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Pediatric bleeding

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https://www.readbyqxmd.com/read/29774760/safety-of-nonsteroidal-anti-inflammatory-drugs-in-copperhead-snakebite-patients
#1
Hoang X Pham, Michael E Mullins
INTRODUCTION: Current management guidelines for pit viper envenomations recommend against the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for pain control due to concern for platelet dysfunction and resulting coagulopathy. However, prior research suggests that copperhead snakes generally do not cause coagulopathy and they are responsible for most of the venomous snakebites in the USA. Thus, we compared the occurrences of clinically apparent bleeding and most abnormal laboratory values of coagulation between copperhead envenomation patients who received NSAIDs and those who did not...
May 18, 2018: Clinical Toxicology
https://www.readbyqxmd.com/read/29770770/adjustable-diameter-tips-in-the-pediatric-patient-the-constrained-technique
#2
Brandon C Perry, Eric J Monroe, Giridhar Shivaram
Placement of transjugular intrahepatic portosystemic shunt (TIPS) is necessary in children with portal hypertension complicated by variceal bleeding or ascites. However, placement of adult-sized endografts may be problematic due to the smaller anatomy of pediatric patients. On the other hand, placement of fixed diameter smaller stents have the corresponding problem of not accommodating future growth of the child. We describe a novel method to create an adjustable diameter TIPS as a technical solution to these problems...
May 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/29756342/safety-of-preoperative-ibuprofen-in-pediatric-tonsillectomy
#3
Alexander Michael, Farrel J Buchinsky, Glenn Isaacson
OBJECTIVE: Oral ibuprofen is believed to be safe and effective after pediatric adenotonsillectomy. There has been little study of its use as a preoperative analgesic. We attempt to document its safety in this setting. STUDY DESIGN: Individual case control study. METHODS: Children who underwent tonsillectomy or adenotonsillectomy from January 2013 to December 2015 did not receive preoperative ibuprofen. Those who underwent tonsillectomy or adenotonsillectomy from January 2016 to December 2017 received oral ibuprofen 7 mg/kg preoperatively...
May 14, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29756168/transsplenic-splenoportography-and-portal-venous-interventions-in-pediatric-patients
#4
Eric J Monroe, Ethan J Speir, C Matthew Hawkins, Giri Shivaram, Kevin S H Koo, Anne E Gill
BACKGROUND: Data regarding transsplenic portal venous access for diagnostic imaging and endovascular intervention in children are limited, possibly due to concerns regarding high bleeding risks and resultant underutilization. OBJECTIVE: To investigate the safety and utility of transsplenic splenoportography and portal venous interventions in children. MATERIALS AND METHODS: A retrospective review was performed of all pediatric patients undergoing percutaneous transsplenic portal venous access and intervention at two large tertiary pediatric institutions between January 2012 and April 2017 was performed...
May 13, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29753821/thromboelastography-is-associated-with-surrogates-for-bleeding-after-pediatric-cardiac-surgery
#5
Sirisha Emani, Lynn A Sleeper, David Faraoni, Michelle Mulone, Fatoumata Diallo, James A DiNardo, Juan Ibla, Sitaram M Emani
BACKGROUND: Perioperative bleeding is a common complication in pediatric patients undergoing cardiac surgery. Although thromboelastography (TEG) has been utilized in patients undergoing adult cardiac surgery, limited data are available in pediatric patients. We hypothesize that TEG parameters may be associated with surrogate endpoints for postoperative bleeding in pediatric patients undergoing complex cardiac surgery. METHODS: In a retrospective study, TEG was obtained after protamine administration and upon intensive care unit (ICU) admission in pediatric patients (≤ 18yrs) undergoing cardiac surgery requiring cardiopulmonary bypass...
May 10, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29747622/postoperative-dental-morbidity-in-children-following-dental-treatment-under-general-anesthesia
#6
Yu-Hsuan Hu, Aileen Tsai, Li-Wei Ou-Yang, Li-Chuan Chuang, Pei-Ching Chang
BACKGROUND: General anesthesia has been widely used in pediatric dentistry in recent years. However, there remain concerns about potential postoperative dental morbidity. The goal of this study was to identify the frequency of postoperative dental morbidity and factors associated with such morbidity in children. METHODS: From March 2012 to February 2013, physically and mentally healthy children receiving dental treatment under general anesthesia at the Department of Pediatric Dentistry of the Chang Gung Memorial Hospital in Taiwan were recruited...
