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https://www.readbyqxmd.com/read/27906197/treatment-and-follow-up-of-venous-thrombosis-in-the-neonatal-intensive-care-unit-a-retrospective-study
#1
J C Bohnhoff, S A DiSilvio, R K Aneja, J R Shenk, Y A Domnina, B S Brozanski, M Good
OBJECTIVE: The critically ill, premature patients of neonatal intensive care units are susceptible to venous thrombosis, an adverse event associated with short- and long-term morbidity. Venous thrombosis is frequently treated with low-molecular-weight heparins (LMWHs) such as enoxaparin, but optimal dosing of LMWH must balance the morbidity of venous thrombosis with the potential adverse affects of anticoagulation. The optimal dosing of enoxaparin for premature infants is unclear. The objective of this study was to describe enoxaparin therapy and follow-up in critically ill neonates diagnosed with venous thrombosis...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27876626/life-threatening-nlrc4-associated-hyperinflammation-successfully-treated-with-interleukin-18-inhibition
#2
Scott W Canna, Charlotte Girard, Louise Malle, Adriana de Jesus, Neil Romberg, Judith Kelsen, Lea F Surrey, Pierre Russo, Andrew Sleight, Eduardo Schiffrin, Cem Gabay, Raphaela Goldbach-Mansky, Edward M Behrens
NLRC4-inflammasome hyperactivity causes infantile-onset Macrophage Activation Syndrome and enterocolitis with extraordinary serum IL-18 elevation (NLRC4-MAS). Herein, we report a critically ill infant with severe, refractory NLRC4-MAS who showed sustained response to treatment with experimental IL-18 inhibition.
November 19, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27875283/does-persistent-inflammatory-catabolic-syndrome-exist-in-critically-ill-neonates
#3
Nicole Ellis, Caitlin Hughes, Vera Mazurak, Chloe Joynt, Bodil Larsen
BACKGROUND: Persistent inflammatory catabolic syndrome (PICS) has not been described in the infant population. This study proposes a definition of PICS in critically ill infants. METHODS: A published adult criterion of PICS was modified using anthropometric and biochemical reference ranges for infants. A prospective chart review of admissions to a tertiary surgical neonatal intensive care unit (NICU) was performed over 65 days. Demographic, anthropometric, biochemical, and other clinical variables such as length of stay and medication use were collected daily throughout admission...
October 10, 2016: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/27863513/epidemiology-of-rubella-virus-cases-in-the-pre-vaccination-era-of-ethiopia-2009-2015
#4
Mekonen Getahun, Berhane Beyene, Kathleen Gallagher, Ayesheshem Ademe, Birke Teshome, Mesfin Tefera, Anjelo Asha, Aklog Afework, Esete Assefa, Yoseph HaileMariam, Yonas HaileGiorgis, Hiwot Ketema, Dejenie Shiferaw, Ayenachew Bekele, Daddi Jima, Amha Kebede
BACKGROUND: Rubella is a common mild rash illness caused by rubella virus. The majority of infections occur in children and young adults. The infection is the cause of a serious birth defect known as Congenital Rubella Syndrome (CRS) when a woman acquires infection early in pregnancy. Ethiopia has not yet established rubella virus surveillance and has not yet introduced rubella vaccine into the routine immunization program. We characterize the epidemiology of laboratory confirmed rubella virus cases collected through measles surveillance from 2009 to 2015 to better understand the burden of the disease in the country...
November 18, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27852457/unexpected-non-maternally-derived-anti-pp1p-k-in-an-11-week-old-patient
#5
Hollie M Reeves, Victoria Cary, Mary Ann Mino, Claire McGrath, James A Westra, Connie Piccone, Katharine A Downes
Alloantibody formation at less than 4 months of age is rare. Most antibodies identified in these patients are maternally derived. Anti-PP1P(k) was detected in an 11-week-old infant that was not maternally derived. A multidisciplinary team approach led to appropriate testing, diagnosis, and transfusion management in this critically ill infant.
November 14, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27850093/453-accuracy-of-ph-as-a-bedside-indicator-of-ng-feeding-tube-placement-in-critically-ill-infants
#6
Kathleen Meert, Ann Pawluszka, Melanie Lulic, Norma Metheny
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27848889/contemporary-pediatric-palliative-care-myths-and-barriers-to-integration-into-clinical-care
#7
Stefan J Friedrichsdorf
At least 20 million children would benefit from Pediatric Palliative Care (PPC) annually, and 8 million children would need specialized PPC services. In the USA alone, more than 42,000 children 0-19 years died in 2013, fifty-five percent of them infants younger than 1 year. This article aims to critically review eight common assumptions, myths and barriers, which may hinder the implementation of PPC into the care of a child with advanced serious illnesses. Interdisciplinary PPC is about matching treatment to patient goals and is considered specialized medical care for children with serious illness...
