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https://www.readbyqxmd.com/read/28643443/national-high-flow-nasal-cannula-and-bronchiolitis-survey-highlights-need-for-further-research-and-evidence-based-guidelines
#1
Paula Sokuri, Paula Heikkilä, Matti Korppi
AIM: High-flow nasal cannula (HFNC) therapy provides non-invasive respiratory support for infant bronchiolitis and its use has increased following good clinical experiences. This national study describes HFNC use in Finland during a severe respiratory syncytial virus (RSV) epidemic. METHODS: A questionnaire on using HFNC for infant bronchiolitis during the 2015-2016 RSV epidemic was sent to the head physicians of 18 Finnish children's hospitals providing inpatient care for infants: 17 hospitals answered, covering 77...
June 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28629604/novel-fkrp-mutations-in-a-japanese-mdc1c-sibship-clinically-diagnosed-with-fukuyama-congenital-muscular-dystrophy
#2
Mieko Yoshioka, Kazuhiro Kobayashi, Tatsushi Toda
INTRODUCTION: Fukuyama congenital muscular dystrophy (FCMD), caused by fukutin mutations, is the most common form of Japanese CMD. We followed a Japanese CMD sibship without fukutin mutation, and herein identified new FKRP mutations causing MDC1C rarely reported in Oriental countries. PATIENTS: Two affected siblings, individuals 1 (I-1, male) and 2 (I-2, female), were born uneventfully to unaffected, non-consanguineous parents. Severe hypotonia was soon apparent and serum CK levels were elevated: I-1: 1025 IU/L (normal range <130 IU/L) and I-2: 5350 IU/L...
June 16, 2017: Brain & Development
https://www.readbyqxmd.com/read/28627976/administration-of-rocuronium-based-on-real-body-weight-versus-fat-free-mass-in-patients-with-lymphedema
#3
Zhang Jing, Aikeremujiang Muheremu, Pengfei Liu, Xiaoyun Hu, Zhao Binjiang
Objective To compare the clinical pharmacokinetics of rocuronium when applied according to fat-free mass versus real body weight during anesthetic induction of patients with lymphedema. Methods Sixty patients with lymphedema (age, 18-60 years; American Society of Anesthesiologists physical status, I-II) undergoing elective surgery with general anesthesia were randomly divided into two groups. Rocuronium was administered based on the fat-free mass in 30 patients and real body weight in 30 patients. General anesthesia was induced with propofol and remifentanil by target-controlled infusion...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28606907/first-line-support-for-assistance-in-breathing-in-children-first-abc-protocol-for-a-multicentre-randomised-feasibility-trial-of-non-invasive-respiratory-support-in-critically-ill-children
#4
Padmanabhan Ramnarayan, Paula Lister, Troy Dominguez, Parviz Habibi, Naomi Edmonds, Ruth Canter, Paul Mouncey, Mark J Peters
INTRODUCTION: Over 18 000 children are admitted annually to UK paediatric intensive care units (PICUs), of whom nearly 75% receive respiratory support (invasive and/or non-invasive). Continuous positive airway pressure (CPAP) has traditionally been used to provide first-line non-invasive respiratory support (NRS) in PICUs; however, high-flow nasal cannula therapy (HFNC), a novel mode of NRS, has recently gained popularity despite the lack of high-quality trial evidence to support its effectiveness...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28603625/physiological-impact-of-high-flow-nasal-cannula-therapy-on-postextubation-acute-respiratory-failure-after-pediatric-cardiac-surgery-a-prospective-observational-study
#5
Naohiro Shioji, Tatsuo Iwasaki, Tomoyuki Kanazawa, Kazuyoshi Shimizu, Tomohiko Suemori, Kentaro Sugimoto, Yasutoshi Kuroe, Hiroshi Morimatsu
BACKGROUND: Reintubation after pediatric cardiac surgery is associated with a high rate of mortality. Therefore, adequate respiratory support for postextubation acute respiratory failure (ARF) is important. However, little is known about the physiological impact of high-flow nasal cannula (HFNC) therapy on ARF after pediatric cardiac surgery. Our working hypothesis was that HFNC therapy for postextubation ARF after pediatric cardiac surgery improves hemodynamic and respiratory parameters...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28601441/evaluation-and-handling-of-constipation-in-critical-patients
#6
J Pérez-Sánchez, J Fernández-Boronat, E Martínez-Méndez, M L Marín-Cagigas, D Mota-Puerto, M C Pérez-Román, G Martínez-Estalella
OBJECTIVE: To evaluate the effectiveness of nursing care against constipation and to identify, analyze and evaluate causes and consequences. METHODOLOGY: Observational, descriptive and prospective study in polyvalent ICU tertiary hospital (2013-2015). INCLUSION CRITERIA: >18 years, stay >7 days, connected to respiratory support, with nasogastric tube and enteral or mixed nutrition. Patients with gastrointestinal pathology, encephalopathic and jejunostomy/ileostomy were excluded...
