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https://www.readbyqxmd.com/read/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#1
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#2
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28430695/cerebral-recovery-index-reliable-help-for-prediction-of-neurologic-outcome-after-cardiac-arrest
#3
Marleen C Tjepkema-Cloostermans, Jeannette Hofmeijer, Albertus Beishuizen, Harold W Hom, Michiel J Blans, Frank H Bosch, Michel J A M van Putten
OBJECTIVE: Early electroencephalography measures contribute to outcome prediction of comatose patients after cardiac arrest. We present predictive values of a new cerebral recovery index, based on a combination of quantitative electroencephalography measures, extracted every hour, and combined by the use of a random forest classifier. DESIGN: Prospective observational cohort study. SETTING: Medical ICU of two large teaching hospitals in the Netherlands...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28425334/remifentanil-for-sedation-of-children-with-traumatic-brain-injury
#4
James L Hungerford, Nicole O'Brien, Melissa Moore-Clingenpeel, Eric A Sribnick, Cheryl Sargel, Mark Hall, Jeffrey R Leonard, Joseph D Tobias
OBJECTIVE: To determine whether remifentanil would provide adequate sedation while allowing frequent and reproducible neurologic assessments in children admitted to the pediatric intensive care unit (PICU) with traumatic brain injury (TBI) during mechanical ventilation. DESIGN: Retrospective review. SETTING: Tertiary care PICU. PATIENTS: Thirty-eight patients over a 30-month period. MEASUREMENTS AND MAIN RESULTS: Median age was 9 years (interquartile range [IQR] 2...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28421189/optic-nerve-sheath-diameter-ultrasound-evaluation-in-intensive-care-unit-possible-role-and-clinical-aspects-in-neurological-critical-patients-daily-monitoring
#5
M Toscano, G Spadetta, P Pulitano, M Rocco, V Di Piero, O Mecarelli, E Vicenzini
Background. The increase of the optic nerve sheath diameter (ONSD) is a reliable, noninvasive sonographic marker of intracranial hypertension. Aim of the study was to demonstrate the efficacy of ONSD evaluation, when monitoring neurocritical patients, to early identify malignant intracranial hypertension in patients with brain death (BD). Methods. Data from ultrasound ONSD evaluation have been retrospectively analyzed in 21 sedated critical patients with neurological diseases who, during their clinical course, developed BD...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28420537/bilateral-versus-unilateral-antegrade-cerebral-perfusion-in-total-arch-replacement-for-type-a-aortic-dissection
#6
Guang Tong, Ben Zhang, Xuan Zhou, Ye Tao, Tao Yan, Xianyue Wang, Hua Lu, Zhongchan Sun, Weida Zhang
BACKGROUND: Antegrade cerebral perfusion (ACP) is the most widely used cerebral protection strategy for complex aortic repair and includes unilateral (u-ACP) and bilateral (b-ACP) techniques. The superiority of b-ACP over u-ACP has been the subject of much debate. Focusing on type A aortic dissection requiring total arch replacement, we investigated the clinical effects of b-ACP versus u-ACP. METHODS: Between September 2006 and August 2014, 203 patients presenting with type A aortic dissection (median age, 51...
