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https://www.readbyqxmd.com/read/29151001/intravenous-fluid-therapy-for-hospitalized-and-critically-ill-children-rationale-available-drugs-and-possible-side-effects
#1
Thomas Langer, Rosamaria Limuti, Concezione Tommasino, Niels van Regenmortel, Els L I M Duval, Pietro Caironi, Manu L N G Malbrain, Antonio Pesenti
Human beings are constituted mainly of water. In particular, children's total body water might reach 75-80% of their body weight, compared to 60-70% in adults. It is therefore not surprising, that children, especially hospitalized newborns and infants, are markedly prone to water and electrolyte imbalances. Parenteral fluid therapy is a cornerstone of medical treatment and is thus of exceptional relevance in this patient population. It is crucial to appreciate the fact that intravenous fluids are drugs with very different characteristics, different indications, contraindications and relevant side effects...
November 18, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29141932/umbilical-artery-perforation-a-potentially-life-threatening-complication-of-umbilical-artery-catheterisation
#2
Daniel Molanus, Machteld van Scherpenzeel, Joep Derikx, Frank van den Dungen
Umbilical artery catheterisation is frequently performed in preterm or critically ill newborn infants for invasive monitoring of blood pressure and blood sampling for laboratory tests. It is associated with well-known complications like catheter-related infections, thromboembolic events and aneurysmal formation of the aorta. In this report, we present another major complication of umbilical artery catheterisation: umbilical artery perforation. This complication occurred in a prematurely born infant and resulted in severe haemorrhagic shock, subsequent renal failure and severe periventricular leukomalacia...
November 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29131465/psychometric-analysis-of-subjective-sedation-scales-used-for-critically-ill-paediatric-patients
#3
Xiaohua Ge, Tingting Zhang, Lingling Zhou
AIMS: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. BACKGROUND: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales...
November 12, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29119806/ethical-dilemmas-associated-with-clinicians-decisions-about-treatment-in-critically-ill-infants-born-in-c%C3%A3-rdoba-argentina
#4
Agustín Alfredo Silberberg, Juan Eduardo Gallo
The objective of this article is to examine end of life decisions made by neonatologists of Córdoba, Argentina. An anonymous questionnaire was designed to investigate neonatologists' decisions on when to initiate or withdraw treatment in critical neonates. All neonatologists who take care of critically ill neonates in Córdoba participated in the survey. More than 75% of them would initiate treatment in preterm infants with uncertain prognosis based on the viability of the newborn. Because it is common to find that critically ill neonates lack sufficient diagnostic information at birth, this attitude seems to manifest a certain therapeutic activism...
March 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29118206/social-origins-of-developmental-risk-for-mental-and-physical-illness
#5
Judy L Cameron, Kathie L Eagleson, Nathan A Fox, Takao K Hensch, Pat Levitt
Adversity in early childhood exerts an enduring impact on mental and physical health, academic achievement, lifetime productivity, and the probability of interfacing with the criminal justice system. More science is needed to understand how the brain is affected by early life stress (ELS), which produces excessive activation of stress response systems broadly throughout the child's body (toxic stress). Our research examines the importance of sex, timing and type of stress exposure, and critical periods for intervention in various brain systems across species...
November 8, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29117060/cognitive-development-1-year-after-infantile-critical-pertussis
#6
John T Berger, Michele E Villalobos, Amy E Clark, Richard Holubkov, Murray M Pollack, Robert A Berg, Joseph A Carcillo, Heidi Dalton, Rick Harrison, Kathleen L Meert, Christopher J L Newth, Thomas P Shanley, David L Wessel, Kanwaljeet J S Anand, Jerry J Zimmerman, Ronald C Sanders, Teresa Liu, Jeri S Burr, Douglas F Willson, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge. DESIGN: Prospective cohort study. SETTING: Eight hospitals comprising the Eunice Kennedy Shriver National Institute for Child Health and Human Development Collaborative Pediatric Critical Care Research Network and 18 additional sites across the United States...
