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https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#1
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29650431/-efficacy-safety-and-satisfaction-of-sedation-analgesia-in-spanish-emergency-departments
#2
Concepción Míguez Navarro, Niki Oikonomopoulou, Arístides Rivas García, Andrea Mora Capín, Gloria Guerrero Márquez
OBJECTIVES: To offer analgesia and sedation should be a priority in paediatric emergency departments. The aim of this study was to determine the effectiveness and safety of the sedation-analgesia procedure, as well as the satisfaction of the doctors, patients and parents. METHODS: A multicentre, observational, and prospective analytical study was conducted on the sedation-analgesia procedure performed on children younger than 18 years old in 18 paediatric emergency departments in Spain from February 2015 until January 2016...
April 9, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29628576/comparison-of-intranasal-dexmedetomidine-compared-to-midazolam-as-a-premedication-in-pediatrics-with-congenital-heart-disease-undergoing-cardiac-catheterization
#3
Medhat M Messeha, Gamal Zakaria El-Morsy
Background: The intranasal route is a reliable way to administer preanesthetics and sedatives to children. The aim of this study was to compare the anxiolytic and sedative effect of intranasal dexmedetomidine and midazolam as a premedication in pediatrics with simple congenital heart disease undergoing cardiac catheterization. Patients and Methods: Sixty children 3-6 years old of either sex with simple congenital heart disease undergoing cardiac catheterization were randomly allocated into two groups: Dexmedetomidine group who received intranasal dexmedetomidine (0...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29587188/nonconvulsive-status-epilepticus-after-cessation-of-convulsive-status-epilepticus-in-pediatric-intensive-care-unit-patients
#4
Jin Chen, Lingling Xie, Yue Hu, Xinghui Lan, Li Jiang
Little is known about pediatric patients suffering from nonconvulsive status epilepticus (NCSE) after convulsive status epilepticus (CSE) cessation. The aim of this study was to identify in pediatric patients the clinical characteristics of NCSE after CSE cessation and the factors that contribute to patient outcomes. Data from clinical features, electroencephalography (EEG) characteristics, neuroimaging findings, treatments, and prognosis were systematically summarized, and the associations between clinical characteristics and prognosis were quantified...
March 24, 2018: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/29570859/oral-lorazepam-can-be-substituted-for-intravenous-midazolam-when-weaning-paediatric-intensive-care-patients-off-sedation
#5
Anna C van der Vossen, Merel van Nuland, Erwin G Ista, Saskia N de Wildt, Lidwien M Hanff
AIM: Intravenous sedatives used in the paediatric intensive care unit (PICU) need to be tapered after prolonged use to prevent iatrogenic withdrawal syndrome (IWS). We evaluated the occurrence of IWS and the levels of sedation before and after conversion from intravenous midazolam to oral lorazepam. METHODS: This was a retrospective, observational, single cohort study of children under the age of 18 admitted to the PICU of the Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands, between January 2013 and December 2014...
March 23, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29557840/an-exploratory-study-of-sevoflurane-as-an-alternative-for-difficult-sedation-in-critically-ill-children
#6
Santiago Mencía, Alba Palacios, Miriam García, Ana M Llorente, Olga Ordóñez, Blanca Toledo, Jesús López-Herce
OBJECTIVES: To analyze the effectiveness of inhaled sevoflurane in critically ill children with challenging sedation. DESIGN: Prospective case series. SETTING: Two PICUs of university hospitals in Spain. INTERVENTIONS: Prospective observational study and exploratory investigation conducted in two PICUs in Madrid, Spain, over a 6-year period. Children treated with inhaled sevoflurane due to difficult sedation were included...
March 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29557601/sedation-and-analgesia-in-patients-on-mechanical-ventilation-in-pediatric-intensive-care-units-in-argentina
#7
Pedro Taffarel, German Bonetto, Facundo Jorro Barón, Claudia Meregalli
INTRODUCTION: Children in pediatric intensive care units (PICUs) are exposed to experiencing pain, stress and anxiety due to their disease, treatment or care setting. Adequate sedation and analgesia are key to their care, particularly in patients requiring mechanical ventilation (MV). OBJECTIVE: To determine the usual practice in sedation and analgesia management in patients requiring MV in PICUs in Argentina. MATERIAL AND METHODS: Descriptive, crosssectional, multi-center study conducted by means of e-mailed surveys...
