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Pediatric AND sepsis

Kathleen M Adelgais, Matthew Hansen, Brooke Lerner, J Joelle Donofrio, Kabir Yadav, Kathleen Brown, Yiju T Liu, Paula Denslow, Kurt Denninghoff, Paul Ishimine, Lenora M Olson
The evidence supporting best practices when treating children in the prehospital setting or even the effect Emergency Medical Services (EMS) has on patient outcomes is limited. Standardizing the critical outcomes for EMS research will allow for focused and comparable effort among the small but growing group of pediatric EMS investigators on specific topics. Standardized outcomes will also provide the opportunity to collectively advance the science of EMS for children and demonstrate the effect of EMS on patient outcomes...
October 12, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Nilesh M Mehta
No abstract text is available yet for this article.
November 2018: Critical Care Medicine
Patrícia Zamberlan, Rubens Feferbaum, Ulysses Doria Filho, Werther Brunow de Carvalho, Artur Figueiredo Delgado
BACKGROUND: Nutrition markers may be useful for diagnosis and monitoring and, also, as additional indicators of estimating death risk. We tested the association of body composition indicators (mid-upper arm circumference and phase angle) with pediatric intensive care unit (PICU) length of stay and mortality in critically ill pediatric patients. METHODS: Data from children aged 2 months-18 years were collected, and bioelectrical impedance was performed to obtain phase angle...
October 10, 2018: Nutrition in Clinical Practice
Ahmed Hussain, Pratap Harbham, Mohamad Zeina
No abstract text is available yet for this article.
October 10, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
Robert P Richter, Robert T Russell, Parker J Hu, Rindi M Uhlich, Thomas A Swain, Jeffrey D Kerby, Jean-Francois Pittet, Jillian R Richter
BACKGROUND: Angiopoietin-1 (Agpt-1) and Agpt-2 are cytokine regulators of vascular endothelial integrity. Elevated plasma Agpt-2 levels and ratios of Agpt-2:Agpt-1 are associated with adverse outcomes in adult trauma and pediatric sepsis populations. However, the behavior of the angiopoietins after pediatric trauma has not been characterized, and their relationship to endothelial glycocalyx damage, indicated by plasma syndecan-1 (Syn-1) levels, has not been established. METHODS: We performed a secondary analysis of prospectively collected data from 52 pediatric trauma patients and 12 control patients at a level one pediatric trauma center from 2013 to 2016...
October 4, 2018: Shock
Xin Xu, Sheng Nie, Aihua Zhang, Jianhua Mao, Hai-Peng Liu, Huimin Xia, Hong Xu, Zhangsuo Liu, Shipin Feng, Wei Zhou, Xuemei Liu, Yonghong Yang, Yuhong Tao, Yunlin Feng, Chunbo Chen, Mo Wang, Yan Zha, Jian-Hua Feng, Qingchu Li, Shuwang Ge, Jianghua Chen, Yongcheng He, Siyuan Teng, Chuanming Hao, Bi-Cheng Liu, Ying Tang, Wenjuan He, Pinghong He, Fan Fan Hou
BACKGROUND AND OBJECTIVES: High-quality epidemiologic data on AKI in children are particularly lacking in developing countries. This study aimed to assess the epidemiology and clinical correlates of AKI among hospitalized children in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a multicenter study, in a cohort of hospitalized children aged 1 month to 18 years, from 25 general and children's hospitals in China during 2013-2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all children who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization...
October 4, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Richard W Pierce, Veronika Shabanova, Michael Canarie, Mathew Pinto, Yong Sing da Silva, Vineet Bhandari, John S Giuliano
OBJECTIVE: Angiopoietins are postulated diagnostic biomarkers in children and adults with severe sepsis and septic shock. The diagnostic value of angiopoietins in children less than 5 years old has not been established, nor has their effect on permeability in the capillary microvasculature. We aim to determine if levels of angiopoietin-1 or -2 (angpt-1, -2) are diagnostic for severe sepsis/shock in young children and whether they affect the permeability of cultured human dermal microvascular endothelial cells (HDMEC)...