November 7, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29105008/impact-of-postpartum-mental-illness-upon-infant-development
#7
REVIEW
Casey Hoffman, Dena M Dunn, Wanjiku F M Njoroge
PURPOSE OF REVIEW: This review evaluates the state of the research regarding the effects of postpartum mental illness on the developing infant. It defines the scope of these disorders in the literature, and includes the impact of disorders referred to as perinatal mood and anxiety disorders (PMADs) on infants. RECENT FINDINGS: New research reveals that PMADs apply to not only mothers, but that fathers can also experience perinatal depression and anxiety. When untreated in a primary caregiver, PMADs adversely affect parental cognitions and beliefs, attachment to the infant, and the growing caregiver-infant relationship...
November 6, 2017: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29100554/intersociety-policy-statement-on-the-use-of-whole-exome-sequencing-in-the-critically-ill-newborn-infant
#8
REVIEW
Alessandro Borghesi, Maria Antonietta Mencarelli, Luigi Memo, Giovanni Battista Ferrero, Andrea Bartuli, Maurizio Genuardi, Mauro Stronati, Alberto Villani, Alessandra Renieri, Giovanni Corsello
The rapid advancement of next-generation sequencing (NGS) technology and the decrease in costs for whole-exome sequencing (WES) and whole-genome sequening (WGS), has prompted its clinical application in several fields of medicine. Currently, there are no specific guidelines for the use of NGS in the field of neonatal medicine and in the diagnosis of genetic diseases in critically ill newborn infants. As a consequence, NGS may be underused with reduced diagnostic success rate, or overused, with increased costs for the healthcare system...
November 3, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/29095348/di-2-ethylhexyl-phthalate-and-its-role-in-developing-cholestasis-an-in-vitro-study-on-different-liver-cell-types
#9
Haristi Gaitantzi, Priska Hakenberg, Jannick Theobald, Hagen Heinlein, Chen Cai, Steffan Loff, Stefan Wölfl, Matthias P Ebert, Katja Breitkopf-Heinlein, Ulrike Subotic
OBJECTIVES: Di(2-ethylhexyl) phthalate (DEHP) is a plasticizer used in many polyvinylchloride medical devices and is washed out easily. Thereby critically ill infants can become exposed to DEHP concentrations significantly exceeding the recommended threshold. We suspect DEHP to play an important role in the development of intestinal failure associated liver disease. The aim of this study was therefore, to determine the direct influence of DEHP on different liver cell types. METHODS: HepG2, human upcyte hepatocytes, primary murine hepatocytes, LX-2, human upcyte hepatic stellate cells and liver organoids were cultured with DEHP (0...
October 31, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29095003/-spanish-multicenter-study-hyperammonemia-not-associated-with-inborn-errors-of-metabolism-in-children
#10
Mercedes Gil Campos, Javier Blasco-Alonso, Concepción Sierra Córcoles, José Luis Cuevas Cervera, Luisa Arrabal Fernández, Luis Aldámiz Echevarría, Amaya Belanger
INTRODUCTION: The hyperammonemic encephalopathy induced by causes different from inborn errors of metabolism is a relatively uncommon but severe complication. OBJETIVES: To study the characteristics of a secondary hyperammonemia episode to discern the triggering causes to get to the diagnosis, and the development in the therapeutic intervention. METHODS: A multicenter retrospective study of children with hyperammonemia unrelated to inborn errors of metabolism, conducted in Spanish hospitals...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29092869/testing-placement-of-gastric-feeding-tubes-in-infants
#11
Norma A Metheny, Ann Pawluszka, Melanie Lulic, Leslie J Hinyard, Kathleen L Meert
BACKGROUND: Inadvertent positioning of a nasogastric tube in the lung can cause serious complications, so identifying methods to detect improperly inserted tubes is imperative. OBJECTIVES: To compare the sensitivity, specificity, and negative and positive predictive values of 4 pH cut points (< 4.0, < 4.5, < 5.0, and < 5.5) in differentiating gastric and tracheal aspirates under various treatment conditions and to explore the utility of a pepsin assay for distinguishing between gastric and tracheal aspirates...