November 15, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27834164/efficacy-of-sequential-nephron-blockade-with-intravenous-chlorothiazide-to-promote-diuresis-in-cardiac-intensive-care-infants
#8
Brady S Moffett, Rocky Tsang, Curt Kennedy, Ron A Bronicki, Ayse Akcan-Arikan, Paul A Checchia
BACKGROUND: Sequential nephron blockade using intravenous chlorothiazide is often used to enhance urine output in patients with inadequate response to loop diuretics. A few data exist to support this practice in critically ill infants. METHODS: We included 100 consecutive patients <1 year of age who were administered intravenous chlorothiazide while receiving furosemide therapy in the cardiac ICU in our study. The primary end point was change in urine output 24 hours after chlorothiazide administration, and patients were considered to be responders if an increase in urine output of 0...
November 11, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27826750/an-international-position-paper-on-mother-infant-perinatal-mental-health-with-guidelines-for-clinical-practice
#9
Ian Brockington, Ruth Butterworth, Nine Glangeaud-Freudenthal
The purpose of this paper is to set out informal, provisional and comprehensive but concise guidelines for mother-infant (perinatal) mental health (psychiatry), as an area of specialisation. It is informal in the sense that the authors are clinicians and researchers from many different nations, who share a common goal and vision, speaking on their own behalf and not with the backing of any authority or society. It is provisional in the expectation that it can be improved by criticism and new research findings...
November 8, 2016: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/27826706/clinical-associations-of-early-dysnatremias-in-critically-ill-neonates-and-infants-undergoing-cardiac-surgery
#10
Jon Kaufman, Daniel Phadke, Suhong Tong, Jennifer Eshelman, Sarah Newman, Christopher Ruzas, Eduardo M da Cruz, Suzanne Osorio
: Dysnatremias (DN) are common electrolyte disturbances in cardiac critical illness and are known risk factors for adverse outcomes in certain populations. Little information exists on DN in children with cardiac disease admitted to the cardiac intensive care unit (CICU) after undergoing cardiac surgery, either corrective or palliative. The aim was to determine the incidence and adverse outcomes associated with DN in neonates and infants undergoing cardiac surgery. Retrospective cohort and single center study performed at Children's Hospital Colorado from May 2013 to May 2014, in children under 1 year old admitted to the CICU after undergoing surgery for congenital or acquired cardiac disease...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27821118/the-intensive-care-lifeboat-a-survey-of-lay-attitudes-to-rationing-dilemmas-in-neonatal-intensive-care
#11
C Arora, J Savulescu, H Maslen, M Selgelid, D Wilkinson
BACKGROUND: Resuscitation and treatment of critically ill newborn infants is associated with relatively high mortality, morbidity and cost. Guidelines relating to resuscitation have traditionally focused on the best interests of infants. There are, however, limited resources available in the neonatal intensive care unit (NICU), meaning that difficult decisions sometimes need to be made. This study explores the intuitions of lay people (non-health professionals) regarding resource allocation decisions in the NICU...
November 8, 2016: BMC Medical Ethics
https://www.readbyqxmd.com/read/27819747/infant-position-in-neonates-receiving-mechanical-ventilation
#12
REVIEW
May Rivas-Fernandez, Marta Roqué I Figuls, Ana Diez-Izquierdo, Joaquin Escribano, Albert Balaguer
BACKGROUND: In patients of various ages undergoing mechanical ventilation (MV), it has been observed that positions other than the standard supine position, such as the prone position, may improve respiratory parameters. The benefits of these positions have not been clearly defined for critically ill newborns receiving MV.This is an update of a review first published in 2005 and last updated in 2013. OBJECTIVES: Primary objectiveTo assess the effects of different positioning of newborn infants receiving MV (supine vs prone, lateral decubitus or quarter turn from prone) in improving short-term respiratory outcomes...
November 7, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27796620/peritoneal-dialysis-for-the-management-of-pediatric-patients-with-acute-kidney-injury
#13
Anil Vasudevan, Kishore Phadke, Hui-Kim Yap
Renal replacement therapy (RRT) is the most important supportive measure used in the management of acute kidney injury (AKI). Peritoneal dialysis (PD) is a safe, simple and inexpensive procedure and has been used in pediatric AKI patients, ranging from neonates to adolescents. It is the modality of choice for RRT in developing countries with cost constraints and limited resources. However, its use has declined with the availability of newer types of extracorporeal modalities for RRT in the developed world. Much controversy exists regarding the dosing and adequacy of PD in the management of AKI...