March 12, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#7
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28417683/tracheostomy-for-severe-pediatric-obstructive-sleep-apnea-indications-and-outcomes
#8
Christopher J Rizzi, Julian D Amin, Amal Isaiah, Tulio A Valdez, Anita Jeyakumar, Suzanne E Smart, Kevin D Pereira
Objectives (1) To describe characteristics of pediatric patients undergoing tracheostomy for obstructive sleep apnea (OSA). (2) To highlight perioperative events and outcomes of the procedure. Study Design Case series with chart review. Setting Four tertiary care academic children's hospitals. Subjects and Methods Twenty-nine children aged <18 years from January 1, 2010, to December 31, 2015, who underwent tracheostomy for severe OSA, defined as an apnea-hypopnea index (AHI) >10, were included in the study...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28416497/prognostication-in-critically-ill-patients-with-severe-traumatic-brain-injury-the-tbi-prognosis-multicentre-feasibility-study
#9
Alexis F Turgeon, François Lauzier, Ryan Zarychanski, Dean A Fergusson, Caroline Léger, Lauralyn A McIntyre, Francis Bernard, Andrea Rigamonti, Karen Burns, Donald E Griesdale, Robert Green, Damon C Scales, Maureen O Meade, Martin Savard, Michèle Shemilt, Jérôme Paquet, Jean-Luc Gariépy, André Lavoie, Kesh Reddy, Draga Jichici, Giuseppe Pagliarello, David Zygun, Lynne Moore
OBJECTIVE: Severe traumatic brain injury is a significant cause of morbidity and mortality in young adults. Assessing long-term neurological outcome after such injury is difficult and often characterised by uncertainty. The objective of this feasibility study was to establish the feasibility of conducting a large, multicentre prospective study to develop a prognostic model of long-term neurological outcome in critically ill patients with severe traumatic brain injury. DESIGN: A prospective cohort study...
April 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28416429/-life-threatening-sleepwalking-elpenor-s-syndrome-in-a-10-year-old-child
#10
M-A Madigand-Tordjman, P-J Egler, F Bertran, M Jokic, F Guénolé
Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. OBSERVATION: This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#11
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28411355/rabies-acquired-through-kidney-transplantation-in-a-child-a-case-report
#12
Bassam Saeed, Mustafa Al-Mousawi
Rabies is usually transmitted to humans through bites of infected animals; however, it can rarely be transmitted through deceased donor organs or tissues when not suspected. Here, we report a case of rabies transmission in a child. The child was a 5-year-old girl who was admitted to the pediatric intensive care unit with encephalitis of unexplained cause 3.5 months after she received a kidney transplant from a deceased donor. The laboratory and imaging studies did not reveal any explanation for her rapidly declining clinical and neurologic condition, which ended with death 4 days after admission...
April 14, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28410771/the-esophageal-cooling-device-a-new-temperature-control-tool-in%C3%A2-the-intensivist-s-arsenal
#13
Ahmed F Hegazy, Danielle M Lapierre, Ron Butler, Janet Martin, Eyad Althenayan
BACKGROUND: Therapeutic hypothermia has been demonstrated to improve neurological outcome in comatose survivors of cardiac arrest. Current temperature control modalities however, have several limitations. Exploring innovative methods of temperature management has become a necessity. METHODS: We describe the first use of a novel esophageal cooling device as a sole modality for hypothermia induction, maintenance and rewarming in a series of four postcardiac arrest patients...
April 11, 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28409728/intracranial-pressure-in-patients-undergoing-decompressive-craniectomy-new-perspective-on-thresholds
#14
Thomas Sauvigny, Jennifer Göttsche, Patrick Czorlich, Eik Vettorazzi, Manfred Westphal, Jan Regelsberger
OBJECTIVE Decompressive craniectomy (DC) is an established part of treatment in patients suffering from malignant infarction of the middle cerebral artery (MCA) or traumatic brain injury (TBI). However, no clear evidence for intracranial pressure (ICP)-guided therapy after DC exists. The lack of this evidence might be due to the frequently used, but simplified threshold for ICP of 20 mm Hg, which determines further therapy. Therefore, the objective of this study was to evaluate this threshold's accuracy and to investigate the course of ICP values with respect to neurological outcome...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28406417/a-rare-complication-of-viper-envenomation-cardiac-failure-a-case-report
#15
K Chara, N Baccouche, O Turki, K Regaig, A Chaari, M Bahloul, M Bouaziz
Viper envenomation is common in North Africa. Cardiac complications are not common features of snakebites, the clinical picture of which is usually dominated by toxin-associated neurological, hematological, and vascular damage. There are rare reports of acute myocardial infarction and/or ischemia caused by snakebites, while myocarditis after envenomation has not yet been reported, to our knowledge. We report the case of a 43-year-old woman admitted to our intensive care unit after viper envenomation complicated by acute heart failure with acute pulmonary edema, in a state of cardiogenic shock, accompanied by multi-organ failure, intravascular disseminated coagulation, and neurological damage...
