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Pediatric Respiratory support

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https://www.readbyqxmd.com/read/28818509/the-use-of-high-flow-nasal-cannula-in-the-pediatric-emergency-department
#1
REVIEW
Katherine N Slain, Steven L Shein, Alexandre T Rotta
OBJECTIVES: To summarize the current literature describing high-flow nasal cannula (HFNC) use in children, the components and mechanisms of action of a HFNC system, the appropriate clinical applications, and its role in the pediatric emergency department (ED). SOURCES: A computer-based search of PubMed/MEDLINE and Google Scholar for literature on HFNC use in children was performed. DATA SUMMARY: HFNC, a non-invasive respiratory support modality, provides heated and fully humidified gas mixtures to patients via a nasal cannula interface...
August 14, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28817604/therapeutic-flexible-airway-endoscopy-of-small-children-in-a-tertiary-referral-center-11-years-experience
#2
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: Use of therapeutic flexible airway endoscopy (TFAE) is very limited in pediatrics. We report our clinical experiences and long term outcomes of TFAE in small children from a single tertiary referral center. METHODS: This is a retrospective cohort study. Small children with their body weight no more than 5.0 kg who had received TFAE between 2005 and 2015 were enrolled. Demographic information and outcomes were reviewed and analyzed from medical charts and TFAE videos...
2017: PloS One
https://www.readbyqxmd.com/read/28816799/successful-extracorporeal-life-support-in-a-pediatric-hematopoietic-stem-cell-transplant-recipient-with-periengraftment-respiratory-failure
#3
Jenny Potratz, Martina Ahlmann, Claudia Rössig, Heymut Omran, Katja Masjosthusmann
The use of extracorporeal life support (ECLS) as ultimate salvage therapy for hematopoietic stem cell transplant recipients remains controversial among oncologists and critical care specialists. Prognosis is poor, particularly after allogeneic transplantation, and literature to guide clinical decision-making is scarce. Our report describes successful ECLS in a pediatric patient undergoing allogeneic hematopoietic stem cell transplantation, who developed acute respiratory failure during severe neutropenia, followed by immediate neutrophil engraftment...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28813765/bronchiolitis-in-infants-and-children
#4
Alexandra Schaller, Carl S Galloway
Bronchiolitis is among the most common illnesses in infants and children, and is the most common cause for hospitalization in infants in the U.S. This illness can be caused by many viruses, most commonly respiratory syncytial virus. It is diagnosed clinically by history and physical exam findings, with a narrow role for ancillary testing. Management is supportive, with medications demonstrating limited utility in multiple studies. Preventive measures include hand hygiene, breastfeeding, avoiding tobacco smoke exposure, and isolation precautions for hospitalized patients...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28806954/-usability-of-data-integration-and-visualization-software-for-multidisciplinary-pediatric-intensive-care-a-human-factors-approach-to-assessing-technology
#5
Ying Ling Lin, Anne-Marie Guerguerian, Jessica Tomasi, Peter Laussen, Patricia Trbovich
BACKGROUND: Intensive care clinicians use several sources of data in order to inform decision-making. We set out to evaluate a new interactive data integration platform called T3™ made available for pediatric intensive care. Three primary functions are supported: tracking of physiologic signals, displaying trajectory, and triggering decisions, by highlighting data or estimating risk of patient instability. We designed a human factors study to identify interface usability issues, to measure ease of use, and to describe interface features that may enable or hinder clinical tasks...
August 14, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28801782/common-pediatric-medical-emergencies-in-office-practice
#6
Bharat Mehra, Suresh Gupta
General Practitioners frequently see children with medical conditions that may evolve into an emergency if not promptly attended to. The most common emergencies encountered in pediatric office practice are respiratory distress, dehydration, anaphylaxis, seizures and trauma. Assessment of children is sometimes difficult as the signs and symptoms might be subtle and not markedly expressed. Also, normal value of vital signs vary with age, thus their interpretation requires discrete knowledge of age appropriate values...