April 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29516704/use-of-low-dose-dexmedetomidine-in-combination-with-opioids-and-midazolam-in-paediatric-cardiac-surgical-patients-randomized-controlled-trial
#8
Cristiana Garisto, Zaccaria Ricci, Lorenzo Tofani, Simona Benegni, Chiara Pezzella, Paola Cogo
BACKGROUND: Dexmedetomidine is a selective agonist of α2 receptors that induces hypnotic, sedative and mild analgesic effect. The aim of our study was to test the effects of dexmedetomidine in combination with opioids and benzodiazepines compared to benzodiazepine-opioids alone. METHODS: A randomized controlled trial was conducted. Patients (children >30 days and <24 months undergoing correction of complex congenital heart diseases -CHD-) were randomized to receive 0...
March 7, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29509264/efficacy-of-inhalational-sevoflurane-anesthesia-induction-on-inhibiting-the-stress-response-to-endotracheal-intubation-in-children-with-congenital-heart-disease
#9
C-H Wang, J Luo, J Li, J-Z Zhang, S-Y Huang, W Shao, H-S Ma
OBJECTIVE: To investigate the efficacy of inhalational sevoflurane anesthesia induction on inhibiting the stress response to endotracheal intubation in pediatric patients with congenital heart disease (CHD). PATIENTS AND METHODS: Forty ASA physical status I/II pediatric patients scheduled for interventricular septal defect repair or interatrial septal defect repair, were randomly divided into two groups (20 each): intravenous induction group (Group C) and inhalational sevoflurane anesthesia induction group (Group D)...
February 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29483782/single-dose-oral-midazolam-for-minor-emergency-department-procedures-in-children-a-retrospective-cohort-study
#10
Gal Neuman, Rana Swed Tobia, Liron Koren, Ronit Leiba, Itai Shavit
Background: In the pediatric emergency department, patients are commonly treated with a single dose of oral midazolam for minor procedures. We sought to evaluate the effect of this treatment on procedure completion rates. Methods: We conducted a single-center retrospective cohort study of all patients who were treated with pre-procedure oral midazolam between January 2011 and June 2016. The primary outcome was the procedure completion rate. Results: During the study period, 1,504 patients were treated with oral midazolam as per department protocol; 1,467 received midazolam and 37 declined midazolam...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29482682/comparison-of-two-morphine-benzodiazepine-hydroxyzine-combinations-for-the-oral-sedation-of-pediatric-dental-patients-a-retrospective-study
#11
Norman Chen, Thomas Tanbonliong
PURPOSE: To investigate the effectiveness of oral morphine sulfate regimens in sedating pediatric dental patients and assess whether pre-sedation disposition and willingness to take the sedative were related to the outcome of the sedation. METHODS: The sedation records of 271 pediatric dental patients sedated with oral morphine were reviewed. Children were either sedated with regimen one (morphine plus midazolam plus hydroxyzine) or regimen two (morphine plus diazepam plus hydroxyzine)...
January 1, 2018: Pediatric Dentistry
https://www.readbyqxmd.com/read/29459611/non-convulsive-status-epilepticus-in-children-clinical-profile-eeg-characteristics-and-treatment
#12
K Fatema, M M Rahman, S Akhter, N Akter, S Begum
Non-convulsive status epilepticus (NCSE) is a term used to denote a range of conditions in which electrographic seizure activity is prolonged and results in non-convulsive clinical symptoms. This study was done to describe the clinical spectrum, EEG findings and to evaluate the efficacy of different therapeutic agents in children with NCSE in 33 patients from January 2011 to December 2015 period. All patients had EEG before and after treatment. Age range was 6 months to 14 year, 25 were male. Regarding development status, 48% had developmental delay, 21% had normal development, 9% had regression and 21% had both developmental delay and regression...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29419606/in-vitro-adsorption-of-analgosedative-drugs-in-new-extracorporeal-membrane-oxygenation-circuits
#13
Genny Raffaeli, Karel Allegaert, Birgit Koch, Giacomo Cavallaro, Fabio Mosca, Dick Tibboel, Enno D Wildschut
OBJECTIVE: Evaluate drug disposition of sedatives and analgesics in the Xenios/Novalung extracorporeal membrane oxygenation circuits. DESIGN: In vitro experimental study. SETTING: Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands. SUBJECTS: Nine closed-loop extracorporeal membrane oxygenation circuits, made up of the iLA Activve console with four different iLA Activve kits: two X-lung kits, two iLA-Activve iLA kits, two MiniLung kits, and three MiniLung petite kits...
