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Critically ill infant

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https://www.readbyqxmd.com/read/28217595/impact-of-pre-hospital-care-on-the-outcome-of-children-arriving-with-agonal-breathing-to-a-pediatric-emergency-service-in-south-india
#1
Debasis Das Adhikari, Krishna Mahathi, Urmi Ghosh, Indira Agarwal, Anila Chacko, Ebor Jacob, Kala Ebenezer
BACKGROUND: Data on the prehospital interventions received by critically ill children at arrival to Paediatric Emergency Services (PES) is limited in developing countries. This study aims to describe the pre-hospital care scenario, transport and their impact on outcome in non-traumatic, acutely ill children presenting in PES with agonal breathing. METHODS: Prospective observational study done on children aged below 15 years arriving in PES with agonal breathing due to non-trauma related causes...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217150/infantile-tremor-syndrome-a-review-and-critical-appraisal-of-its-etiology
#2
REVIEW
Jatinder Singh Goraya, Sukhjot Kaur
Infantile tremor syndrome (ITS) is defined by the tetrad of pallor, developmental delay/regression, skin pigmentation, and brown scanty scalp hair. Involuntary movements in the form of tremors supervene in the natural course of the illness in a significant number of cases. The disorder occurs in exclusively breast-fed infants of vegetarian mothers belonging to economically deprived sections of society. Most of the children eventually recover but are frequently left with long-term cognitive and language neurodeficits...
October 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28207570/international-survey-of-critically-ill-children-with-acute-neurologic-insults-the-prevalence-of-acute-critical-neurological-disease-in-children-a-global-epidemiological-assessment-study
#3
Ericka L Fink, Patrick M Kochanek, Robert C Tasker, John Beca, Michael J Bell, Robert S B Clark, Jamie Hutchison, Monica S Vavilala, Anthony Fabio, Derek C Angus, R Scott Watson
OBJECTIVE: The international scope of critical neurologic insults in children is unknown. Our objective was to assess the prevalence and outcomes of children admitted to PICUs with acute neurologic insults. DESIGN: Prospective study. SETTING: Multicenter (n = 107 PICUs) and multinational (23 countries, 79% in North America and Europe). PATIENTS: Children 7 days to 17 years old admitted to the ICU with new traumatic brain injury, stroke, cardiac arrest, CNS infection or inflammation, status epilepticus, spinal cord injury, hydrocephalus, or brain mass...
February 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28198754/relationship-between-adverse-tracheal-intubation-associated-events-and-picu-outcomes
#4
Margaret M Parker, Gabrielle Nuthall, Calvin Brown, Katherine Biagas, Natalie Napolitano, Lee A Polikoff, Dennis Simon, Michael Miksa, Eleanor Gradidge, Jan Hau Lee, Ashwin S Krishna, David Tellez, Geoffrey L Bird, Kyle J Rehder, David A Turner, Michelle Adu-Darko, Sholeen T Nett, Ashley T Derbyshire, Keith Meyer, John Giuliano, Erin B Owen, Janice E Sullivan, Keiko Tarquinio, Pradip Kamat, Ronald C Sanders, Matthew Pinto, G Kris Bysani, Guillaume Emeriaud, Yuki Nagai, Melissa A McCarthy, Karen H Walson, Paula Vanderford, Anthony Lee, Jesse Bain, Peter Skippen, Ryan Breuer, Sarah Tallent, Vinay Nadkarni, Akira Nishisaki
OBJECTIVE: Tracheal intubation in PICUs is a common procedure often associated with adverse events. The aim of this study is to evaluate the association between immediate events such as tracheal intubation associated events or desaturation and ICU outcomes: length of stay, duration of mechanical ventilation, and mortality. STUDY DESIGN: Prospective cohort study with 35 PICUs using a multicenter tracheal intubation quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from January 2013 to June 2015...
