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https://www.readbyqxmd.com/read/29762868/candidemia-in-children-epidemiology-prevention-and-management
#1
REVIEW
Elpis Mantadakis, Zoe Dorothea Pana, Theoklis Zaoutis
Candidemia is the leading cause of invasive fungal infections in hospitalized children. The highest rates of candidemia have been recorded in neonates and infants <1 year of age. Candidemia is more frequent in neonates and young infants than in adults, and is associated with better clinical outcomes, but higher inpatient costs. Over the last 10 years, a declining trend has been noted in the incidence of pediatric candidemia in the US and elsewhere due to the hospital-wide implementation of central-line insertion and maintenance bundles that emphasize full sterile barrier precautions, chlorhexidine skin preparation during line insertion, meticulous site and tubing care, and daily discussion of catheter necessity...
May 15, 2018: Mycoses
https://www.readbyqxmd.com/read/29757789/sociocultural-factors-influencing-infant-feeding-choices-among-african-immigrant-women-living-with-hiv-a-synthesis-of-the-literature
#2
Josephine Etowa, Shannan MacDonald, Jean Hannan, J Craig Phillips, Nana Yaa Boadu, Seye Babatunde
BACKGROUND AND PURPOSE: The World Health Organizations (WHO) strategy is to eliminate pediatric HIV. HIV prevention guidelines in high-income countries recommend mothers living with HIV avoid breastfeeding. Yet, breastfeeding is promoted as the normal and unequalled method of feeding infants. This creates a paradox for mothers coming from cultures where breastfeeding is an expectation and formula feeding suggests illness. Therefore, the purpose of this literature review is to examine the context influencing infant feeding among African immigrant women living with HIV to develop interventions to reduce the risk of HIV mother-to-child transmission...
April 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29755961/correlation-and-interchangeability-of-venous-and-capillary-blood-gases-in-non-critically-ill-neonates
#3
Ratna N G B Tan, Steffen C Pauws, Evelyne van Loon, Vivanne E H J Smits, Enrico Lopriore, Arjan B Te Pas
Background: Venous blood gas (VBG) is frequently used in the neonatal unit as alternative for capillary blood gas (CBG). However, studies reporting correlation are conflicting and data on interchangeability in neonates are lacking. Objective: We investigated the correlation and interchangeability of the components between VBG and CBG in infants admitted to the neonatal intensive care unit. Methods: In a prospective study in the neonatal unit in Leiden University Medical Center (Netherlands), simultaneously VBG and CBG were withdrawn in neonates when both venous puncture and intravenous access as blood gas monitoring was indicated...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29754749/comparison-of-oral-and-axillary-temperatures-in-intubated-pediatric-patients
#4
Danielle Wood, Mary Heitschmidt, Louis Fogg
PURPOSE: Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures...
May 10, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29746151/determinants-of-successful-direct-breastfeeding-at-hospital-discharge-in-high-risk-premature-infants
#5
Lara Casey, Sandra Fucile, Kimberly E Dow
BACKGROUND: Despite a mother's intention to breastfeed, there are many barriers to feeding preterm infants that decrease breastfeeding rates. OBJECTIVE: The objective of this research was to determine factors associated with successful direct breastfeeding (DBF) of the preterm infant at hospital discharge. MATERIALS AND METHODS: A retrospective chart review of 69 preterm (<34 weeks' gestational age) infants in the neonatal intensive care unit, whose mothers intended to breastfeed, was conducted...
May 10, 2018: Breastfeeding Medicine: the Official Journal of the Academy of Breastfeeding Medicine
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#6
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29720910/a-retrospective-review-of-infants-receiving-sildenafil
#7
Aliva De, Payal Shah, Jacqueline Szmuszkovicz, Shazia Bhombal, Stanley Azen, Roberta M Kato
OBJECTIVE: The purpose of the study was to assess mortality in an infant population receiving sildenafil. METHODS: A retrospective review of hospitalized infants at Children's Hospital Los Angeles who received sildenafil between 2008 and 2012 was conducted. Patient characteristics, comorbidities, and treatment characteristics were analyzed. Primary outcome was mortality at discharge. Sildenafil dosage ranges were based on the Sildenafil in Treatment-Naïve Children, Aged 1-17 Years, With Pulmonary Arterial Hypertension trial and were categorized as small (<1...