November 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/29072785/predicting-cyp3a-mediated-midazolam-metabolism-in-critically-ill-neonates-infants-children-and-adults-with-inflammation-and-organ-failure
#12
J M Brussee, N J Vet, E H J Krekels, A J Valkenburg, E Jacqz-Aigrain, J M A van Gerven, E L Swart, J N van den Anker, D Tibboel, M de Hoog, S N de Wildt, C A J Knibbe
AIMS: Inflammation and organ failure have been reported to impact cytochrome P450 (CYP) 3A-mediated clearance of midazolam in critically ill children. Our aim was to evaluate a previously developed population pharmacokinetic model in both critically ill children and other populations in order to allow the model to be used to guide dosing in clinical practice. METHODS: The model was externally evaluated in 136 individuals, including (pre)term neonates, infants, children, and adults (body weight 0...
October 26, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29067568/anemia-at-pediatric-intensive-care-unit-discharge-prevalence-and-risk-markers
#13
Pierre Demaret, Oliver Karam, Marisa Tucci, Jacques Lacroix, Hélène Behal, Alain Duhamel, Frédéric Lebrun, André Mulder, Stéphane Leteurtre
BACKGROUND: Anemia is prevalent at pediatric intensive care unit (PICU) admission and incident during PICU stay, but little is known about anemia at PICU discharge . Anemia after critical illness is an important issue because it could impact post-PICU outcome. We aimed to estimate the prevalence of anemia at PICU discharge and to determine its risk markers. METHODS: This is an ancillary study of a prospective observational study on transfusion practices conducted in the PICU of a tertiary care children's hospital...
October 24, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29025070/interdisciplinary-family-conferences-to-improve-patient-experience-in-the-neonatal-intensive-care-unit
#14
Jennifer A Trujillo, Yesenia Fernandez, Lyla Ghafoori, Kristina Lok, Arwin Valencia
Parents play a significant role in the development of their neonate. They can affect the length of stay in a neonatal intensive care unit (NICU) and are seen as an integral part of the team. Parents are often put in positions where difficult decision making is required of them in the care of their critically ill child. Studies suggest that one way to improve the family's experience and to encourage their involvement is by establishing a formal and focused family conference. Therefore, the NICU social workers and the interdisciplinary team collaborated to formulate strategies to improve communication that would enhance current practice...
September 15, 2017: Health & Social Work
https://www.readbyqxmd.com/read/29017631/infants-born-with-critical-chd-in-arizona-and-capacities-of-birth-centres-for-screening-and-management
#15
Lydia Villa, Brent Bjornsen, Heather Giacone, Erica M Weidler, Ekta Bajaj, Andrew Muth, Melanie Kennedy, Timothy Flood, Dianna Contreras, Joseph Spadafino, Ashish Shah
OBJECTIVES: The aims of this study were to identify locations of births in Arizona with critical CHD, as well as to assess the current use of pulse-oximetry screening and capacities of birth centres to manage a positive screen. Study design Infants (n=487) with a potentially critical CHD were identified from the Arizona Department of Health Services from 2012 and 2013; charts were retrospectively reviewed. Diagnosis was confirmed using echocardiographies. ArcGIS was used to generate maps to visualise the location of treating facility and mother's residence...
October 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28991109/patient-blood-management-in-pediatric-cardiac-surgery-a-review
#16
Jill M Cholette, David Faraoni, Susan M Goobie, Victor Ferraris, Nabil Hassan
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population...
