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Pediatric cardiac arrest

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https://www.readbyqxmd.com/read/28434268/ubiquitin-c-terminal-hydrolase-l1-uch-l1-as-a-therapeutic-and-diagnostic-target-in-neurodegeneration-neurotrauma-and-neuro-injuries
#1
Kevin K Wang, Zhihui Yang, George Sarkis, Isabel Torres, Vijaya Raghavan
Since its discovery as a major CNS-abundant protein 25 years ago, Ubiquitin C-terminal hydrolase-L1 (UCH-L1) has emerged as an important enzyme in regulating brain protein metabolism, by coupling to the proteasome pathway of protein degradation. Areas covered: UCH-L1 is implicated in both familial and sporadic Parkinson disease and other chronic neurodegenerative diseases. Also, UCH-L1 has been recently emerging as a biofluid-based biomarker for various forms of acute neurotrauma and CNS injury. Expert opinion: The loss of UCH-L1 activity coupled with the gain of proteinopathy function are linked to neurodegeneration such as Parkinsonism and Alzheimer's disease...
April 24, 2017: Expert Opinion on Therapeutic Targets
https://www.readbyqxmd.com/read/28433454/a-randomized-comparison-of-three-chest-compression-techniques-and-associated-hemodynamic-effect-during-infant-cpr-a-randomized-manikin-study
#2
Jacek Smereka, Lukasz Szarpak, Antonio Rodríguez-Núñez, Jerzy R Ladny, Steve Leung, Kurt Ruetzler
INTRODUCTION: Pediatric cardiac arrest is an uncommon but critical life-threatening event requiring effective cardiopulmonary resuscitation. High-quality cardio-pulmonary resuscitation (CPR) is essential, but is poorly performed, even by highly skilled healthcare providers. The recently described two-thumb chest compression technique (nTTT) consists of the two thumbs directed at the angle of 90° to the chest while having the fingers fist-clenched. This technique might facilitate adequate chest-compression depth, chest-compression rate and rate of full chest-pressure relief...
April 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28419060/relationship-of-hospital-costs-with-mortality-in-pediatric-critical-care-a-multi-institutional-analysis
#3
Punkaj Gupta, Mallikarjuna Rettiganti
OBJECTIVE: With increasing emphasis on high "value" care, we designed this study to evaluate the relationship between hospital costs and patient outcomes in pediatric critical care. DESIGN: Post hoc analysis of data from an existing administrative national database, Pediatric Health Information Systems. Multivariable mixed effects logistic regression models were fitted to evaluate association of hospital cost tertiles with odds of mortality after adjusting for patient and center characteristics...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28416430/-extracorporeal-membrane-oxygenation-in-critically-ill-neonates-and-children
#4
J Rambaud, J Guilbert, I Guellec, S Jean, A Durandy, M Demoulin, A Amblard, R Carbajal, P-L Leger
Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest)...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28414559/evaluating-the-cost-and-utility-of-mandating-schools-to-stock-epinephrine-auto-injectors
#5
Chelsea Steffens, Benjamin Clement, William Fales, Ahel El Haj Chehade, Kevin Putman, Robert Swor
BACKGROUND: The Michigan Legislature mandated that all public schools stock epinephrine auto-injectors (EAIs). A minimal amount is known regarding the incremental value of EAIs in schools. Our primary objective was to describe the frequency of administration of epinephrine for EMS patients with acute allergic reactions in public schools. Our secondary objective was to estimate the cost of mandating public schools to stock EAIs. METHODS: We performed a retrospective cohort study of EMS cases with an impression of allergic reaction and who received epinephrine recorded in the 2014 Michigan EMS Information System (MI-EMSIS)...
