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Ventilator associated pneumonia in children

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https://www.readbyqxmd.com/read/28403662/diagnostic-efficacy-of-serum-amyloid-a-protein-and-soluble-intercellular-adhesion-molecule-1-in-pediatric-ventilator-associated-pneumonia
#1
Hamdy H Abo-Hagar, Ahmed Abd ElBasset Abo-Elezz, Mostafa Mehrez, Maaly M Mabrouk, Ola A Elshora
OBJECTIVES: Study of inflammatory biomarkers which may aid in early detection of ventilator-associated pneumonia (VAP) in children and predicting their outcome. PATIENTS: Thirty-five children, aged 2 months to 13 years, needed mechanical ventilation (MV) for more than 48 hours due to causes other than pneumonia. METHODS: Measurement of serum amyloid A (SAA) protein, soluble intercellular adhesion molecule 1 (sICAM-1), and C-reactive protein (CRP), modified clinical pulmonary infection score (CPIS) and performing culture of endotracheal aspirate at the start and on the third day of MV...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#2
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28371525/risk-factors-for-mortality-in-children-with-pneumonia-admitted-to-the-pediatric-intensive-care-unit
#3
Jia Wen Janine Cynthia Koh, Judith Ju-Ming Wong, Rehena Sultana, Petrina Poh Chen Wong, Yee Hui Mok, Jan Hau Lee
AIMS: To describe the epidemiology of children with severe pneumonia and identify risk factors for poor outcomes. METHODS: We conducted a retrospective study of children admitted to pediatric intensive care unit (PICU) from 2010 to 2014 with a diagnosis of pneumonia. Clinical microbiological, ventilation and other pertinent PICU data were collected. Primary outcome was PICU mortality. Univariate and multivariate logistic regression model were used to identify risk factors for mortality...
April 3, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28358176/early-versus-late-tracheostomy-in-pediatric-intensive-care-unit-does-it-matter-a-6-year-experience
#4
Alessandro Pizza, Enzo Picconi, Marco Piastra, Orazio Genovese, Daniele G Biasucci, Giorgio Conti
BACKGROUND: The aim of this study is to examine the clinical data of children who underwent tracheostomy during their stay in Pediatric Intensive Care Unit (PICU), in order to describe the relationship between the timing of tracheostomy, the length of PICU stay and the occurrence of Ventilator-Associated Pneumonia (VAP). METHODS: This is a retrospective cohort study that collects all patients undergoing tracheostomy during their PICU stay over a six year period...
March 28, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28347624/efficacy-and-safety-of-normal-saline-instillation-and-paediatric-endotracheal-suction-an-integrative-review
#5
REVIEW
Jessica O'Leary, Marion L Mitchell, Marie Cooke, Andreas Schibler
OBJECTIVE: To synthesise research findings regarding the efficacy and safety of normal saline instillation (NSI) during endotracheal suction in the paediatric intensive care unit. DATA SOURCES: The Cochrane Library, PROSPERO, the National Health Service Centre for Reviews and Dissemination, PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) databases were systematically searched. Subject headings included "suctioning, endotracheal", "suction", "sodium chloride", "normal saline" and "paediatrics"...
March 24, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28341980/implementation-and-evaluation-of-a-paediatric-nurse-driven-sedation-protocol-in-a-paediatric-intensive-care-unit
#6
Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet
BACKGROUND: Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#7
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28302205/-value-of-nutritional-risk-screening-in-evaluating-adverse-clinical-outcomes-in-children-with-severe-pneumonia
#8
Xiao-Hui Guo, Yan-Feng Sun, Jiang-Bo Wang, Shu-Zhen Han, Jing Miao, Min Cui
OBJECTIVE: To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. METHODS: According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53)...
March 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28273700/-ventilator-associated-pneumonia-among-premature-infants-34-weeks-gestational-age-in-neonatal-intensive-care-unit-in-china-a-multicenter-study
#9
S J Li, S Y Yan, Y Zhou, K L E E Han, W L Guo, Q Xia, S P Vibhuti, J Z Wang, S W Ji, S H A H Yang, S N Yang, C Shan, C Y Liu, Z Z Yi, R B Liu, L Lin, B Wang, J Q He, Z L Li, Y Pan, L Guo, M X Chen, X N Liu, Y Zhou, L Li, C Q Xiong, Q Qi, X Y Hei, J Cao, Y J Jiang, M Y Zhang, Y Shoo
Objective: To investigate the incidence and pathogen distribution of ventilator-associated pneumonia (VAP) among preterm infants admitted to level Ⅲ neonatal intensive care units (NICU) in China. Method: A prospective study was conducted in 25 level Ⅲ NICU, enrolling all preterm infants <34 weeks gestational age admitted to the participating NICU within the first 7 days of life from May 2015 to April 2016. Chi-square test, t test and Mann-Whitney U test were used for statistical analysis. Result: A total of 7 918 patients were enrolled, within whom 4 623(58...