February 6, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29390298/comparison-of-hemodynamic-effects-of-sevoflurane-and-ketamine-as-basal-anesthesia-by-a-new-and-direct-monitoring-during-induction-in-children-with-ventricular-septal-defect-a-prospective-randomized-research
#14
Ding Han, Ya-Guang Liu, Shoudong Pan, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Sevoflurane and ketamine are commonly used to obtain sedation and facilitate intravenous anesthetic induction in children undergoing cardiac surgery who are uncooperative. We used a new and direct systemic hemodynamic monitoring technique pressure recording analytical method and compared the hemodynamic effects of sevoflurane and ketamine to facilitate intravenous anesthetic induction. METHODS: Forty-four children with ventricular septal defect (2.2 ± 1...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29364730/improving-prehospital-protocol-adherence-using-bundled-educational-interventions
#15
Megan C Marino, Daniel G Ostermayer, Juan A Mondragon, Elizabeth A Camp, Elizabeth M Keating, Louis B Fornage, Charles A Brown, Manish I Shah
BACKGROUND: Seizures and anaphylaxis are life-threatening conditions that require immediate treatment in the prehospital setting. There is variation in treatment of pediatric prehospital patients for both anaphylaxis and seizures. This educational study was done to improve compliance with pediatric prehospital protocols, educate prehospital providers and decrease variation in care. OBJECTIVE: To improve the quality of care for children with seizures and anaphylaxis in the prehospital setting using a bundled, multifaceted educational intervention...
January 24, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29364490/intranasal-drug-administration-for-procedural-sedation-in-children-admitted-to-pediatric-emergency-room
#16
C Fantacci, G C Fabrizio, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: Pain relief is a very important aspect in Pediatrician's clinical practice. It is often thought that young children, particularly infants, do not perceive as much pain as adults because of their immature nervous system and that untreated pain would not have adverse long-term consequences. Instead, it has been demonstrated that infants and children experience pain in a similar manner to adults. Many factors, particularly emotional factors, can increase the child's pain perception...
January 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29337835/promethazine-and-oral-midazolam-preanesthetic-children-medication
#17
Sedigheh Nadri, Hormoz Mahmoudvand, Nadereh Taee, Khatereh Anbari, Siavash Beiranvand
AIMS: Several kinds of drugs have been investigated in preschool children as a preanesthetic sedation after various routes of administration for surgeries. This study aims to compare the efficacy of promethazine and oral midazolam for premedication in children aged 3 to 9 years who were scheduled for surgeries. METHODS: This is a double-blind randomized controlled study conducted on 93 patients between the age of 3 and 9 years at Loresten University of Medical Sciences Teaching Hospital, Khoramabad, Iran...
January 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29320603/drug-management-for-acute-tonic-clonic-convulsions-including-convulsive-status-epilepticus-in-children
#18
REVIEW
Amy McTague, Timothy Martland, Richard Appleton
BACKGROUND: Tonic-clonic convulsions and convulsive status epilepticus (currently defined as a tonic-clonic convulsion lasting at least 30 minutes) are medical emergencies and require urgent and appropriate anticonvulsant treatment. International consensus is that an anticonvulsant drug should be administered for any tonic-clonic convulsion that has been continuing for at least five minutes. Benzodiazepines (diazepam, lorazepam, midazolam) are traditionally regarded as first-line drugs and phenobarbital, phenytoin and paraldehyde as second-line drugs...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29306558/high-dose-phenobarbitone-coma-in-pediatric-refractory-status-epilepticus-a-retrospective-case-record-analysis-a-proposed-protocol-and-review-of-literature
#19
Sheffali Gulati, Vishal Sondhi, Biswaroop Chakrabarty, Prashant Jauhari, Rakesh Lodha, Jhuma Sankar
BACKGROUND: Ongoing refractory status epilepticus is associated with significant morbidity and mortality. Therapeutic coma induction with midazolam, thiopentone, phenobarbitone or propofol is indicated when conventional antiepileptics fail to abort seizure. Of these, the most extensively studied is midazolam. Amongst the remaining three, phenobarbitone has the most favourable pharmacological profile, but has not been studied adequately, more so in the pediatric age group. The current retrospective case records analysis is an attempt to describe use of phenobarbitone coma in pediatric refractory status epilepticus...
April 2018: Brain & Development
https://www.readbyqxmd.com/read/29303138/is-age-a-determinant-for-nausea-and-vomiting-in-disabled-patients-after-dental-treatment-under-sedation
#20
Hüseyin Cihad Turgut, Metin Alkan, Gülay Kip, Mustafa Sancar Ataç, Sevil Kahraman Altundağ, Süleyman Bozkaya, Berrin Işik, Mustafa Arslan
BACKGROUND AND AIM: Postoperative nausea and vomiting (PONV) is one of most frequently encountered problems after dental treatment of mentally and/or motor disabled patients under sedation or general anesthesia. In this study, we aimed to investigate whether PONV incidence in disabled patients differs between adults (≥18 years) and children/teenage (<18 years). Also investigating complication rates related with anesthesia protocols were additional objectives of the study. MATERIALS AND METHODS: We retrospectively evaluated anesthesia reports of 664 cases undergone different dental treatment procedures under deep sedation with various anesthetic agents...
November 2017: Nigerian Journal of Clinical Practice
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