March 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29681181/failed-umbilical-artery-catheterization-and-adverse-outcomes-in-extremely-low-birth-weight-infants
#8
Matthew B Wallenstein, Gary M Shaw, Wei Yang, David K Stevenson
PURPOSE: To determine whether successful catheterization of the umbilical artery is associated with a reduced risk of death or neurodevelopment impairment among critically ill extremely low birth weight (ELBW) infants. STUDY DESIGN: A retrospective chart review was conducted between 2007 and 2014 at Stanford University for all ELBW infants that required intubation immediately after birth. The primary outcome was death or neurodevelopmental impairment at 18-22 months...
April 22, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29597214/evolution-of-technology-for-continuous-renal-replacement-therapy-forty-years-of-improvement
#9
Claudio Ronco
Continuous arteriovenous hemofiltration (CAVH) was proposed in 1977 as an alternative treatment for acute renal failure in patients in whom peritoneal dialysis or hemodialysis was clinically or technically precluded. In the mid-1980s, this technique was extended to infants and children. CAVH presented important advantages in the areas of hemodynamic stability, control of circulating volume, and nutritional support. However, there were serious shortcomings such as the need for arterial cannulation and limited solute clearance...
2018: Contributions to Nephrology
https://www.readbyqxmd.com/read/29596267/a-stewardship-program-to-optimize-the-use-of-inhaled-nitric-oxide-in-pediatric-critical-care
#10
Tanya Di Genova, Christina Sperling, Ashley Gionfriddo, Zelia Da Silva, Leanne Davidson, Jason Macartney, Michael Finelli, Robert P Jankov, Peter C Laussen
PURPOSE: Inhaled nitric oxide (iNO) is a pulmonary vasodilator that is approved for use in term and near-term neonates with hypoxic respiratory failure associated with evidence of pulmonary hypertension. However, it is commonly used in infants and children to treat a variety of other cardiopulmonary diseases associated with pulmonary hypertension and hypoxic respiratory failure. In critically ill children, iNO therapy may be continued for a prolonged period, and this increases the risk for adverse consequences including toxicity and unnecessary costs...
April 2018: Quality Management in Health Care
https://www.readbyqxmd.com/read/29580679/accuracy-of-pulse-oximetry-screening-for-critical-congenital-heart-defects-after-home-birth-and-early-postnatal-discharge
#11
Ilona C Narayen, Nico A Blom, Nan van Geloven, Ellen I M Blankman, Annique J M van den Broek, Martijn Bruijn, Sally-Ann B Clur, Frank A van den Dungen, Hester M Havers, Henriëtte van Laerhoven, Shahryar E Mir, Moira A Muller, Odette M Polak, Lukas A J Rammeloo, Gracita Ramnath, Sophie R D van der Schoor, Anton H van Kaam, Arjan B Te Pas
OBJECTIVE: To assess the accuracy of pulse oximetry screening for critical congenital heart defects (CCHDs) in a setting with home births and early discharge after hospital deliveries, by using an adapted protocol fitting the work patterns of community midwives. STUDY DESIGN: Pre- and postductal oxygen saturations (SpO2 ) were measured ≥1 hour after birth and on day 2 or 3. Screenings were positive if the SpO2 measurement was <90% or if 2 independent measures of pre- and postductal SpO2 were <95% and/or the pre-/postductal difference was >3%...
