Alexis A Topjian
PURPOSE: We aimed to determine whether EEG background characteristics remain stable across discrete time periods during the acute period after resuscitation from pediatric cardiac arrest. METHODS: Children resuscitated from cardiac arrest underwent continuous conventional EEG monitoring. The EEG was scored in 12-hour epochs for up to 72 hours after return of circulation by an electroencephalographer using a Background Category with 4 levels (normal, slow-disorganized, discontinuous/burst-suppression, or attenuated-featureless) or 2 levels (normal/slow-disorganized or discontinuous/burst-suppression/attenuated-featureless)...
February 13, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29440830/impact-of-intensive-care-unit-attending-physician-training-background-on-outcomes-in-children-undergoing-heart-operations
#4
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29438177/eeg-factors-after-pediatric-cardiac-arrest
#5
Nicholas S Abend, Douglas J Wiebe, Rui Xiao, Shavonne L Massey, Mark Fitzgerald, France Fung, Alexis A Topjian
PURPOSE: We aimed to determine whether conventional standardized EEG features could be consolidated into a more limited number of factors and whether the derived factor scores changed during the acute period after pediatric cardiac arrest. METHODS: Children resuscitated after cardiac arrest underwent conventional continuous EEG monitoring. The EEG was scored in 12-hour epochs for up to 72-hours after return of circulation by an electroencephalographer using standardized critical care EEG terminology...
February 12, 2018: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/29432248/neurologic-complications-in-the-pediatric-intensive-care-unit
#6
Mark S Wainwright
PURPOSE OF REVIEW: All critical care is directed at maintaining brain health, but recognizing neurologic complications of critical illness in children is difficult, and limited data exist to guide practice. This article discusses an approach to the recognition and management of seizures, stroke, and cardiac arrest as complications of other critical illnesses in the pediatric intensive care unit. RECENT FINDINGS: Convulsive and nonconvulsive seizures occur frequently in children after cardiac arrest or traumatic brain injury and during extracorporeal membrane oxygenation...
February 2018: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/29406474/childhood-drowning-review-of-patients-presenting-to-the-emergency-departments-of-2-large-tertiary-care-pediatric-hospitals-near-and-distant-from-the-sea-coast
#7
Neta Cohen, Dennis Scolnik, Ayelet Rimon, Uri Balla, Miguel Glatstein
OBJECTIVE: Drowning is a leading cause of death among infants and toddlers. Unique physiological and behavioral factors contribute to high mortality rates. Drowning incidents predominantly occur during warmer months and holidays. The aim of this study was to describe the characteristics of pediatric drowning victims who attended 2 different emergency departments (EDs), 1 near and 1 distant from the sea coast, to recognize risk factors, complications, causes of death, and the educational needs of families and caregivers...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29394226/extracorporeal-cardiopulmonary-resuscitation-in-pediatric-cardiac-arrest-same-principles-different-practices
#8
Michele B Domico, Monica E Kleinman, Graeme MacLaren
No abstract text is available yet for this article.
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29384839/is-there-any-alternative-to-standard-chest-compression-techniques-in-infants-a-randomized-manikin-trial-of-the-new-2-thumb-fist-option
#9
Jerzy R Ladny, Jacek Smereka, Antonio Rodríguez-Núñez, Steve Leung, Kurt Ruetzler, Lukasz Szarpak
BACKGROUND: Pediatric cardiac arrest is a fatal emergent condition that is associated with high mortality, permanent neurological injury, and is a socioeconomic burden at both the individual and national levels. The aim of this study was to test in an infant manikin a new chest compression (CC) technique ("2 thumbs-fist" or nTTT) in comparison with standard 2-finger (TFT) and 2-thumb-encircling hands techniques (TTEHT). METHODS: This was prospective, randomized, crossover manikin study...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29367204/cardiac-arrest-survival-in-pediatric-and-general-emergency-departments
#10
Kenneth A Michelson, Joel D Hudgins, Michael C Monuteaux, Richard G Bachur, Jonathan A Finkelstein
BACKGROUND AND OBJECTIVES: Pediatric out-of-hospital cardiac arrest (OHCA) has a low rate of survival to hospital discharge. Understanding whether pediatric emergency departments (EDs) have higher survival than general EDs may help identify ways to improve care for all patients with OHCA. We sought to determine if OHCA survival differs between pediatric and general EDs. METHODS: We used the 2009-2014 Nationwide Emergency Department Sample to study children under 18 with cardiac arrest...
January 24, 2018: Pediatrics
https://www.readbyqxmd.com/read/29353904/differences-in-return-of-spontaneous-circulation-in-early-vs-late-endotracheal-intubation-among-patients-in-hospital-cardiac-arrest
#11
Battu Kumar Shrestha, Apurb Sharma, Parbesh Kumar Gyawali
BACKGROUND: Common airway management strategies during cardiopulmonary resuscitation are bag- mask-valve ventilation followed by endotracheal intubation. Timing of endotracheal intubation is controversial. This study was designed to compare the effect of early vs late endotracheal intubation in terms of return of spontaneous circulation. METHODS: This is an observational retrospective study done at tertiary center for the period of two years. The study population was inpatient, adult and pediatric with witnessed cardiac arrest in whom airway management was initially done with bag-valve-mask ventilation followed by endotracheal intubation...
