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Pediatrics critical care

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https://www.readbyqxmd.com/read/29913072/postgraduate-clinical-physiotherapy-education-in-acute-hospitals-a-cohort-study
#1
Emma K Bastick, David D O'Keeffe, Melanie K Farlie, Danielle T Ryan, Terry P Haines, Nikki Katz, Jessica L Knight, Laura K Keely, Kelly J Saber, Tamica R Sturgess, Elizabeth H Skinner
BACKGROUND: Junior physiotherapists require satisfactory clinical skills to work effectively within the acute hospital setting for service quality and consistency. OBJECTIVE: To investigate the effects of stream-specific clinical training on junior physiotherapist self-efficacy, self-rated confidence, and self-rated ability to work independently during weekend shifts. DESIGN: Prospective cohort study. PARTICIPANTS: Eighteen junior physiotherapists...
June 18, 2018: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/29912937/comparison-of-three-non-invasive-hemodynamic-monitoring-methods-in-critically-ill-children
#2
Chanapai Chaiyakulsil, Marut Chantra, Poomiporn Katanyuwong, Anant Khositseth, Nattachai Anantasit
INTRODUCTION: Hemodynamic parameters measurements were widely conducted using pulmonary artery catheter (PAC) with thermodilution as a reference standard. Due to its technical difficulties in children, transthoracic echocardiography (TTE) has been widely employed instead. Nonetheless, TTE requires expertise and is time-consuming. Noninvasive cardiac output monitoring such as ultrasonic cardiac output monitor (USCOM) and electrical velocimetry (EV) can be performed rapidly with less expertise requirement...
2018: PloS One
https://www.readbyqxmd.com/read/29912069/the-impact-of-critical-care-nursing-certification-on-pediatric-patient-outcomes
#3
Patricia A Hickey, Kimberlee Gauvreau, Courtney Porter, Jean A Connor
OBJECTIVES: To examine the relationship of nursing and unit characteristics including Critical Care Registered Nurse certification on patient complications for children undergoing congenital heart surgery in free-standing children's hospitals in the United States. DESIGN: A cross-sectional descriptive survey of nursing and organizational characteristics was sent electronically. SETTING: Free-standing children's hospitals in the United States...
June 14, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29908681/the-impact-of-early-enteral-nutrition-on-pediatric-acute-respiratory-failure
#4
Amanda Haney, Emily Burritt, Christopher J Babbitt
BACKGROUND AND AIMS: Children who are critically ill undergo metabolic stress and it is important that they receive adequate calories and protein in order to recover. Our objective was to investigate the impact of early enteral nutrition (EEN) on pediatric intensive care (PICU) patients with acute respiratory failure. METHODS: A retrospective cohort study was performed on all patients admitted to a 20 bed PICU at a tertiary children's hospital over a 30 month period...
August 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29907141/serum-and-urine-fgf23-and-igfbp-7-for-the-prediction-of-acute-kidney-injury-in-critically-ill-children
#5
Zhenjiang Bai, Fang Fang, Zhong Xu, Chunjiu Lu, Xueqin Wang, Jiao Chen, Jian Pan, Jian Wang, Yanhong Li
BACKGROUND: Fibroblast growth factor 23 (FGF23) and insulin-like growth factor binding protein 7 (IGFBP-7) are suggested to be biomarkers for predicting acute kidney injury (AKI). We compared them with proposed AKI biomarker of cystatin C (CysC), and aimed (1) to examine whether concentrations of these biomarkers vary with age, body weight, illness severity assessed by pediatric risk of mortality III score, and kidney function assessed by estimated glomerular filtration rate (eGFR), (2) to determine the association between these biomarkers and AKI, and (3) to evaluate whether these biomarkers could serve as early independent predictors of AKI in critically ill children...