June 7, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28598946/dexmedetomidine-for-sedation-during-noninvasive-ventilation-in-pediatric-patients
#7
Rasika Venkatraman, James L Hungerford, Mark W Hall, Melissa Moore-Clingenpeel, Joseph D Tobias
OBJECTIVES: To describe the use of dexmedetomidine for sedation in a large cohort of nonintubated children with acute respiratory insufficiency receiving noninvasive ventilatory support. DESIGN: Single-center, retrospective, observational cohort study. SETTING: A large quaternary-care PICU. PATIENTS: The study cohort included 202 children receiving noninvasive ventilatory and a dexmedetomidine infusion within 48 hours of PICU admission over a 6-month period...
June 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28596379/using-exhaled-co2-to-guide-initial-respiratory-support-at-birth-a-randomised-controlled-trial
#8
Ashley Y Ngan, Po-Yin Cheung, Ann Hudson-Mason, Megan O'Reilly, Sylvia van Os, Manoj Kumar, Khalid Aziz, Georg M Schmölzer
IMPORTANCE: A sustained inflation (SI) provided at birth might reduce bronchopulmonary dysplasia (BPD). OBJECTIVE: This study aims to examine whether an SI-guided exhaled carbon dioxide (ECO2) compared with positive pressure ventilation (PPV) alone at birth decreases BPD. DESIGN: Randomised controlled trial. Infants were randomly allocated to either SI (SI group) or PPV (PPV group). PARTICIPANTS: Participants of this study include infants between 23(+0) and 32(+6) weeks gestation with a need for PPV at birth...
June 8, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28589894/advising-women-with-diabetes-in-pregnancy-to-express-breastmilk-in-late-pregnancy-diabetes-and-antenatal-milk-expressing-dame-a-multicentre-unblinded-randomised-controlled-trial
#9
Della A Forster, Anita M Moorhead, Susan E Jacobs, Peter G Davis, Susan P Walker, Kerri M McEgan, Gillian F Opie, Susan M Donath, Lisa Gold, Catharine McNamara, Amanda Aylward, Christine East, Rachael Ford, Lisa H Amir
BACKGROUND: Infants of women with diabetes in pregnancy are at increased risk of hypoglycaemia, admission to a neonatal intensive care unit (NICU), and not being exclusively breastfed. Many clinicians encourage women with diabetes in pregnancy to express and store breastmilk in late pregnancy, yet no evidence exists for this practice. We aimed to determine the safety and efficacy of antenatal expressing in women with diabetes in pregnancy. METHODS: We did a multicentre, two-group, unblinded, randomised controlled trial in six hospitals in Victoria, Australia...
