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https://www.readbyqxmd.com/read/28601711/identification-of-qrs-complex-in-non-stationary-electrocardiogram-of-sick-infants
#1
S Kota, C B Swisher, T Al-Shargabi, N Andescavage, A du Plessis, R B Govindan
BACKGROUND: Due to the high-frequency of routine interventions in an intensive care setting, electrocardiogram (ECG) recordings from sick infants are highly non-stationary, with recurrent changes in the baseline, alterations in the morphology of the waveform, and attenuations of the signal strength. Current methods lack reliability in identifying QRS complexes (a marker of individual cardiac cycles) in the non-stationary ECG. In the current study we address this problem by proposing a novel approach to QRS complex identification...
June 2, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28594681/delirium-and-benzodiazepines-associated-with-prolonged-icu-stay-in-critically-ill-infants-and-young-children
#2
Heidi A B Smith, Maalobeeka Gangopadhyay, Christina M Goben, Natalie L Jacobowski, Mary Hamilton Chestnut, Jennifer L Thompson, Rameela Chandrasekhar, Stacey R Williams, Katherine Griffith, E Wesley Ely, D Catherine Fuchs, Pratik P Pandharipande
OBJECTIVES: Delirium is prevalent among critically ill children, yet associated outcomes and modifiable risk factors are not well defined. The objective of this study was to determine associations between pediatric delirium and modifiable risk factors such as benzodiazepine exposure and short-term outcomes. DESIGN: Secondary analysis of collected data from the prospective validation study of the Preschool Confusion Assessment Method for the ICU. SETTING: Tertiary-level PICU...
June 7, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28578542/citrate-versus-heparin-anticoagulation-in-continuous-renal-replacement-therapy-in-small-children
#3
Paulien A M A Raymakers-Janssen, Marc Lilien, Ingrid A van Kessel, Esther S Veldhoen, Roelie M Wösten-van Asperen, Josephus P J van Gestel
BACKGROUND: Citrate is preferred over heparin as an anticoagulant in adult continuous renal replacement therapy (CRRT). However, its potential adverse effects and data on use in CRRT in infants and toddlers is limited. We conducted a prospective study on using citrate in CRRT in critically ill small children. METHODS: Children who underwent CRRT with the smallest filter in our PICU between November 2011 and November 2016 were included. Both heparin and citrate were applied according to a strict protocol...
June 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28572120/burden-of-disease-and-change-in-practice-in-critically-ill-infants-with-bronchiolitis
#4
Luregn J Schlapbach, Lahn Straney, Ben Gelbart, Janet Alexander, Donna Franklin, John Beca, Jennifer A Whitty, Subodh Ganu, Barry Wilkins, Anthony Slater, Elizabeth Croston, Simon Erickson, Andreas Schibler
Bronchiolitis represents the most common cause of non-elective admission to paediatric intensive care units (ICUs).We assessed changes in admission rate, respiratory support, and outcomes of infants <24 months with bronchiolitis admitted to ICU between 2002 and 2014 in Australia and New Zealand.During the study period, bronchiolitis was responsible for 9628 (27.6%) of 34 829 non-elective ICU admissions. The estimated population-based ICU admission rate due to bronchiolitis increased by 11.76 per 100 000 each year (95% CI 8...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28557770/disaster-preparedness-in-neonatal-intensive-care-units
#5
Wanda D Barfield, Steven E Krug
Disasters disproportionally affect vulnerable, technology-dependent people, including preterm and critically ill newborn infants. It is important for health care providers to be aware of and prepared for the potential consequences of disasters for the NICU. Neonatal intensive care personnel can provide specialized expertise for their hospital, community, and regional emergency preparedness plans and can help develop institutional surge capacity for mass critical care, including equipment, medications, personnel, and facility resources...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28546374/pediatric-ards
#6
Ira M Cheifetz
The Pediatric Acute Lung Injury Consensus Conference (PALICC) has provided the critical care community with the first pediatric-focused definition for ARDS. The PALICC recommendations provide guidance on conventional ventilator management, gas exchange goals, use of high-frequency ventilation, adjunct management approaches, and the application of extracorporeal membrane oxygenation for pediatric ARDS (PARDS). Although outcomes for PARDS have improved over the past decade, mortality and morbidity remain significant...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#7
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28526589/a-rapid-salmonella-detection-method-involving-thermophilic-helicase-dependent-amplification-and-a-lateral-flow-assay
#8
Xin-Jun Du, Tian-Jiao Zhou, Ping Li, Shuo Wang
Salmonella is a major foodborne pathogen that is widespread in the environment and can cause serious human and animal disease. Since conventional culture methods to detect Salmonella are time-consuming and laborious, rapid and accurate techniques to detect this pathogen are critically important for food safety and diagnosing foodborne illness. In this study, we developed a rapid, simple and portable Salmonella detection strategy that combines thermophilic helicase-dependent amplification (tHDA) with a lateral flow assay to provide a detection result based on visual signals within 90 min...