May 10, 2018: BMC Oral Health
https://www.readbyqxmd.com/read/29747378/treating-mucocele-in-pediatric-patients-using-a-diode-laser-three-case-reports
#7
Sara M Bagher, Ayman M Sulimany, Martin Kaplan, Cheen Y Loo
A mucocele is the most common minor salivary gland disease and among the most common biopsied oral lesions in pediatric patients. Clinically, a mucocele appears as a round well-circumscribed painless swelling ranging from deep blue to mucosa alike in color. Mucoceles rarely resolve on their own and surgical removal under local anesthesia is required in most cases. Different treatment options are described in the literature, including cryosurgery, intra-lesion injection of corticosteroid, micro-marsupialization and conventional surgical removal using a scalpel, and laser ablation...
May 9, 2018: Dentistry journal
https://www.readbyqxmd.com/read/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#8
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29744656/pediatric-pulmonary-artery-rehabilitation-a-review-of-our-experience-and-a-novel-approach-using-bronchial-blockers
#9
Peter D Winch, Dmitry Tumin, Jeffrey Moore, Samantha J Vizzini, Darren P Berman, Aymen N Naguib
Recent advances in the field of pediatric interventional cardiology have resulted in therapies for patients in need of augmented pulmonary artery (PA) flow. Catheter-based PA rehabilitation can be performed safely but not without the potential risk of pulmonary hemorrhage. When severe, this bleeding has the ability to contaminate the bronchi and trachea, and possibly occlude the endotracheal tube. This can result in a critical inability to ventilate and oxygenate these patients. Herein, we review our institutional experience with pulmonary hemorrhage associated with these procedures and the feasibility of predicting this outcome...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29733506/a-comparison-of-intraoperative-hemostatic-techniques-during-tonsillectomy-suture-versus-electrocautery-a-study-to-assess-post-operative-pain-scores-and-duration-to-resumption-of-normal-diet
#10
Michele Cassano, Nuray Bayar Muluk, Francesco Di Taranto, Somasundaram Subramaniam
OBJECTIVES: To assess postoperative pain and pattern of recovery to normal diet in children who underwent tonsillectomy. METHODS: Cold steel tonsillectomy (or adenotonsillectomy) was performed in 61 children. Hemostasis was attained with sutures in Group 1 (n=30, 8 tonsillectomy and 22 adenotonsillectomy), and electrocautery in Group 2 (n=31,6 tonsillectomy and 25 adenotonsillectomy). Information obtained included post-operative pain scores and the number of postoperative days taken to resume normal diet...
May 7, 2018: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29728153/maternal-bleeding-complications-following-early-versus-delayed-umbilical-cord-clamping-in-multiple-pregnancies
#11
Chayatat Ruangkit, Matthew Leon, Kasim Hassen, Katherine Baker, Debra Poeltler, Anup Katheria
BACKGROUND: In 2015, the American Academy of Pediatrics recommended delayed umbilical cord clamping for at least 30-60 s for all infants. However, there is limited data regarding the maternal safety of delayed cord clamping in multiple pregnancies. We aimed to compare the maternal bleeding complications following early cord clamping (ECC) versus of delayed cord clamping (DCC) in multiple pregnancies. METHODS: A retrospective cohort study of pregnant women with multiples who delivered live-born infants at Sharp Healthcare Hospitals in San Diego, CA, USA during January 1st, 2016 - September 30th, 2017...
May 4, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29727368/platelet-transfusion-practices-in-critically-ill-children
#12
Marianne E Nellis, Oliver Karam, Elizabeth Mauer, Melissa M Cushing, Peter J Davis, Marie E Steiner, Marisa Tucci, Simon J Stanworth, Philip C Spinella
OBJECTIVES: Little is known about platelet transfusions in pediatric critical illness. We sought to describe the epidemiology, indications, and outcomes of platelet transfusions among critically ill children. DESIGN: Prospective cohort study. SETTING: Multicenter (82 PICUs), international (16 countries) from September 2016 to April 2017. PATIENTS: Children ages 3 days to 16 years prescribed a platelet transfusion in the ICU during screening days...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29717359/serious-complications-after-button-battery-ingestion-in-children
#13
Hilde Krom, Margot Visser, Jessie M Hulst, Victorien M Wolters, Anita M Van den Neucker, Tim de Meij, Hubert P J van der Doef, Obbe F Norbruis, Marc A Benninga, Margot J M Smit, Angelika Kindermann
Serious and fatal complications after button battery ingestion are increasing worldwide. The aim of this study is to describe serious complications after battery ingestion in children in the Netherlands.All pediatric gastroenterologists in the Netherlands performing upper endoscopies were asked to report all serious complications after battery ingestion in children (0-18 years) between 2008 and 2016 retrospectively.Sixteen serious complications were reported: death after massive bleeding through esophageal-aortal fistula (n = 1), esophageal-tracheal fistula (n = 5), stenosis after (suspected) perforation and mediastinitis (n = 5), (suspected) perforation and mediastinitis (n = 3), vocal cord paralysis (n = 1), and required reintubation for dyspnea and stridor (n = 1)...