June 3, 2017: Lancet
https://www.readbyqxmd.com/read/28578160/fertility-treatment-is-associated-with-stay-in-the-neonatal-intensive-care-unit-and-respiratory-support-in-late-preterm-infants
#10
Erica T Wang, Lauren W Sundheimer, Carla Spades, Cara Quant, Charles F Simmons, Margareta D Pisarska
Late preterm infants are at risk for short-term morbidities. We report that late preterm singletons conceived with fertility treatment have increased risk for admission to the neonatal intensive care unit and respiratory support compared with spontaneously conceived infants. Fertility treatment may be a risk factor to consider in managing late preterm infants.
May 31, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28572120/burden-of-disease-and-change-in-practice-in-critically-ill-infants-with-bronchiolitis
#11
Luregn J Schlapbach, Lahn Straney, Ben Gelbart, Janet Alexander, Donna Franklin, John Beca, Jennifer A Whitty, Subodh Ganu, Barry Wilkins, Anthony Slater, Elizabeth Croston, Simon Erickson, Andreas Schibler
Bronchiolitis represents the most common cause of non-elective admission to paediatric intensive care units (ICUs).We assessed changes in admission rate, respiratory support, and outcomes of infants <24 months with bronchiolitis admitted to ICU between 2002 and 2014 in Australia and New Zealand.During the study period, bronchiolitis was responsible for 9628 (27.6%) of 34 829 non-elective ICU admissions. The estimated population-based ICU admission rate due to bronchiolitis increased by 11.76 per 100 000 each year (95% CI 8...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28571898/-recommendations-for-respiratory-support-in-the-newborn-iv-high-frequency-ventilation-ex-utero-intrapartum-treatment-exit-extracorporeal-membrane-oxygenation-ecmo
#12
Félix Castillo Salinas, Dolores Elorza Fernández, Antonio Gutiérrez Laso, Julio Moreno Hernando, Gerardo Bustos Lozano, Manuel Gresa Muñoz, Xavier Miracle Echegoyen
The recommendations included in this document will be part a series of updated reviews of the literature on respiratory support in the newborn infant. These recommendations are structured into 12 modules, and in this work module 8 is presented. Each module is the result of a consensus process amongst all members of the Surfactant and Respiratory Group of the Spanish Society of Neonatology. They represent a summary of the published papers on each specific topic, as well as the clinical experience of each one of the members of the group...
May 29, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28569744/delivery-room-interventions-to-prevent-bronchopulmonary-dysplasia-in-extremely-preterm-infants
#13
E E Foglia, E A Jensen, H Kirpalani
Bronchopulmonary dysplasia (BPD) is the most common chronic respiratory complication of preterm birth. Preterm infants are at risk for acute lung injury immediately after birth, which predisposes to BPD. In this article, we review the current evidence for interventions applied during neonatal transition (delivery room and first postnatal hours of life) to prevent BPD in extremely preterm infants: continuous positive airway pressure (CPAP), sustained lung inflation, supplemental oxygen use during neonatal resuscitation, and surfactant therapy including less-invasive surfactant administration...
June 1, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28569202/a-health-partnership-to-reduce-neonatal-mortality-in-four-hospitals-in-rwanda
#14
Placide Ntigurirwa, Kathy Mellor, Daniel Langer, Mari Evans, Emily Robertson, Lisine Tuyisenge, Alan Groves, Tom Lissauer
BACKGROUND: A health partnership to improve hospital based neonatal care in Rwanda to reduce neonatal mortality was requested by the Rwandan Ministry of Health. Although many health system improvements have been made, there is a severe shortage of health professionals with neonatal training. METHODS: Following a needs assessment, a health partnership grant for 2 years was obtained. A team of volunteer neonatologists and paediatricians, neonatal nurses, lactation consultants and technicians with experience in Rwanda or low-income countries was assembled...