May 16, 2017: Molecular and Cellular Probes
https://www.readbyqxmd.com/read/28510638/%C3%AE-asarone-suppresses-the-proliferation-and-migration-of-asmcs-through-targeting-the-lncrna-pvt1-mir-203a-e2f3-signal-pathway-in-rsv-infected-rats
#9
Xiao Yu, Zhe Zhe, Binqing Tang, Shaobin Li, Ling Tang, Yingen Wu, Xiaorong Chen, Hong Fang
Asthma is a chronic inflammatory pulmonary disease and respiratory syncytial virus (RSV) infection is a common cause of lower respiratory tract illness in infants and young children. α-Asarone presents many pharmacological effects and has been demonstrated to be useful in treating asthma. However, the functional mechanism of α-asarone in RSV-infected asthma has not been investigated. Long non-coding RNAs (lncRNAs) have been reported to play critical roles in many biological processes. Although many lncRNAs have been characterized, few were reported in asthma, especially in RSV-induced asthma...
May 16, 2017: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/28506866/non-maturational-covariates-for-dynamic-systems-pharmacology-models-in-neonates-infants-and-children-filling-the-gaps-beyond-developmental-pharmacology
#10
REVIEW
Karel Allegaert, Sinno H P Simons, Dick Tibboel, Elke H Krekels, Catherijne A Knibbe, John N van den Anker
Pharmacokinetics and -dynamics show important changes throughout childhood. Studies on the different maturational processes that influence developmental pharmacology have been used to create population PK/PD models that can yield individualized pediatric drug dosages. These models were subsequently translated to semi-physiologically or physiology-based PK (PBPK) models that support predictions in pediatric patient cohorts and other special populations. Although these translational efforts are crucial, these models should be further improved towards individual patient predictions by including knowledge on non-maturational covariates...
May 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28506544/development-of-the-vanderbilt-assessment-for-delirium-in-infants-and-children-to-standardize-pediatric-delirium-assessment-by-psychiatrists
#11
REVIEW
Maalobeeka Gangopadhyay, Heidi Smith, Maryland Pao, Gabrielle Silver, Deepmala Deepmala, Claire De Souza, Georgina Garcia, Lisa Giles, Danica Denton, Natalie Jacobowski, Pratik Pandharipande, Catherine Fuchs
BACKGROUND: Pediatric delirium assessment is complicated by variations in baseline language and cognitive skills, impairment during illness, and absence of pediatric-specific modifiers within the Diagnostic and Statistical Manual of Mental Disorders delirium criterion. OBJECTIVE: To develop a standardized approach to pediatric delirium assessment by psychiatrists. METHODS: A multidisciplinary group of clinicians used Diagnostic and Statistical Manual criterion as the foundation for the Vanderbilt Assessment for Delirium in Infants and Children (VADIC)...
July 2017: Psychosomatics
https://www.readbyqxmd.com/read/28501490/colistin-use-in-critically-ill-neonates-a%C3%A2-case-control-study
#12
Mehmet Sah İpek, Fesih Aktar, Nilufer Okur, Muhittin Celik, Erdal Ozbek
BACKGROUND: The aim of this study was to assess the safety and efficacy of colistin use in critically ill neonates. METHODS: This was a case-control study that included newborn infants with proven or suspected nosocomial infections between January 2012 and October 2015, at two centers in Diyarbakir, Turkey. The clinical and laboratory characteristics and outcomes of patients who received colistin therapy were reviewed and compared to patients who were treated with antimicrobial agents other than colistin during the same period...
March 27, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28494827/use-of-placental-umbilical-blood-sampling-for-neonatal-admission-blood-cultures-benefits-challenges-and-strategies-for-implementation
#13
Shannon P Moore, Desi M Newberry, Amy J Jnah
Placental blood remains an underused resource for early neonatal care despite ample evidence that placental blood provides the same clinical decision making information without the need for painful, invasive blood sampling procedures. Potential benefits of placental/umbilical blood sampling (PUBS) for neonatal admission labs include decreases in pain reactivity, rates of anemia, need for blood transfusions, use of vasopressors, and rates of intraventricular hemorrhage. Here, we present a unique case study of a critically ill infant with contradictory blood culture results from PUBS and direct infant sampling...