April 17, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28402986/no-small-matter-pediatric-resuscitation
#6
Taylor McCormick, Kevin McVaney, Paul E Pepe
PURPOSE OF REVIEW: To present advancements in pediatric cardiac arrest research, highlighting articles most relevant to clinical practice published since the latest international guidelines for cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Clinical trials examining targeted temperature management in children support avoidance of hyperthermia for both pediatric in-hospital cardiac arrest (PIHCA) and out-of-hospital cardiac arrest (POHCA), but no statistically significant outcome differences were confirmed comparing 33 and 36 °C in the limited populations studied...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28395992/does-transport-time-of-out-of-hospital-cardiac-arrest-patients-matter-a-systematic-review-and-meta-analysis
#7
REVIEW
Guillaume Geri, Joshua Gilgan, Wen Wu, Sandy Vijendira, Carolyn Ziegler, Ian R Drennan, Laurie Morrison, Steve Lin
BACKGROUND: Despite increasing evidence for specialized cardiac arrest centers, the impact of transport time on out-of-hospital cardiac arrest (OHCA) patients' outcome remains unclear. We systematically reviewed the prognostic impact of transport time in OHCA patients. METHODS: We searched PubMed, Embase, the Cochrane Library, and Web of Science from inception to May 2016 for studies that had reported the relationship between transport time and outcome in OHCA patients...
April 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28377295/frequency-of-medical-emergency-team-activation-prior-to-pediatric-cardiopulmonary-resuscitation
#8
Natalie Jayaram, Maya L Chan, Fengming Tang, Christopher S Parshuram, Paul S Chan
BACKGROUND: Medical Emergency Teams (METs) are designed to respond to signs of clinical decline in order to prevent cardiopulmonary arrest and reduce mortality. The frequency of MET activation prior to pediatric cardiopulmonary resuscitation (CPR) is unknown. METHODS: Within the Get With The Guidelines-Resuscitation Registry (GWTG-R), we identified children with bradycardia or cardiac arrest requiring CPR on the general inpatient or telemetry floors from 2007 to 2013...
April 1, 2017: Resuscitation
https://www.readbyqxmd.com/read/28367771/the-effect-of-step-stool-use-and-provider-height-on-cpr-quality-during-pediatric-cardiac-arrest-a-simulation-based-multicentre-study
#9
Adam Cheng, Yiqun Lin, Vinay Nadkarni, Brandi Wan, Jonathan Duff, Linda Brown, Farhan Bhanji, David Kessler, Nancy Tofil, Kent Hecker, Elizabeth A Hunt
OBJECTIVES: We aimed to explore whether a) step stool use is associated with improved cardiopulmonary resuscitation (CPR) quality; b) provider adjusted height is associated with improved CPR quality; and if associations exist, c) determine whether just-in-time (JIT) CPR training and/or CPR visual feedback attenuates the effect of height and/or step stool use on CPR quality. METHODS: We analysed data from a trial of simulated cardiac arrests with three study arms: No intervention; CPR visual feedback; and JIT CPR training...
April 3, 2017: CJEM
https://www.readbyqxmd.com/read/28338520/integration-of-single-center-data-driven-vital-sign-parameters-into-a-modified-pediatric-early-warning-system
#10
Catherine E Ross, Iliana J Harrysson, Veena V Goel, Erika J Strandberg, Peiyi Kan, Deborah E Franzon, Natalie M Pageler
OBJECTIVES: Pediatric early warning systems using expert-derived vital sign parameters demonstrate limited sensitivity and specificity in identifying deterioration. We hypothesized that modified tools using data-driven vital sign parameters would improve the performance of a validated tool. DESIGN: Retrospective case control. SETTING: Quaternary-care children's hospital. PATIENTS: Hospitalized, noncritically ill patients less than 18 years old...
March 23, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28328788/early-presence-of-sleep-spindles-on-electroencephalography-is-associated-with-good-outcome-after-pediatric-cardiac-arrest
#11
Laurence Ducharme-Crevier, Craig A Press, Jonathan E Kurz, Michele G Mills, Joshua L Goldstein, Mark S Wainwright
OBJECTIVES: The role of sleep architecture as a biomarker for prognostication after resuscitation from cardiac arrest in children hospitalized in an ICU remains poorly defined. We sought to investigate the association between features of normal sleep architecture in children after cardiac arrest and a favorable neurologic outcome at 6 months. DESIGN: Retrospective review of medical records and continuous electroencephalography monitoring. SETTING: Cardiac and PICU of a tertiary children's hospital...