March 23, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29551482/role-of-neonatologist-performed-echocardiography-in-the-assessment-and-management-of-patent-ductus-arteriosus-physiology-in-the-newborn
#12
REVIEW
W P de Boode, M Kluckow, P J McNamara, S Gupta
Neonatologist-performed echocardiography (NPE) is an indispensable tool in the haemodynamic management of critically ill newborn infants. NPE is used to facilitate timely diagnosis of a patent ductus arteriosus (PDA) in preterm infants and to assess its haemodynamic significance. Before treatment is considered, it is obligatory to confirm structural cardiac normality. Importantly, NPE offers the ability to guide therapeutic interventions, allowing an individualised haemodynamic management approach to the PDA...
March 7, 2018: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29550034/overfeeding-associated-hyperglycemia-and-injury-response-homeostasis-in-critically-ill-neonates
#13
Tina Tian, Joshua Coons, Hong Chang, Walter J Chwals
BACKGROUND: Injury severity induces a proportionate acute metabolic stress response, associated with increased risk of hyperglycemia. We hypothesized that excess caloric delivery (overfeeding) during high stress states would increase hyperglycemia and disrupt response homeostasis. METHODS: Gestational age, daily weight, total daily caloric intake, serum C-reactive protein (CRP), prealbumin, and blood glucose concentrations in all acutely-injured premature NICU infants requiring TPN over the past 3years were reviewed...
December 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29549119/the-case-for-early-use-of-rapid-whole-genome-sequencing-in-management-of-critically-ill-infants-late-diagnosis-of-coffin-siris-syndrome-in-an-infant-with-left-congenital-diaphragmatic-hernia-congenital-heart-disease-and-recurrent-infections
#14
Nathaly M Sweeney, Shareef A Nahas, Shimul Chowdhury, Miguel Del Campo, Marilyn C Jones, David P Dimmock, Stephen F Kingsmore, Rcigm Investigators
Congenital diaphragmatic hernia (CDH) results from incomplete formation of the diaphragm leading to herniation of abdominal organs into the thoracic cavity. CDH is associated with pulmonary hypoplasia, congenital heart disease and pulmonary hypertension. Genetically, it is associated with aneuploidies, chromosomal copy number variants, and single gene mutations. CDH is the most expensive non-cardiac congenital defect: Management frequently requires implementation of Extracorporeal Membrane Oxygenation (ECMO), which increases management expenditures 2...
March 16, 2018: Cold Spring Harbor Molecular Case Studies
https://www.readbyqxmd.com/read/29516865/clinical-performance-of-a-novel-textile-interface-for-neonatal-chest-electrical-impedance-tomography
#15
L Sophocleous, I Frerichs, M Miedema, M Kallio, T Papadouri, C Karaoli, T Becher, D G Tingay, A H van Kaam, R Bayford, A D Waldmann
OBJECTIVE: Critically ill neonates and infants might particularly benefit from continuous chest electrical impedance tomography (EIT) monitoring at the bedside. In this study a textile 32-electrode interface for neonatal EIT examination has been developed and tested to validate its clinical performance. The objectives were to assess ease of use in a clinical setting, stability of contact impedance at the electrode-skin interface and possible adverse effects. APPROACH: Thirty preterm infants (gestational age: 30...
April 26, 2018: Physiological Measurement
https://www.readbyqxmd.com/read/29505450/a-device-for-the-quantification-of-oxygen-consumption-and-caloric-expenditure-in-the-neonatal-range
#16
Einav Nachman, Peter Clemensen, Katheryn Santos, Alexis R Cole, Brian D Polizzotti, Grace Hofmann, Kristen T Leeman, Sarah J van den Bosch, John N Kheir
BACKGROUND: The accurate measurement of oxygen consumption (VO2) and energy expenditure (EE) may be helpful to optimize the treatment of critically ill patients. However, current techniques are limited in their ability to accurately quantify these end points in infants due to a low VO2, low tidal volume, and rapid respiratory rate. This study describes and validates a new device intended to perform in this size range. METHODS: We created a customized device that quantifies inspiratory volume using a pneumotachometer and concentrations of oxygen and carbon dioxide gas in the inspiratory and expiratory limbs...