May 1, 2017: Neonatal Network: NN
https://www.readbyqxmd.com/read/28471441/how-to-assess-hemodynamic-status-in-very-preterm-newborns-in-the-first-week-of-life
#14
G Escourrou, L Renesme, E Zana, A Rideau, M O Marcoux, E Lopez, G Gascoin, P Kuhn, P Tourneux, I Guellec, C Flamant
BACKGROUND: Assessing hemodynamic status in preterm newborns is an essential task, as many studies have shown increased morbidity when hemodynamic parameters are abnormal. Although oscillometric monitoring of arterial blood pressure (BP) is widely used due to its simplicity and lack of side effects, these values are not always correlated with microcirculation and oxygen delivery. OBJECTIVES: This review focuses on different tools for the assessment of hemodynamic status in preterm newborns...
May 4, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28471143/perioperative-factors-influencing-neurocognitive-outcomes-in-infants
#15
Mary E McCann
Neonates have a higher perioperative mortality risk largely due to the premorbid state of the infants and the complex nature of many of the surgeries. Another contributing factor is the rapidly changing physiology of neonates especially during the first 3 days of life. The perioperative management of these critically ill neonates may affect their cerebral perfusion and ultimately neurocognitive outcomes. This article discusses perioperative techniques to maximize cerebral perfusion.
May 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28462900/hyperdehydroepiandrosterone-in-neonates-with-hypoxic-ischemic-encephalopathy-and-circulatory-collapse
#16
Abdelmoneim Khashana, Engy Ahmed
BACKGROUND: Circulatory collapse is a very common complication of the critical illnesses in neonates including neonates with hypoxic ischemic encephalopathy; it can be the end result and cause of death of several conditions. Often, despite treatment with fluid resuscitation and vasopressor agents, circulatory collapse persist, and blood pressure can remain critically low, compromising adequate blood flow to vital organs and brain. Low blood pressure has been associated with increased mortality...
April 12, 2017: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/28449646/when-is-the-use-of-pacifiers-justifiable-in-the-baby-friendly-hospital-initiative-context-a-clinician-s-guide
#17
Welma Lubbe, Wilma Ten Ham-Baloyi
BACKGROUND: The use of pacifiers is an ancient practice, but often becomes a point of debate when parents and professionals aim to protect and promote breastfeeding as most appropriately for nurturing infants. We discuss the current literature available on pacifier use to enable critical decision-making regarding justifiable use of pacifiers, especially in the Baby-Friendly Hospital Initiative context, and we provide practical guidelines for clinicians. DISCUSSION: Suck-swallow-breathe coordination is an important skill that every newborn must acquire for feeding success...
April 27, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28448623/development-of-the-cutaneous-microbiome-in-the-preterm-infant-a-prospective-longitudinal-study
#18
Mohan Pammi, Jacqueline L O'Brien, Nadim J Ajami, Matthew C Wong, James Versalovic, Joseph F Petrosino
BACKGROUND: Neonatal sepsis in preterm infants is often due to organisms that colonize the skin including Staphylococcus spp. and Candida spp. Development and maturation of the skin microbiome in the neonatal period, especially in preterm infants, may be critical in preventing colonization with pathogens and subsequent progression to neonatal sepsis. Development of the skin microbiome in preterm infants or its determinants in the first 4 weeks of life has not been evaluated. METHODS: We evaluated the skin microbiome from three body sites, antecubital fossa, forehead and gluteal region, in a prospective cohort of 15 preterm (birth weight < 1500 g and < 32 weeks of gestation) and 15 term neonates...
2017: PloS One
https://www.readbyqxmd.com/read/28420365/social-determinants-of-antibiotic-misuse-a-qualitative-study-of-community-members-in-haryana-india
#19
Anna K Barker, Kelli Brown, Muneeb Ahsan, Sharmila Sengupta, Nasia Safdar
BACKGROUND: Antibiotic resistance is a global public health crisis. In India alone, multi-drug resistant organisms are responsible for over 58,000 infant deaths each year. A major driver of drug resistance is antibiotic misuse, which is a pervasive phenomenon worldwide. Due to a shortage of trained doctors, access to licensed allopathic doctors is limited in India's villages. Pharmacists and unlicensed medical providers are commonly the primary sources of healthcare. Patients themselves are also key participants in the decision to treat an illness with antibiotics...
April 19, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28419552/feasibility-and-utility-of-portable-ultrasound-during-retrieval-of-sick-preterm-infants
#20
Kathryn Browning Carmo, Tracey Lutz, Mark Greenhalgh, Andrew Berry, Martin Kluckow, Nick Evans
AIM: Document the incidence of haemodynamic pathology in critically ill preterm newborns requiring transport. METHOD: A transport neonatologist performed cardiac and cerebral ultrasound before and after transportation of infants born ≤ 30 weeks gestation. RESULTS: 44 newborns were studied 2008 - 2015, 21 transported by road, 19 by helicopter and 4 by fixed wing. Median birth weight 1130g (680-1960g), median gestation 27 weeks (23-30) and 30/44 were male...
April 17, 2017: Acta Paediatrica
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