June 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29905634/ability-to-assent-in-pediatric-critical-care-research-a-prospective-environmental-scan-of-two-canadian-picus
#6
Katharine J O'Hearn, Dori-Ann Martin, Maryse Dagenais, Kusum Menon
OBJECTIVES: To determine the number of patients considered not appropriate to approach for assent within the first 24 hours of PICU admission. DESIGN: Exploratory prospective 1-month environmental scan. SETTING: Two tertiary Canadian PICUs. PATIENTS: Ninety patients age newborn to 17 years old admitted to the PICU during September 2016 (Site 1) or May 2017 (Site 2). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At PICU admission, 81% of patients were deemed not appropriate to approach for assent most commonly due to age, influence of psychotropic medications, and/or mechanical ventilation...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29905632/an-ethical-claim-for-providing-medical-recommendations-in-pediatric-intensive-care
#7
Katie M Moynihan, Melanie A Jansen, Shih-Ning Liaw, Peta M A Alexander, Robert D Truog
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one of paternalism to more informed, shared decision-making. Unfortunately, there is an increasing trend for clinicians to avoid making recommendations, instead providing a "menu" of care options from which patients and families must choose. This seems to be underpinned by the belief that it is unacceptably paternalistic to give guidance as to which course of action may be best to take...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29904575/recent-advances-in-transfusions-in-neonates-infants
#8
REVIEW
Ruchika Goel, Cassandra D Josephson
Transfusions of red blood cells (RBCs), platelets, and plasma are critical therapies for infants and neonates (particularly preterm neonates) in the neonatal intensive care unit, who are the most frequently transfused subpopulation across all ages. Although traditionally a significant gap has existed between the blood utilization and the evidence base essential to adequately guide transfusion practices in infants and neonates, pediatric transfusion medicine is evolving from infancy and gradually coming of age...
2018: F1000Research
https://www.readbyqxmd.com/read/29901527/knowledge-accrual-following-participation-in-pediatric-fundamental-critical-care-support-course-in-gaborone-botswana
#9
Megan Cox, Natasha Afonso, Loeto Mazhani, David Kloeck, Mohan Mysore, Kevin Roy, Segolame Setlhare, Tlamelo Daman, Peter A Meaney
OBJECTIVES: To describe provider characteristics, knowledge acquisition, perceived relevance, and instruction quality of the Society of Critical Care Medicine's Pediatric Fundamentals of Critical Care Support course pilot implementation in Botswana. DESIGN: Observational, single center. SETTING: Academic, upper middle-income country. SUBJECTS: Healthcare providers in Botswana. INTERVENTIONS: A cohort of healthcare providers completed the standard 2-day Pediatric Fundamentals of Critical Care Support course and qualitative survey during the course...
June 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29900801/biobanking-in-the-pediatric-critical-care-setting-adolescent-young-adult-perspectives
#10
Erin D Paquette, Sabrina F Derrington, Avani Shukla, Neha Sinha, Sarah Oswald, Lauren Sorce, Kelly N Michelson
Biorepository research in children raises numerous ethical questions that are heightened in the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents of PICU patients to elucidate perspectives on biorepository research. A/YAs had a positive attitude toward biobanking. In young adults, comprehension was higher for knowledge of a choice to withdraw and participate in the research and lower for purpose, procedures, risks, and benefits of participation...
June 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/29900403/feedback-quality-using-an-observation-form
#11
Gary L Beck Dallaghan, Joy Higgins, Adam Reinhardt
Background: Direct observations with focused feedback are critical components for medical student education. Numerous challenges exist in providing useful comments to students during their clerkships. Students' evaluations of the clerkship indicated they were not receiving feedback from preceptors or house officers. Objective: To encourage direct observation with feedback, Structured Patient Care Observation (SPCO) forms were used to evaluate third-year medical students during patient encounters...
January 2018: Journal of Medical Education and Curricular Development
https://www.readbyqxmd.com/read/29894446/parental-presence-at-the-bedside-of-critically-ill-children-in-a-unit-with-unrestricted-visitation
#12
Jennifer R Foster, Farhana I AlOthmani, Jamie A Seabrook, Tariq AlOfisan, Yasser M AlGarni, Amrita Sarpal
OBJECTIVES: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. DESIGN: Prospective cohort study. SETTING: PICU in a single tertiary care children's hospital. SUBJECTS: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015...
June 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29893932/challenges-in-transitional-care-in-inflammatory-bowel-disease-a-review-of-the-current-literature-in-transition-readiness-and-outcomes
#13
Jessica R Philpott, Jacob A Kurowski
Transitional care for patients with IBD focuses on efforts to successfully transfer care from pediatric to adult providers while encouraging the assumption of health care responsibility. As 25% of patients will be diagnosed with IBD before the age of 18 years, many will undergo this process. Efforts to enhance this process have included transition clinics and other means to improve patient comfort with transition and develop the skill of health care self-management. Currently, most pediatric practitioners provide transition care with informal education and emphasize independence without formal programs...