February 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28167225/no-child-left-behind-liver-transplantation-in-critically-ill-children
#5
Abbas Rana, Michael Kueht, Moreshwar Desai, Fong Lam, Tamir Miloh, Jennifer Moffett, N Thao N Galvan, Ronald Cotton, Christine O'Mahony, John Goss
BACKGROUND: Advances in critical care prolong survival in children with liver failure, allowing more critically ill children to undergo orthotopic liver transplantation (OLT). In order to justify the use of a scarce donor resource and avoid futile transplants, we sought to determine survival in children who undergo OLT while receiving pre-OLT critical care. STUDY DESIGN: We analyzed 13,723 pediatric OLTs using the United Network for Organ Sharing (UNOS) database from 1987 to 2015, including 6,746 recipients in the Model for End-Stage Liver Disease/Pediatric End-Stage Liver Disease (MELD/PELD) era (2002 to 2015)...
February 3, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28157793/ultrasound-guided-subclavian-vein-cannulation-in-low-birth-weight-neonates
#6
Ulrik Lausten-Thomsen, Zied Merchaoui, Cécile Dubois, Sergio Eleni Dit Trolli, Nolwenn Le Saché, Mostafa Mokhtari, Pierre Tissières
OBJECTIVES: Central venous access in critically ill, small infants remains technically challenging even in experienced hands. Several vascular accesses exist, but the subclavian vein is often preferred for central venous catheter insertion in infants where abdominal malformation and/or closure of the vein preclude the use of umbilical venous catheters, as catheterization of the subclavian vein is easier in very short necks than the internal jugular vein for age-related anatomical reasons...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28152539/hyperoxia-and-the-immature-brain
#7
Bettina Reich, Daniela Hoeber, Ivo Bendix, Ursula Felderhoff-Mueser
Despite major advances in obstetrics and neonatal intensive care, preterm infants frequently suffer from neurological impairments in later life. Preterm and also full-term neonates are generally susceptible to injury caused by reactive oxygen species due to the immaturity of endogenous radical scavenging systems. It is well known that high oxygen levels experienced during the critical phase of maturation can profoundly influence developmental processes. Supraphysiological oxygen concentrations used for resuscitation or in the care of critically ill infants are known to have deleterious effects on the developing lung and retina, contributing to the pathophysiology of neonatal diseases like bronchopulmonary dysplasia and retinopathy of prematurity...
February 3, 2017: Developmental Neuroscience
https://www.readbyqxmd.com/read/28141899/intravenous-midazolam-infusion-for-sedation-of-infants-in-the-neonatal-intensive-care-unit
#8
REVIEW
Eugene Ng, Anna Taddio, Arne Ohlsson
BACKGROUND: Proper sedation for neonates undergoing uncomfortable procedures may reduce stress and avoid complications. Midazolam is a short-acting benzodiazepine that is used increasingly in neonatal intensive care units (NICUs). However, its effectiveness as a sedative in neonates has not been systematically evaluated. OBJECTIVES: Primary objeciveTo assess the effectiveness of intravenous midazolam infusion for sedation, as evaluated by behavioural and/or physiological measurements of sedation levels, in critically ill neonates in the NICU...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28134705/cutaneous-manifestations-of-systemic-viral-diseases-in-neonates-an-update
#9
Stephanie A Castillo, Anh Khoa Pham, James G Dinulos
PURPOSE OF REVIEW: Dermatologic findings may be the first signs of a neonatal viral infection. This review provides an update of the diagnostic features and therapies for selected viral illnesses [herpes simplex virus (HSV), varicella zoster virus, enterovirus, and Zika virus] that present with cutaneous manifestations in the neonate. RECENT FINDINGS: HSV DNA polymerase chain reaction of plasma and cerebrospinal fluid, routinely used in the diagnosis of neonatal HSV, may have expanded utility in assessing prognosis and acyclovir therapeutic efficacy...