June 1, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28567028/gelsemium-elegans-poisoning-a-case-with-8%C3%A2-months-of-follow-up-and-review-of-the-literature
#15
Zhou Zhou, Lei Wu, Yuhua Zhong, Xiaobo Fang, Yanmei Liu, Hongbing Chen, Weixi Zhang
BACKGROUND: Gelsemium elegans (G. elegans) is a toxic plant indigenous to Southeast Asia. It is highly poisonous due to its strong respiratory depressive effect. However, G. elegans poisoning cases have not been summarized comprehensively and are rarely reported in English journals. Furthermore, none of the present reports present prognosis in detail. CASE PRESENTATION: A 26-year-old female was found comatose at home and brought to the hospital with deep coma, hypoxia, and acidosis...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28566471/emergency-treatment-of-decompensated-aortic-stenosis
#16
Dario Bongiovanni, Constantin Kühl, Sabine Bleiziffer, Lynne Stecher, Felix Poch, Martin Greif, Julinda Mehilli, Steffen Massberg, Norbert Frey, Rüdiger Lange, Karl-Ludwig Laugwitz, Gerhard Schymik, Derk Frank, Christian Kupatt
OBJECTIVE: The optimal treatment of patients with acute and severe decompensation of aortic stenosis is unclear due to recent advances in transcatheter interventions and supportive therapies. Our aim was to assess the early outcome of emergency transcatheter aortic valve implantation (eTAVI) versus emergency balloon aortic valvuloplasty (eBAV) followed by TAVI under elective circumstances. METHODS: Emergency conditions were defined as: cardiogenic shock with requirement of catecholamine therapy, severe acute dyspnoea (NYHA IV), cardiac resuscitation or mechanic respiratory support...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28559463/development-and-testing-of-a-bubble-bi-level-positive-airway-pressure-system
#17
Stephen C John, Joseph D Barnett, Nickolas D Habben, Hoa T Le, Eric Cheng, Sunil P John, Peter A Gustafson
BACKGROUND: Neonatal respiratory distress results in > 1 million annual deaths worldwide. Bubble CPAP is a simple, effective, and widely used therapy for infants in respiratory distress. In low-resource settings, more advanced respiratory support is limited by cost, technical expertise, and sporadic electricity. We sought to develop a safe, inexpensive, and simple solution to provide further respiratory support for these infants. METHODS: A standard bubble CPAP system was modified to provide 2 levels of positive airway pressure (bi-level positive airway pressure) by attaching a novel device...
May 30, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28559125/respiratory-syncytial-virus-and-rhinovirus-related-bronchiolitis-in-children-aged-2-years-in-an-english-district-general-hospital
#18
S P Paul, A Mukherjee, T McAllister, M J Harvey, B A Clayton, P C Turner
BACKGROUND: Bronchiolitis is the most common reason for hospitalization in young children. In addition to respiratory syncytial virus (RSV), other viruses have been increasingly implicated. Guidance on testing has also changed. AIMS: To compare clinicopathological outcomes in young children admitted with bronchiolitis due to RSV in comparison with rhinovirus (RV), and identify associated risk/epidemiological factors. METHODS: Children aged less than two years admitted to hospital with a clinical diagnosis of bronchiolitis with positive results for either RSV or RV were included in this study...
May 3, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28557863/pediatric-extracorporeal-life-support-organization-registry-international-report-2016
#19
Ryan P Barbaro, Matthew L Paden, Yigit S Guner, Lakshmi Raman, Lindsay M Ryerson, Peta Alexander, Viviane G Nasr, Melania M Bembea, Peter T Rycus, Ravi R Thiagarajan
The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers...
May 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28555461/high-flow-nasal-cannulae-for-respiratory-support-in-adult-intensive-care-patients
#20
REVIEW
Amanda Corley, Claire M Rickard, Leanne M Aitken, Amy Johnston, Adrian Barnett, John F Fraser, Sharon R Lewis, Andrew F Smith
BACKGROUND: High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU). OBJECTIVES: We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment...
May 30, 2017: Cochrane Database of Systematic Reviews
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