June 11, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29893805/vancomycin-monotherapy-may-be-insufficient-to-treat-methicillin-resistant-staphylococcus-aureus-coinfection-in-children-with-influenza-related-critical-illness
#14
Adrienne G Randolph, Ruifei Xu, Tanya Novak, Margaret M Newhams, Juliane Bubeck Wardenburg, Scott L Weiss, Ronald C Sanders, Neal J Thomas, Mark W Hall, Keiko M Tarquinio, Natalie Cvijanovich, Rainer G Gedeit, Edward J Truemper, Barry Markovitz, Mary E Hartman, Kate G Ackerman, John S Giuliano, Steven L Shein, Kristin Moffitt
Background: Respiratory coinfection with influenza virus and methicillin-resistant Staphylococcus aureus (MRSA) causes life-threatening necrotizing pneumonia in children. Sporadic incidence precludes evaluation of antimicrobial efficacy. We assessed the clinical characteristics and outcomes of critically ill children with influenza-MRSA respiratory coinfection and evaluated antibiotic use. Methods: We prospectively enrolled children (<18 years) with influenza infection and acute respiratory failure across 34 pediatric intensive care units Nov 2008 to May 2016...
June 9, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29893624/developmental-disorders-and-medical-complications-among-infants-with-subclinical-intrauterine-opioid-exposures
#15
Eric S Hall, Jennifer M McAllister, Scott L Wexelblatt
The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old...
June 12, 2018: Population Health Management
https://www.readbyqxmd.com/read/29892595/advances-in-pediatric-critical-care-research-in-india
#16
REVIEW
Utpal Bhalala, Arun Bansal, Krishan Chugh
Over last 2 decades, there has been a significant progress made in the field of pediatric critical care in India. There has been complementary and parallel growth in the pediatric critical care services in India and the number of pediatric critical care providers who are either formally trained in India or who have returned to India after their formal training abroad. The pediatric critical care community in India has recognized obvious differences in profiles of critical illnesses and patients between Indian subcontinent and the West...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29891404/influenza-associated-neurological-complications-during-2014-2017-in-taiwan
#17
Li-Wen Chen, Chao-Ku Teng, Yi-Shan Tsai, Jieh-Neng Wang, Yi-Fang Tu, Ching-Fen Shen, Ching-Chuan Liu
INTRODUCTION: Seasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014-2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. MATERIALS/SUBJECTS: During January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed...
June 8, 2018: Brain & Development
https://www.readbyqxmd.com/read/29891258/epidemiology-of-lower-extremity-deep-venous-thrombosis-in-critically-ill-adolescents
#18
Edward Vincent S Faustino, Veronika Shabanova, Matthew G Pinto, Simon Li, Erin Trakas, Michael Miksa, Shira Gertz, Lee A Polikoff, Massimo Napolitano, Adele R Brudnicki, Joana A Tala, Cicero T Silva
OBJECTIVE: To determine the epidemiology of lower extremity deep venous thrombosis (DVT) in critically ill adolescents, which currently is unclear. STUDY DESIGN: We performed a multicenter, prospective, cohort study. Adolescents aged 13-17 years who were admitted to 6 pediatric intensive care units and were anticipated to receive cardiopulmonary support for at least 48 hours were eligible, unless they were admitted with DVT or pulmonary embolism or were receiving or anticipated to receive therapeutic anticoagulation...
June 8, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29887165/nurses-experiences-of-end-of-life-photography-in-nicu-bereavement-support
#19
Sara Martel, Lori Ives-Baine
PURPOSE: To qualitatively explore neonatal intensive care nurses' experiences with end-of-life photography as part of their bereavement support work with families. DESIGN AND METHODS: An Interpretive Phenomenological Analysis with data collected through a focus group (n = 6) and one semi-structured interview (n = 1) with neonatal nurses from a Level 3/4 NICU in a Canadian pediatric hospital. RESULTS: Participants' comfort with EOL photography developed over time through exposure to bereavement scenarios and positive experiences with families...
June 7, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29886503/transition-of-care-from-childhood-to-adulthood-congenital-hypogonadotropic-hypogonadism
#20
Andrew A Dwyer, Nelly Pitteloud
Passage from childhood to adult life involves biological changes culminating in full reproductive capacity as well as psychosocial development. For patients with congenital hypogonadotropic hypogonadism (CHH), this can be an emotionally challenging time as their pubertal failure results in striking physical differences from their peers. CHH is difficult to differentiate from common disorders of puberty such as constitutional delay of growth and puberty. As such, delays in diagnosis are frequent, and it is a common source of stress and frustration for these adolescents...
2018: Endocrine Development
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