January 27, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28121832/central-venous-to-arterial-co2-difference-after-cardiac-surgery-in-infants-and-neonates
#10
Leslie A Rhodes, W Clinton Erwin, Santiago Borasino, David C Cleveland, Jeffrey A Alten
OBJECTIVES: Venous to arterial CO2 difference correlates with cardiac output in critically ill adults, but its utility in pediatric patients is unclear. We sought to correlate venous to arterial CO2 difference with other cardiac output surrogates (arteriovenous oxygen saturation difference, central venous oxygen saturation, and lactate) and investigate its capacity to predict poor outcomes associated with low cardiac output (low cardiac output syndrome) in infants after cardiac surgery with cardiopulmonary bypass...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28111188/the-emergence-of-functional-architecture-during-early-brain-development
#11
Kristin Keunen, Serena J Counsell, Manon J N L Benders
Early human brain development constitutes a sequence of intricate processes resulting in the ontogeny of functionally operative neural circuits. Developmental trajectories of early brain network formation are genetically programmed and can be modified by epigenetic and environmental influences. Such alterations may exert profound effects on neurodevelopment, potentially persisting throughout the lifespan. This review focuses on the critical period of fetal and early postnatal brain development. Here we collate findings from neuroimaging studies, with a particular focus on functional MRI research that interrogated early brain network development in both health and high-risk or disease states...
January 20, 2017: NeuroImage
https://www.readbyqxmd.com/read/28078864/human-herpesviruses-6-and-7-encephalitis-in-immunocompetent-infants-are-they-really-so-uncommon
#12
L Marseglia, S Manti, G D Angelo, G Stroscio, D Impollonia, S Arena, C Salpietro, E Gitto
Human herpesviruses-6 and -7 (HHV-6 and 7) are considered uncommon causes of central nervous system infection and may occasionally cause encephalitis in young infants, however, the clinical syndrome and incidence are not well defined. In immunosuppressed hosts, reactivation is associated with a worse outcome such as encephalitis, hepatitis, or graft rejection. In immunocompetent hosts, this persistent infection is generally of no consequence. We report 4 cases of immunocompetent critically ill children, affected by HHV-6 and -7 encephalitis, admitted to our Pediatric Intensive Care Unit...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28078861/interleukin-6-and-interleukin-8-in-diagnosing-neonatal-septicemia
#13
Y Q Wu, J Shen, Q L Zhou, H W Zhao, L R Liu, X Liu
Neonatal septicemia (NS) is a common cause of death of newborn infants, hence early diagnosis and treatment are of the utmost importance. However, lack of specific clinical symptoms and late detection delay a correct diagnosis. It is therefore of great importance to establish auxiliary indexes for the early diagnosis of NS. To evaluate the value of interleukin (IL-6 and IL-8) in the diagnosis of NS, a prospective study was carried out. Seventy-five newborns who developed septicemia and received treatment in our hospital from January 2013 to December 2014 were selected as research subjects; also, 50 healthy newborns were set as a control group...
October 2016: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28075691/complexity-of-brain-signals-is-associated-with-outcome-in-preterm-infants
#14
Cristine Sortica da Costa, Michal M Placek, Marek Czosnyka, Brenno Cabella, Magdalena Kasprowicz, Topun Austin, Peter Smielewski
A characteristic feature of complex healthy biological systems is the ability to react and adapt to minute changes in the environment. This 'complexity' manifests itself in highly irregular patterns of various physiological measurements. Here, we apply Multiscale Entropy (MSE) analysis to assess the complexity of systemic and cerebral near-infrared spectroscopy (NIRS) signals in a cohort of 61 critically ill preterm infants born at median (range) gestational age of 26 (23-31) weeks, before 24 h of life. We further correlate the complexity of these parameters with brain injury and mortality...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28058755/characteristics-of-bordetella-pertussis-infection-among-infantsand-children-admitted-to-paediatric-intensive-care-units-in-greece-a-multicentre-11-year-study
#15
Maria S Kazantzi, Anargyroula Prezerakou, Serafeia N Kalamitsou, Stavroula Ilia, Panagiotis K Kalabalikis, John Papadatos, Maria M Sdougka, George Briassoulis, Maria N Tsolia
AIM: To describe children with pertussis who required intensive care. METHODS: This is a retrospective analysis of pertussis admissions to all (six) national intensive care units in Greece from 2003 to 2013. RESULTS: A total of 31 children were included, 28 of whom were younger than 12 months old. Cough was the most prominent symptom, being present in 27 of 31 (87%) patients, and on admission, only 7 (22.6%) satisfied the case definition...