February 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/28402834/long-term-outcome-of-refractory-status-epilepticus-in-adults-a-retrospective-population-based-study
#16
Anne-Mari Kantanen, Matti Reinikainen, Ilkka Parviainen, Reetta Kälviäinen
PURPOSE: Refractory status epilepticus (RSE) is a neurological emergency with significant morbidity and mortality. We aimed to analyze the long-term outcome of intensive care unit (ICU)-treated RSE and super-refractory status epilepticus (SRSE) patients in a population based cohort. METHODS: A retrospective study of ICU- and anesthesia-treated RSE patients in Kuopio University Hospital's (KUH) special responsibility area hospitals in the central and eastern part of Finland from Jan...
April 2, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28399640/associations-of-maternal-testosterone-and-cortisol-levels-with-health-outcomes-of-mothers-and-their-very-low-birth-weight-infants
#17
June Cho, Xiaogang Su, Diane Holditch-Davis
OBJECTIVE: Although the roles of testosterone and cortisol in various health problems have been extensively investigated, little is known about their associations with health outcomes in mothers and their very-low-birth weight (VLBW) infants when maternal testosterone and cortisol are examined together during the postpartum period. METHOD: The 101 mother-VLBW infant pairs were recruited from the neonatal intensive care unit of a tertiary medical center in the southeastern United States...
January 1, 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28399095/-modern-principles-of-integrated-diagnostics-and-rehabilitation-of-perinatal-lesions-of-the-nervous-system-and-their-consequences
#18
S A Nemkova
The article is devoted to the comprehensive diagnosis and treatment of perinatal lesions of the nervous system and their consequences in children. Reflects modern approaches to data classification conditions, taking into account ideas on the etiology and pathogenesis of the disease, the clinical manifestations of the main syndromes (excitation and depression, hypertensive, convulsive, movement disorders) as the neonatal period, and in the formation of long-term effects (motor and mental delay and speech development, hyperkinetic syndrome, cerebral palsy and others)...
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28393780/does-sleep-quality-affects-the-immediate-clinical-outcome-in-patients-undergoing-coronary-artery-bypass-grafting-a-clinico-biochemical-correlation
#19
Minati Choudhury, Anushree Gupta, Milind P Hote, Poonam Malhotra Kapoor, Sandeep Khanna, M V Kalaivani, Usha Kiran
OBJECTIVE: Poor sleep quality is emerging as high prevalence among the patients suffering from cardiometabolic disturbances. The vascular polypeptide endothelin 1 (ET-1) is involved in many of the health disorders. However, its potential involvement in patients having poor sleep quality along with cardiovascular problem is limited. The present study was formulated to conduct a prospective analysis of the relationship between ET-1 and in hospital outcome in sleep disorder patients undergoing routine coronary artery bypass grafting (CABG)...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28385479/opportunity-to-reduce-transfer-of-patients-with-mild-traumatic-brain-injury-and-intracranial-hemorrhage-to-a-level-1-trauma-center
#20
Brian J Yun, Benjamin A White, H Benjamin Harvey, Anand M Prabhakar, Jonathan D Sonis, McKinley Glover, Emily Vallillo, Sun Choi, Pierre Borczuk, Ali S Raja
OBJECTIVE: Current guidelines do not address the disposition of patients with mild traumatic brain injury (TBI) and resultant intracranial hemorrhage (ICH). Emergency medicine clinicians working in hospitals without neurosurgery coverage typically transfer patients with both to a trauma center with neurosurgery capability. Evidence is accruing which demonstrates that the risk of neurologic decompensation depends on the type of ICH and as a result, not every patient may need to be transferred...
March 30, 2017: American Journal of Emergency Medicine
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