October 28, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/27779775/clonidine-for-sedation-and-analgesia-and-withdrawal-in-critically-ill-infants-and-children
#14
Amanda C Capino, Jamie L Miller, Peter N Johnson
The need for sedation and analgesia and treatment of iatrogenic drug withdrawal is common in critically ill children. First-line therapy typically includes opioid agonists. However, clonidine, a central alpha2 agonist, has been suggested as a treatment option for sedation and analgesia and iatrogenic drug withdrawal. Therefore, we conducted a literature search to identify articles evaluating the use of enteral and transdermal clonidine in critically ill infants and children for sedation and analgesia and treatment of iatrogenic drug withdrawal...
October 25, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27777585/time-trends-and-predictors-of-abnormal-postoperative-body-temperature-in-infants-transported-to-the-intensive-care-unit
#15
Hedwig Schroeck, Angela K Lyden, Wendy L Benedict, Satya Krishna Ramachandran
Background. Despite increasing adoption of active warming methods over the recent years, little is known about the effectiveness of these interventions on the occurrence of abnormal postoperative temperatures in sick infants. Methods. Preoperative and postoperative temperature readings, patient characteristics, and procedural factors of critically ill infants at a single institution were retrieved retrospectively from June 2006 until May 2014. The primary endpoints were the incidence and trend of postoperative hypothermia and hyperthermia on arrival at the intensive care units...
2016: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/27773638/diagnosis-and-risk-factors-of-acute-kidney-injury-in-very-low-birth-weight-infants
#16
Ankana Daga, Fredrick Dapaah-Siakwan, Sharina Rajbhandari, Cassandra Arevalo, Agnes Salvador
BACKGROUND: Acute kidney injury (AKI) is common in critically ill premature infants. There is a lack of consensus on the diagnostic definition of AKI in very low birth weight (VLBW) infants. The primary aim of this study was to determine the incidence and risk factors for AKI in VLBW infants using the AKI network (AKIN) and pRIFLE (pediatric Risk, Injury, Failure, Loss, End-Stage) criteria and to evaluate whether Clinical Risk Index for Babies (CRIB II) score is a predictor of AKI. The secondary objective was to determine the extent of agreement between the AKIN and pRIFLE criteria in the diagnosis of AKI in VLBW infants...
September 28, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/27751300/antegrade-transvenous-balloon-angioplasty-for-coarctation-of-the-aorta-in-infants-with-ventricular-septal-defect
#17
Reyhan Dedeoglu, Levent Saltık, Sezen Ugan Atik, Ayşe Güler Eroglu
For a newborn, surgical correction has been the primary treatment of native coarctation at most centers; however, there has been an increased use of balloon angioplasty (BA). The anterograde transvenous (AT) technique is another alternative way for coarctation (AoC) angioplasty in low weight patients with large ventricular septal defect (VSD). Four, 5-day-old to 7-month-old, infants weighing 2500, 2700, 2800, and 3400g, respectively presented to emergency unit (EU) with cyanosis, tachypnea, and loss of weight...
September 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27749805/a-grounded-theory-qualitative-analysis-of-interprofessional-providers-perceptions-on-caring-for-critically-ill-infants-and-children-in-pediatric-and-general-emergency-departments
#18
Sandeep Gangadharan, Gunjan Tiyyagura, Marcie Gawel, Barbara M Walsh, Linda L Brown, Megan Lavoie, Khoon-Yen Tay, Marc A Auerbach
OBJECTIVE: The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. METHODS: This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27742148/pressure-ulcers-in-maturing-skin-a-clinical-perspective
#19
Anna-Barbara Schlüer
While the problem of Pressure Ulcers (PU) in adults has received a great deal of attention, far less is known about PUs in neonates and children. The overall health status of children is generally better and multi-morbidity is limited to a small percentage of patients, like very low term neonates (born before 32 weeks of gestation age), newborns with congenital abnormalities, genetic disorders, perinatal distress syndrome or children with a limited immunity. Survival rates of both critically and chronically ill neonates, infants and children have improved dramatically in recent years, introducing new challenges for medical and nursing care...
October 8, 2016: Journal of Tissue Viability
https://www.readbyqxmd.com/read/27735929/international-variations-in-application-of-the-best-interest-standard-across-the-age-spectrum
#20
N Laventhal, A A E Verhagen, T W R Hansen, E Dempsey, P G Davis, G A Musante, A Wiles, W Meadow, A Janvier
OBJECTIVE: Ethically and legally, assertions that resuscitation is in a patient's best interest should be inversely correlated with willingness to forego intensive care (and accept comfort care) at the surrogate's request. Previous single country studies have demonstrated a relative devaluation of neonates when compared with other critically ill patients. STUDY DESIGN: In this international study, physicians in Argentina, Australia, Canada, Ireland, The Netherlands, Norway and the United States were presented with eight hypothetical vignettes of incompetent critically ill patients of different ages...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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