March 1, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29486493/effect-of-a-pediatric-early-warning-system-on-all-cause-mortality-in-hospitalized-pediatric-patients-the-epoch-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Christopher S Parshuram, Karen Dryden-Palmer, Catherine Farrell, Ronald Gottesman, Martin Gray, James S Hutchison, Mark Helfaer, Elizabeth A Hunt, Ari R Joffe, Jacques Lacroix, Michael Alice Moga, Vinay Nadkarni, Nelly Ninis, Patricia C Parkin, David Wensley, Andrew R Willan, George A Tomlinson
Importance: There is limited evidence that the use of severity of illness scores in pediatric patients can facilitate timely admission to the intensive care unit or improve patient outcomes. Objective: To determine the effect of the Bedside Paediatric Early Warning System (BedsidePEWS) on all-cause hospital mortality and late admission to the intensive care unit (ICU), cardiac arrest, and ICU resource use. Design, Setting, and Participants: A multicenter cluster randomized trial of 21 hospitals located in 7 countries (Belgium, Canada, England, Ireland, Italy, New Zealand, and the Netherlands) that provided inpatient pediatric care for infants (gestational age ≥37 weeks) to teenagers (aged ≤18 years)...
March 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29480945/critically-ill-neonates-displayed-stable-vital-parameters-and-reduced-metabolic-acidosis-during-neonatal-emergency-airborne-transport-in-sweden
#18
Ingrid Frid, Johan Ågren, Mattias Kjellberg, Erik Normann, Richard Sindelar
AIM: This study evaluated the medical quality of acute airborne transports carried out by a neonatal emergency transport service in a Swedish healthcare region from 2012 to 2015. METHODS: The transport charts and patient records of all infants transported to the regional centre were reviewed for transport indications and vital parameters and outcomes. RESULTS: We identified 187 acute airborne transports and the main indications for referral were therapeutic hypothermia after perinatal asphyxia, extremely preterm birth and respiratory failure...
February 26, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29475450/neonatal-central-venous-line-observational-study-on-thrombosis-neoclot-evaluation-of-a-national-guideline-on-management-of-neonatal-catheter-related-thrombosis
#19
Jeanine J Sol, Moniek van de Loo, Marit Boerma, Klasien A Bergman, Albertine E Donker, Mark A H B M van der Hoeven, Christiaan V Hulzebos, Ronny Knol, K Djien Liem, Richard A van Lingen, Enrico Lopriore, Monique H Suijker, Daniel C Vijlbrief, Remco Visser, Margreet A Veening, Mirjam M van Weissenbruch, C Heleen van Ommen
BACKGROUND: In critically ill (preterm) neonates, central venous catheters (CVCs) are increasingly used for administration of medication or parenteral nutrition. A serious complication, however, is the development of catheter-related thrombosis (CVC-thrombosis), which may resolve by itself or cause severe complications. Due to lack of evidence, management of neonatal CVC-thrombosis varies among neonatal intensive care units (NICUs). In the Netherlands an expert-based national management guideline has been developed which is implemented in all 10 NICUs in 2014...
February 23, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29472708/no-question-too-small-development-of-a-question-prompt-list-for-parents-of-critically-ill-infants
#20
Monica E Lemmon, Pamela K Donohue, Erin P Williams, Debra Brandon, Peter A Ubel, Renee D Boss
OBJECTIVE: To develop a question prompt list tailored to the needs of parents of critically ill infants at risk of neurodevelopmental impairment. STUDY DESIGN: Question content was derived from audio-recorded neonatal intensive care unit family meetings and interviews with parents of infants treated with therapeutic hypothermia. Question content was refined using clinician focus groups. Acceptability testing was performed with parents and clinicians caring for infants in the neonatal intensive care unit...
February 22, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
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