May 2, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29716799/emergency-and-critical-care-applications-for-contrast-enhanced-ultrasound
#14
REVIEW
Tobias Kummer, Laura Oh, Mary Beth Phelan, Robert D Huang, Jason T Nomura, Srikar Adhikari
INTRODUCTION: Contrast-enhanced ultrasound (CEUS) using intravascular microbubbles has potential to revolutionize point-of-care ultrasonography by expanding the use of ultrasonography into clinical scenarios previously reserved for computed tomography (CT), magnetic resonance imaging, or angiography. METHODS: We performed a literature search and report clinical experience to provide an introduction to CEUS and describe its current applications for point-of-care indications...
April 22, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29709361/partial-thromboplastin-time-is-more-predictive-of-bleeding-than-anti-xa-levels-in-heparinized-pediatric-patients-after-cardiac-surgery
#15
Olubunmi O Oladunjoye, Lynn A Sleeper, Asha G Nair, Cameron C Trenor, Christina VanderPluym, John N Kheir, Sitaram M Emani
OBJECTIVES: Anticoagulation with unfractionated heparin (UFH) after pediatric cardiac surgery can be monitored using either activated partial thromboplastin time (aPTT) or anti-factor Xa activity (anti-Xa). However, correlation of bleeding with either of these laboratory values has not been established. We sought to determine the correlation between bleeding events and aPTT and anti-Xa in patients who undergo anticoagulation after congenital heart surgery. METHODS: We prospectively studied pediatric patients treated with UFH after cardiac surgery over an 11-month period...
April 4, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29706445/reoperative-complications-following-pediatric-liver-transplantation
#16
Dor Yoeli, Ruth L Ackah, Rohini R Sigireddi, Michael L Kueht, N Thao N Galvan, Ronald T Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
BACKGROUND: The aim of this study is to describe the incidence and impact of reoperation following pediatric liver transplantation, as well as the indications and risk factors for these complications. METHODS: All primary pediatric liver transplants performed at our institution between January 2012 and September 2016 were reviewed. A reoperative complication was defined as a complication requiring return to the operating room within 30 days or the same hospital admission as the transplant operation, excluding retransplantation...
April 7, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29703492/predictive-factors-of-fatal-bleeding-in-acute-promyelocytic-leukemia
#17
Simon Mantha, Martin S Tallman, Sean M Devlin, Gerald A Soff
Acute promyelocytic leukemia (APL) is associated with a profound coagulopathy. Based on retrospective assessments, several potential risk factors for hemorrhagic morbidity and mortality have emerged. Several studies have shown elevated white blood cell (WBC) count at presentation to be a robust predictor of bleeding events. Other clinical and laboratory parameters have been evaluated with variable association with hemorrhagic morbidity or mortality. These include ECOG performance status, age, morphological subtype, platelet count, peripheral blood blast count, ethnicity, body mass index, prothrombin time, activated partial thromboplastin time, lactate dehydrogenase, d-dimers, creatinine and fibrinogen levels...
April 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29698347/trends-in-imaging-findings-interventions-and-outcomes-among-children-with-isolated-head-trauma
#18
Eric R Coon, Thomas B Newman, Matt Hall, Jacob Wilkes, Susan L Bratton, Alan R Schroeder
OBJECTIVE: The aim was to analyze the impact of decreased head computed tomography (CT) imaging on detection of abnormalities and outcomes for children with isolated head trauma. METHODS: The study involves a multicenter retrospective cohort of patients younger than 19 years presenting for isolated head trauma to emergency departments in the Pediatric Health Information System database from 2003 to 2015. Patients directly admitted or transferred to another facility and those with a discharge diagnosis code for child maltreatment were excluded...
April 24, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#19
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29685487/risk-factors-for-recurrence-of-intussusception-in-pediatric-patients-a-retrospective-study
#20
Xiaolong Xie, Yang Wu, Qi Wang, Yiyang Zhao, Bo Xiang
OBJECTIVES: The aim of this study was to explore the risk factors associated with recurrence of intussusception after operative or nonoperative reduction in children. METHODS: Between January 2004 and December 2012, patients with intussusception treated with nonoperative and operative reduction were retrospectively analyzed. We included the patients who were diagnosed with intussusception from the age of 0 year to 18 years who received nonoperative and operative reduction as an initial treatment...
March 28, 2018: Journal of Pediatric Surgery
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