January 1, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29351501/pediatric-anaphylaxis-in-the-prehospital-setting-incidence-characteristics-and-management
#12
Emily Andrew, Ziad Nehme, Stephen Bernard, Karen Smith
OBJECTIVE: Although hospital presentations for pediatric anaphylaxis have been described in the literature, a minimal amount is known regarding the incidence, characteristics, and management of pediatric anaphylaxis presenting to emergency medical services (EMS). METHODS: We performed a retrospective observational study of pediatrics (≤16 years) presenting to EMS in Victoria, Australia. Patients with suspected anaphylaxis were included if they were treated with epinephrine before or after EMS arrival...
January 19, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29332781/pediatric-extracorporeal-cardiopulmonary-resuscitation-patient-with-traumatic-subarachnoid-hemorrhage-and-takotsubo-syndrome
#13
Thomas E Pearson, Meg A Frizzola, Marc A Priest, Monica F Rochman, Curtis D Froehlich
Takotsubo syndrome is rare in pediatric patients but must be considered in patients with subarachnoid hemorrhage with pulmonary edema and cardiomyopathy. A systematic, collaborative approach is needed to facilitate emergent transfer of patients where extracorporeal cardiopulmonary resuscitation (e-CPR) is used as a lifesaving measure. Extracorporeal membrane oxygenation (ECMO) use in transport requires preplanning, role delineation, resources, and research efforts to be successful. We present an unusual transport case of successful e-CPR/ECMO treatment of Takotsubo syndrome in a 12-year-old boy with an isolated traumatic intracranial injury, cardiomyopathy with pulmonary edema, and multiple cardiac arrests...
January 2018: Air Medical Journal
https://www.readbyqxmd.com/read/29329164/a-systematic-review-of-risk-factors-associated-with-cognitive-impairment-after-pediatric-critical-illness
#14
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/29317058/whole-body-periodic-acceleration-pgz-as-a-non-invasive-preconditioning-strategy-for-pediatric-cardiac-surgery
#15
Jose A Adams, Peter Pastuszko, Arkady Uryash, David Wilson, Jose R Lopez Padrino, Vinay Nadkarni, Anna Pastuszko
We hypothesized that pGz has cardio and neuroprotective effects due to upregulation of pathways which include eNOS, anti-apoptotic, and anti-inflammatory pathways. We analyze protein expression of these pathways in the brain of neonatal piglets, as well as report on the myocardial function after Deep Hypothermic Circulatory Arrest (DHCA) and pGz preconditioning. Animal data affirms both a cardio and neuroprotective role for pGz. These findings suggest that pGz can be a simple, non-invasive cardio and neuroprotective strategy preconditioning strategy in children requiring surgical intervention...
January 2018: Medical Hypotheses
https://www.readbyqxmd.com/read/29302124/extracorporeal-life-support-as-a-rescue-measure-for-managing-life-threatening-arrythmia-and-brugada-syndrome
#16
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29286944/update-of-a-systematic-review-of-autoresuscitation-after-cardiac-arrest
#17
Laura Hornby, Sonny Dhanani, Sam D Shemie
OBJECTIVES: There has been a growth in publications focusing on the phenomena of autoresuscitation in recent years. In 2010, we systematically reviewed the medical literature with the primary objective of summarizing the evidence on the timing of autoresuscitation. Healthcare professionals have continued to voice concerns regarding the potential for autoresuscitation. With this in mind, the objective of this brief report is to update the results of our original review of autoresuscitation...
December 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29280985/pediatric-hypothermic-submersion-injury-and-protective-factors-associated-with-optimal-outcome-a-case-report-and-literature-review
#18
Daniel Kriz, Juan Piantino, Devin Fields, Cydni Williams
Drowning is the 3rd leading cause of unintentional injury death worldwide, with the highest rates of fatality among young children. Submersion injuries with cardiac arrest can lead to long-term neurologic morbidity. Severe hypothermic submersion injuries have complex treatment courses and survivors have variable neurocognitive outcomes. We describe the course of a hypothermic submersion injury in a 6-year-old previously healthy boy. The description includes premorbid and post-injury neurocognitive functioning...
December 27, 2017: Children
https://www.readbyqxmd.com/read/29279413/association-between-diastolic-blood-pressure-during-pediatric-in-hospital-cardiopulmonary-resuscitation-and-survival
#19
Robert A Berg, Robert M Sutton, Ron W Reeder, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Kathleen L Meert, Andrew R Yates, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, David L Wessel, Tammara L Jenkins, Daniel A Notterman, Richard Holubkov, Robert F Tamburro, J Michael Dean, Vinay M Nadkarni
Background -Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using BP to guide pediatric CPR. However, evidence-based BP targets during pediatric CPR remain an important knowledge gap for CPR guidelines. Methods -All children ≥37 weeks gestation and <19 years old in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 minute and invasive arterial blood pressure monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included...
December 26, 2017: Circulation
https://www.readbyqxmd.com/read/29261563/pediatric-in-hospital-cardiac-arrest-secondary-to-acute-pulmonary-embolism
#20
Ryan W Morgan, Hannah R Stinson, Heather Wolfe, Robert B Lindell, Alexis A Topjian, Vinay M Nadkarni, Robert M Sutton, Robert A Berg, Todd J Kilbaugh
OBJECTIVES: Pulmonary embolism is a rarely reported and potentially treatable cause of cardiac arrest in children and adolescents. The objective of this case series is to describe the course of five adolescent patients with in-hospital cardiac arrest secondary to pulmonary embolism. DESIGN: Case series. SETTING: Single, large academic children's hospital. PATIENTS: All patients under the age of 18 years (n = 5) who experienced an in-hospital cardiac arrest due to apparent pulmonary embolism from August 1, 2013, to July 31, 2017...
December 19, 2017: Critical Care Medicine
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