March 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28248714/nebulization-of-antiinfective-agents-in-invasively-mechanically-ventilated-adults-a-systematic-review-and-meta-analysis
#10
Candela Solé-Lleonart, Jean-Jacques Rouby, Stijn Blot, Garyfallia Poulakou, Jean Chastre, Lucy B Palmer, Matteo Bassetti, Charles-Edouard Luyt, Jose M Pereira, Jordi Riera, Tim Felton, Jayesh Dhanani, Tobias Welte, Jose M Garcia-Alamino, Jason A Roberts, Jordi Rello
BACKGROUND: Nebulization of antiinfective agents is a common but unstandardized practice in critically ill patients. METHODS: A systematic review of 1,435 studies was performed in adults receiving invasive mechanical ventilation. Two different administration strategies (adjunctive and substitute) were considered clinically relevant. Inclusion was restricted to studies using jet, ultrasonic, and vibrating-mesh nebulizers. Studies involving children, colonized-but-not-infected adults, and cystic fibrosis patients were excluded...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#11
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#12
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#13
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#14
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27914588/obesity-in-pediatric-trauma
#15
Cordelie E Witt, Saman Arbabi, Avery B Nathens, Monica S Vavilala, Frederick P Rivara
BACKGROUND/PURPOSE: The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated...
April 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27904542/the-effect-of-brushing-with-a-soft-toothbrush-and-distilled-water-on-the-incidence-of-ventilator-associated-pneumonia-in-the-intensive-care-unit
#16
Khadijeh Nasiriani, Fakhri Torki, Mohammad Hossein Jarahzadeh, Fahimeh Rashidi Maybodi
BACKGROUND: Ventilator-associated pneumonia (VAP) is a common nosocomial infection, which results in longer hospitalization, increased treatment costs, and higher mortality rates. One major cause of VAP is colonization and microaspiration of oropharyngeal secretions following the formation of dental plaque, which is due to poor oral hygiene and failure to mechanically remove these microorganisms from the teeth. This study was conducted to determine the effect of brushing teeth with distilled water on the incidence of VAP in patients admitted to intensive care unit (ICU)...
2016: Tanaffos
https://www.readbyqxmd.com/read/27889372/-non-invasive-ventilation-in-children-do-we-need-more-evidence
#17
G Mortamet, G Emeriaud, P Jouvet, B Fauroux, S Essouri
Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care...
January 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27848998/fatal-community-acquired-pneumonia-in-children-caused-by-re-emergent-human-adenovirus-7d-associated-with-higher-severity-of-illness-and-fatality-rate
#18
Zhiwu Yu, Zhiwei Zeng, Jing Zhang, Yuxian Pan, Manjun Chen, Yonghui Guo, Nan Yu, James Chodosh, Ning Fu, Xiaoyan Che, Qiwei Zhang
Human adenoviruses (HAdVs) are highly contagious pathogens causing acute respiratory disease (ARD), such as community-acquired pneumonia. HAdV-7d, a re-emergent genomic variant, has been recently reported in Asia and the United States after a several-decade absence. However, whether HAdV-7d is associated with higher severity than other types is currently unclear. In this study, the clinical and epidemiological investigation showed that fever, cough, and sore throat were the three most common respiratory symptoms of HAdV infections...
November 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27844091/preoperative-staphylococcus-aureus-carriage-and-risk-of-surgical-site-infection-after-cardiac-surgery-in-children-younger-than-1%C3%A2-year-a-pilot-cohort-study
#19
J Macher, C Gras Le Guen, A Chenouard, J M Liet, B Gaillard Le Roux, A Legrand, J Mahuet, E Launay, V Gournay, N Joram
Surgical site infections (SSI) increase length of stay, morbidity, mortality and cost of hospitalization. Staphylococcus aureus (SA) carriage is a known risk factor of SSI in adults, but its role in pediatrics remains uncertain. The main objective of this pilot prospective monocentric cohort study was to describe the prevalence of SA colonization in children under 1 year old before cardiac surgery. The secondary objectives were to compare the incidence of SSI and other nosocomial infections (NI) between preoperative carriers and non-carriers...
January 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/27805553/-monoinfection-of-human-metapneumovirus-in-cordoba-first-clinical-and-epidemiological-research-in-children-with-respiratory-infection-in-2011
#20
Pamela Elizabeth Rodriguez, María Pilar Adamo, María Gabriela Paglini, Laura Moreno, Jorge Augusto Camara, Alicia Camara
Human metapneumovirus (hMPV) RNA virus discovered in 2001, is a pathogen associated with acute respiratory infection (ARI) in children under 5 years; its prevalence ranges from 5-15%. In Córdoba, it is not integrated into the viral research in patients with low IRA (LARI). OBJECTIVE: Detect hMPV in children under 5 years hospitalized for LARI in the Children's Hospital "Santísima Trinidad" of Cordoba (HNC) in 2011 and describe the clinical and epidemiological characteristics of monoinfecciones without comorbidity...
2016: Revista de la Facultad de Ciencias Médicas
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