August 12, 2017: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/28798290/bradycardia-and-hypothermia-complicating-azithromycin-treatment
#7
Kerri Benn, Sam Salman, Madhu Page-Sharp, Timothy M E Davis, Jim P Buttery
BACKGROUND Azithromycin is a macrolide antibiotic widely used to treat respiratory, urogenital, and other infections. Gastrointestinal upset, headache, and dizziness are common adverse effects, and prolongation of the rate-corrected electrocardiographic QT interval and malignant arrhythmias have been reported. There are rare reports of bradycardia and hypothermia but not in the same patient. CASE REPORT A 4-year-old boy given intravenous azithromycin as part of treatment for febrile neutropenia complicating leukemia chemotherapy developed hypothermia (rectal temperature 35...
August 11, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28792716/a-3-month-old-child-with-acute-gastroenteritis-with-enterovirus-d68-detected-from-stool-specimen
#8
Ngan T K Pham, Aksara Thongprachum, Tsuneyoshi Baba, Shoko Okitsu, Quang D Trinh, Shihoko Komine-Aizawa, Hiroyuki Shimizu, Satoshi Hayakawa, Hiroshi Ushijima
Enterovirus D68 (EV-D68) is known to be causative agent of mild to severe upper and lower respiratory illnesses in sporadic cases and outbreaks. We present a case report of a 3-month-old child with acute gastroenteritis who visited a pediatric clinic in Kyushu area in Japan in 2015. A stool sample collected from the patient was screened for diarrheal viruses by multiplex RT-PCR. The result showed that the sample was positive only for enterovirus, and EV-D68 clade B3 was identified by sequence analysis of the viral protein 1 gene...
July 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28782157/initial-clinical-experiences-with-novel-diagonal-ecls-system-in-pediatric-cardiac-patients
#9
Yildiz Okan, Haydin Sertac, Ozturk Erkut, Kasar Taner, Onan I Selen, Altin H Firat, Cine Nihat, Ayyildiz Pelin, Erkan Halime, Guzeltas Alper
Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012...
August 2017: Artificial Organs
https://www.readbyqxmd.com/read/28767532/cardiac-arrest-secondary-to-lightning-strike-case-report-and-review-of-the-literature
#10
Elena L Rotariu, Mioara D Manole
Lightning strike injuries, although less common than electrical injuries, have a higher morbidity rate because of critical alterations of the circulatory system, respiratory system, and central nervous system. Most lightning-related deaths occur immediately after injury because of arrhythmia or respiratory failure. We describe the case of a pediatric patient who experienced cardiorespiratory arrest secondary to a lightning strike, where the Advanced Cardiac Life Support and Basic Life Support chain of survival was well executed, leading to return of spontaneous circulation and intact neurological survival...
August 1, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28756973/extracorporeal-membrane-oxygenation-support-may-be-a-lifesaving-modality-in-patients-with-burn-and-severe-acute-respiratory-distress-syndrome-experience-of-formosa-water-park-dust-explosion-disaster-in-taiwan
#11
Yu-Jen Chiu, Hsu Ma, Wen-Chieh Liao, Yu-Chung Shih, Mei-Chun Chen, Chun-Che Shih, Tai-Wei Chen, Cherng-Kang Perng
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) has been reported to improve outcomes in patients with refractory respiratory failure. These successful experiences have stimulated interest in using ECMO as a potential therapy for patients with acute pulmonary failure resulting from burn and inhalation lung injury. Current literature has supported the use of ECMO in critically-ill, pediatric burn patients. On the other hand, it is controversial to apply ECMO in adult burn patients, and the evidence is limited by the shortcomings of small sample size...
July 27, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#12
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28753678/coughing-sneezing-and-aching-online-twitter-and-the-volume-of-influenza-like-illness-in-a-pediatric-hospital
#13
David M Hartley, Courtney M Giannini, Stephanie Wilson, Ophir Frieder, Peter A Margolis, Uma R Kotagal, Denise L White, Beverly L Connelly, Derek S Wheeler, Dawit G Tadesse, Maurizio Macaluso
This study investigates the relation of the incidence of georeferenced tweets related to respiratory illness to the incidence of influenza-like illness (ILI) in the emergency department (ED) and urgent care clinics (UCCs) of a large pediatric hospital. We collected (1) tweets in English originating in our hospital's primary service area between 11/1/2014 and 5/1/2015 and containing one or more specific terms related to respiratory illness and (2) the daily number of patients presenting to our hospital's EDs and UCCs with ILI, as captured by ICD-9 codes...