October 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28988964/epidemiology-of-bacteremia-in-febrile-infants-aged-60-days-and-younger
#17
Elizabeth C Powell, Prashant V Mahajan, Genie Roosevelt, John D Hoyle, Rajender Gattu, Andrea T Cruz, Alexander J Rogers, Shireen M Atabaki, David M Jaffe, T Charles Casper, Octavio Ramilo, Nathan Kuppermann
STUDY OBJECTIVE: To describe the current epidemiology of bacteremia in febrile infants 60 days of age and younger in the Pediatric Emergency Care Applied Research Network (PECARN). METHODS: We conducted a planned secondary analysis of a prospective observational study of febrile infants 60 days of age and younger presenting to any of 26 PECARN emergency departments (2008 to 2013) who had blood cultures obtained. We excluded infants with significant comorbidities or critically ill appearance...
October 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28981515/the-heuristics-of-nurse-responsiveness-to-critical-patient-monitor-and-ventilator-alarms-in-a-private-room-neonatal-intensive-care-unit
#18
Rohan Joshi, Heidi van de Mortel, Loe Feijs, Peter Andriessen, Carola van Pul
AIM: Alarm fatigue is a well-recognized patient safety concern in intensive care settings. Decreased nurse responsiveness and slow response times to alarms are the potentially dangerous consequences of alarm fatigue. The aim of this study was to determine the factors that modulate nurse responsiveness to critical patient monitor and ventilator alarms in the context of a private room neonatal intensive care setting. METHODS: The study design comprised of both a questionnaire and video monitoring of nurse-responsiveness to critical alarms...
2017: PloS One
https://www.readbyqxmd.com/read/28973083/use-of-exome-sequencing-for-infants-in-intensive-care-units-ascertainment-of-severe-single-gene-disorders-and-effect-on-medical-management
#19
Linyan Meng, Mohan Pammi, Anirudh Saronwala, Pilar Magoulas, Andrew Ray Ghazi, Francesco Vetrini, Jing Zhang, Weimin He, Avinash V Dharmadhikari, Chunjing Qu, Patricia Ward, Alicia Braxton, Swetha Narayanan, Xiaoyan Ge, Mari J Tokita, Teresa Santiago-Sim, Hongzheng Dai, Theodore Chiang, Hadley Smith, Mahshid S Azamian, Laurie Robak, Bret L Bostwick, Christian P Schaaf, Lorraine Potocki, Fernando Scaglia, Carlos A Bacino, Neil A Hanchard, Michael F Wangler, Daryl Scott, Chester Brown, Jianhong Hu, John W Belmont, Lindsay C Burrage, Brett H Graham, Vernon Reid Sutton, William J Craigen, Sharon E Plon, James R Lupski, Arthur L Beaudet, Richard A Gibbs, Donna M Muzny, Marcus J Miller, Xia Wang, Magalie S Leduc, Rui Xiao, Pengfei Liu, Chad Shaw, Magdalena Walkiewicz, Weimin Bi, Fan Xia, Brendan Lee, Christine M Eng, Yaping Yang, Seema R Lalani
Importance: While congenital malformations and genetic diseases are a leading cause of early infant death, to our knowledge, the contribution of single-gene disorders in this group is undetermined. Objective: To determine the diagnostic yield and use of clinical exome sequencing in critically ill infants. Design, Setting, and Participants: Clinical exome sequencing was performed for 278 unrelated infants within the first 100 days of life who were admitted to Texas Children's Hospital in Houston, Texas, during a 5-year period between December 2011 and January 2017...
October 2, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28970318/parental-experience-of-interaction-with-healthcare-professionals-during-their-infant-s-stay-in-the-neonatal-intensive-care-unit
#20
Katie Gallagher, Chloe Shaw, Narendra Aladangady, Neil Marlow
OBJECTIVE: To explore the experiences of parents of infants admitted to the neonatal intensive care unit towards interaction with healthcare professionals during their infants critical care. DESIGN: Semi-structured interviews were conducted with parents of critically ill infants admitted to neonatal intensive care and prospectively enrolled in a study of communication in critical care decision making. Interviews were transcribed verbatim and uploaded into NVivo V...
September 29, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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