January 6, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28046032/inflammatory-mediators-in-tracheal-aspirates-of-preterm-infants-participating-in-a-randomized-trial-of-inhaled-nitric-oxide
#16
Mandy Laube, Elena Amann, Ulrike Uhlig, Yang Yang, Hans W Fuchs, Michael Zemlin, Jean-Christophe Mercier, Rolf F Maier, Helmut D Hummler, Stefan Uhlig, Ulrich H Thome
BACKGROUND: Ventilated preterm infants frequently develop bronchopulmonary dysplasia (BPD) which is associated with elevated inflammatory mediators in their tracheal aspirates (TA). In animal models of BPD, inhaled nitric oxide (iNO) has been shown to reduce lung inflammation, but data for human preterm infants is missing. METHODS: Within a European multicenter trial of NO inhalation for preterm infants to prevent BPD (EUNO), TA was collected to determine the effects of iNO on pulmonary inflammation...
2017: PloS One
https://www.readbyqxmd.com/read/28040697/mother-s-recognition-of-and-treatment-triggers-for-common-childhood-illnesses-among-migrant-santal-tribe-living-in-bhubaneswar-odisha-india
#17
Suchismita Mishra, Yadlapalli S Kusuma, Bontha V Babu
BACKGROUND: Accelerating reduction in infant and other child mortality rates calls for comprehensive child survival strategies. Early recognition of illness and timely seeking of treatment are critical elements to prevent child deaths, and cultural explanation for these care-seeking behaviours is important. The present article reports (i) mothers' recognition of illness and (ii) triggers of treatment related to some childhood illnesses among a migrant tribal community living in Bhubaneswar city, India...
December 30, 2016: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/27988146/simplified-antibiotic-regimens-for-treatment-of-clinical-severe-infection-in-the-outpatient-setting-when-referral-is-not-possible-for-young-infants-in-pakistan-simplified-antibiotic-therapy-trial-satt-a-randomised-open-label-equivalence-trial
#18
Fatima Mir, Imran Nisar, Shiyam S Tikmani, Benazir Baloch, Sadia Shakoor, Fyezah Jehan, Imran Ahmed, Simon Cousens, Anita K M Zaidi
BACKGROUND: Parenteral antibiotic therapy for young infants (aged 0-59 days) with suspected sepsis is sometimes not available or feasible in countries with high neonatal mortality. Outpatient treatment could save lives in such settings. We aimed to assess the equivalence of two simplified antibiotic regimens, comprising fewer injections and oral rather than parenteral administration, compared with a reference treatment for young infants with clinical severe infection. METHODS: We undertook the Simplified Antibiotic Therapy Trial (SATT), a three-arm, randomised, open-label, equivalence trial in five communities in Karachi, Pakistan...
February 2017: Lancet Global Health
https://www.readbyqxmd.com/read/27986330/making-the-quick-diagnosis-a-case-of-neonatal-shock
#19
Mike Gardiner, Timothy K Ruttan, Andrew J Kienstra, Matthew Wilkinson
BACKGROUND: The work-up and initial management of a critically ill neonate is challenging and anxiety provoking for the Emergency Physician. While sepsis and critical congenital heart disease represent a large proportion of neonates presenting to the Emergency Department (ED) in shock, there are several additional etiologies to consider. Underlying metabolic, endocrinologic, gastrointestinal, neurologic, and traumatic disorders must be considered in a critically ill infant. Several potential etiologies will present with nonspecific and overlapping signs and symptoms, and the diagnosis often is not evident at the time of ED assessment...
December 13, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27977013/acupuncture-in-the-neonatal-intensive-care-unit-using-ancient-medicine-to-help-today-s-babies-a-review
#20
K L Chen, I Quah-Smith, G M Schmölzer, R Niemtzow, J L Oei
Acupuncture has been used for thousands of years in Eastern medicine for a variety of conditions and illnesses, including pain. Neonatal intensive care, on the other hand, is a relatively new branch of medicine that has emerged as the pivotal influence in increasing survival of critically ill newborn infants only within the last 50 years. Unfortunately, pain is an inevitable part of treatment in a neonatal intensive care unit (NICU). The control and prevention of pain remains a major issue for clinicians despite recognition and understanding of the myriad of short- and long-term problems that are associated with both pain and its treatment within the NICU environment...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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