March 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28319562/translating-biomarkers-from-research-to-clinical-use-in-pediatric-neurocritical-care-focus-on-traumatic-brain-injury-and-cardiac-arrest
#12
Andrew J Prout, Michael S Wolf, Ericka L Fink
PURPOSE OF REVIEW: Traumatic brain injury (TBI) and cardiac arrest are important causes of morbidity and mortality in children. Improved diagnosis and outcome prognostication using validated biomarkers could allow clinicians to better tailor therapies for optimal efficacy. RECENT FINDINGS: Contemporary investigation has yielded plentiful biomarker candidates of central nervous system (CNS) injury, including macromolecules, genetic, inflammatory, oxidative, and metabolic biomarkers...
March 17, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#13
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306631/thermoregulate-autoregulate-and-ventilate-brain-directed-critical-care-for-pediatric-cardiac-arrest
#14
Jonathan E Kurz, Craig M Smith, Mark S Wainwright
PURPOSE OF REVIEW: Cardiac arrest in childhood is associated with a high risk for mortality and poor long-term functional outcome. This review discusses the current evidence for neuroprotective therapies and goals for postarrest care in the context of the pathophysiology of hypoxic-ischemic injury, modalities for neurologic prognostication in these children and potential future monitoring paradigms for maximizing cerebral perfusion in the postarrest period. RECENT FINDINGS: The recent publication of the in-hospital and out-of-hospital Therapeutic Hypothermia After Cardiac Arrest trials demonstrated a lack of statistically significant benefit for the use of postarrest therapeutic hypothermia...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#15
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#16
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28274812/pediatric-cardiac-arrest-due-to-drowning-and-other-respiratory-etiologies-neurobehavioral-outcomes-in-initially-comatose-children
#17
Beth S Slomine, Vinay M Nadkarni, James R Christensen, Faye S Silverstein, Russell Telford, Alexis Topjian, Joshua D Koch, Jill Sweney, Ericka L Fink, Mudit Mathur, Richard Holubkov, J Michael Dean, Frank W Moler
AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28267617/effect-of-prehospital-advanced-airway-management-for-pediatric-out-of-hospital-cardiac-arrest
#18
Naoko Ohashi-Fukuda, Tatsuma Fukuda, Kent Doi, Naoto Morimura
BACKGROUND: Respiratory care may be important in pediatric out-of-hospital cardiac arrest (OHCA) due to the asphyxial nature of the majority of events. However, evidence of the effect of prehospital advanced airway management (AAM) for pediatric OHCA is scarce. METHODS: This was a nationwide population-based study of pediatric OHCA in Japan from 2011 to 2012 based on data from the All-Japan Utstein Registry. We included pediatric OHCA patients aged between 1 and 17 years old...
March 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28263789/pediatric-extracorporeal-cardiopulmonary-resuscitation-during-nights-and-weekends
#19
Christopher R Burke, Titus Chan, Thomas V Brogan, D Michael McMullan
AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is a lifesaving rescue therapy for patients with refractory cardiac arrest. Previous studies suggest that maintaining a 24/7 in-house surgical team may reduce ECPR initiation time and improve survival in adult patients. However, an association between cardiac arrest occurring during off-hours and ECPR outcome has not been established in children. METHODS: This is a single institution, retrospective review of all pediatric patients who received ECPR from December 2008 to August 2015...
March 2, 2017: Resuscitation
https://www.readbyqxmd.com/read/28259482/accuracy-of-postresuscitation-team-debriefings-in-a-pediatric-emergency-department
#20
Paul C Mullan, Niall H Cochrane, James M Chamberlain, Randall S Burd, Fawn D Brown, Lauren E Zinns, Kristen M Crandall, Karen J O'Connell
STUDY OBJECTIVE: Guideline committees recommend postresuscitation debriefings to improve performance. "Hot" postresuscitation debriefings occur immediately after the event and rely on team recall. We assessed the ability of resuscitation teams to recall their performance in team-based, hot debriefings in a pediatric emergency department (ED), using video review as the criterion standard. We hypothesized that debriefing accuracy will improve during the course of the study. METHODS: Resuscitation physician and nurse leaders cofacilitated debriefings after ED resuscitations involving cardiopulmonary resuscitation (CPR) or intubation...
March 1, 2017: Annals of Emergency Medicine
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