2017: PloS One
https://www.readbyqxmd.com/read/28743722/bedside-tracheostomy-on-pediatric-icu-subjects-supported-by-extracorporeal-membrane-oxygenation
#14
Stephanie P Schwartz, Desiree Bonadonna, Matthew G Hartwig, Ira M Cheifetz
BACKGROUND: Tracheostomy facilitates ambulatory extracorporeal membrane oxygenation (ECMO) as a bridge to recovery or lung transplantation in patients with respiratory failure, yet data on this procedure in this population are lacking. This report describes a series of pediatric ICU patients who had a bedside tracheostomy performed while being supported on ECMO and examines the potential impact of this procedure on active rehabilitation and sedation requirements. METHODS: This retrospective case series reviews all patients in the pediatric ICU who received a tracheostomy while being supported on ECMO at a single tertiary care center for the past 3 y...
July 25, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#15
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#16
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28720673/challenges-with-implementation-of-a-respiratory-therapist-driven-protocol-of-spontaneous-breathing-trials-in-the-pediatric-icu
#17
Conrad Krawiec, Dale Carl, Christy Stetter, Lan Kong, Gary D Ceneviva, Neal J Thomas
BACKGROUND: Timely ventilator liberation is crucial in the pediatric ICU. In many pediatric ICUs, the decision to initiate weaning is driven by the physician, which may lead to delays in ventilator liberation. The objectives of this quality improvement project were to develop and implement a respiratory therapist (RT)-led protocol for screening for spontaneous breathing trial (SBT) readiness, to test protocol feasibility, and to evaluate its impact on SBT timing. METHODS: A retrospective chart review was performed on all intubated patients in the pediatric ICU for 18 months prior to protocol institution...
July 18, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28654569/maintaining-interrater-agreement-of-core-assessment-instruments-in-a-multisite-randomized-controlled-clinical-trial-the-randomized-evaluation-of-sedation-titration-for-respiratory-failure-restore-trial
#18
RANDOMIZED CONTROLLED TRIAL
Ruth Lebet, Jennifer Hayakawa, Tracy B Chamblee, Joana A Tala, Nakul Singh, David Wypij, Martha A Q Curley
BACKGROUND: RESTORE (Randomized Evaluation of Sedation Titration for Respiratory Failure) was a cluster randomized clinical trial evaluating a sedation strategy in children 2 weeks to <18 years of age with acute respiratory failure supported on mechanical ventilation. A total of 31 U.S. pediatric intensive care units (PICUs) participated in the trial. Staff nurse rater agreement on measures used to assess a critical component of treatment fidelity was essential throughout the 4-year data collection period...
July 2017: Nursing Research
https://www.readbyqxmd.com/read/28653420/impact-of-endotracheal-tube-shortening-on-work-of-breathing-in-neonatal-and-pediatric-in-vitro-lung-models
#19
Rebecca Mohr, Jörg Thomas, Vincenzo Cannizzaro, Markus Weiss, Alexander R Schmidt
BACKGROUND: Work of breathing accounts for a significant proportion of total oxygen consumption in neonates and infants. Endotracheal tube inner diameter and length significantly affect airflow resistance and thus work of breathing. While endotracheal tube shortening reduces endotracheal tube resistance, the impact on work of breathing in mechanically ventilated neonates and infants remains unknown. AIM: The objective of this in vitro study was to quantify the effect of endotracheal tube shortening on work of breathing in simulated pediatric lung settings...
September 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28651525/sofia-%C3%A2-rsv-prospective-laboratory-evaluation-and-implementation-of-a-rapid-diagnostic-test-in-a-pediatric-emergency-ward
#20
Léa C Tran, Céline Tournus, Julia Dina, Rémy Morello, Jacques Brouard, Astrid Vabret
BACKGROUND: Respiratory syncytial virus (RSV) is responsible for severe respiratory infections and higher costs in medical care. The two aims of this work were to assess the performances of SOFIA(®)RSV tests in "real-life-laboratory" conditions (study 1) and implemented at point-of-care testing in a pediatric emergency department (ED, study 2), during two consecutive winter seasons. METHODS: In study 1, fresh nasopharyngeal swabs from patients of all ages were sampled in 1...
June 26, 2017: BMC Infectious Diseases
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