October 3, 2018: Shock
Gemechu Jofiro, Kemal Jemal, Lemlem Beza, Tigist Bacha Heye
BACKGROUND: Childhood mortality remains high in resource-limited third world countries. Most childhood deaths in hospital often occur within the first 24 h of admission. Many of these deaths are from preventable causes. This study aims to describe the patterns of mortality in children presenting to the pediatric emergency department. METHODS: This was a five-year chart review of deaths in pediatric patients aged 7 days to 13 years presenting to the Tikur Anbessa Specialized Tertiary Hospital (TASTH) from January 2012 to December 2016...
October 2, 2018: BMC Pediatrics
Anastasia A Ignatova, Evgeniya A Ponomarenko, Dmitry M Polokhov, Elena V Suntsova, Pavel A Zharkov, Daria V Fedorova, Ekaterina N Balashova, Anastasia E Rudneva, Vadim V Ptushkin, Evgeniy A Nikitin, Anna Shcherbina, Alexei A Maschan, Galina A Novichkova, Mikhail A Panteleev
The ability of platelets to carry out their hemostatic function can be impaired in a wide range of inherited and acquired conditions: trauma, surgery, inflammation, pre-term birth, sepsis, hematological malignancies, solid tumors, chemotherapy, autoimmune disorders, and many others. Evaluation of this impairment is vitally important for research and clinical purposes. This problem is particularly pronounced in pediatric patients, where these conditions occur frequently, while blood volume and the choice of blood collection methods could be limited...
October 4, 2018: Platelets
Jonathan R Studnek, E Brooke Lerner, Manish I Shah, Lorin R Browne, David C Brousseau, Jeremy T Cushman, Peter S Dayan, Patrick C Drayna, Amy L Drendel, Matthew P Gray, Christopher A Kahn, Michael T Meyer, Manish N Shah, Rachel M Stanley
BACKGROUND: Emergency Medical Services (EMS) providers must be able to identify the most appropriate destination facility when treating children with potentially severe medical illnesses. Currently, no validated tool exists to assist EMS providers in identifying children who need transport to a hospital with higher-level pediatric care. In order for such a tool to be developed, a criterion standard needs to be defined that identifies children who received higher-level pediatric medical care...
October 3, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Nonie S Arora, Anne M Danicek, Rachel R Osborn, Sarah Q Fried, Olivia R Negris, Karson Lychuk, Kerry P Mychaliska, Maria S Skoczylas, Kimberly K Monroe
OBJECTIVES: In 2015, the American Academy of Pediatrics (AAP) published an updated consensus statement containing 17 discharge recommendations for healthy term newborn infants. In this study, we identify whether the AAP criteria were met before discharge at a tertiary care academic children's hospital. METHODS: A stratified random sample of charts from newborns who were discharged between June 1, 2015, and May 31, 2016, was reviewed. Of the 531 charts reviewed, 433 were included in the study...
October 2, 2018: Hospital Pediatrics
Matthew N Alder, Amy M Opoka, Hector R Wong
BACKGROUND: There is controversy around the prescription of adjunct corticosteroids in patients with fluid-refractory septic shock, and studies provide mixed results, showing benefit, no benefit, and harm. Traditional means for evaluating whether a patient receives corticosteroids relied on anecdotal experience or measurement of serum cortisol production following stimulation. We set out to measure both serum cortisol and the intracellular signaling receptor for cortisol, the glucocorticoid receptor (GCR), in this group of patients...
September 29, 2018: Critical Care: the Official Journal of the Critical Care Forum
Yin Ting Cheung, Aaron Eskind, Hiroto Inaba, Melissa M Hudson, Ching-Hon Pui, Kevin R Krull, Joshua Wolf
No abstract text is available yet for this article.
September 24, 2018: JAMA Pediatrics
Azeem Tariq Malik, Jeffery Kim, Elizabeth Yu, Safdar N Khan
OBJECTIVE: To assess the impact of fixation to pelvis on 30-day outcomes following posterior spinal fusions in pediatric spine deformities. METHODS: The 2012-2016 American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) Pediatric database was queried using Current Procedural Terminology codes for patients undergoing posterior spinal fusions (22800, 22802 and 22804). Patients undergoing concurrent anterior fusion/combined fusion and anterior-only fusions were removed from the study...
September 24, 2018: World Neurosurgery
Rhys D Evans, Marie Docherty, Anna Seeley, Alison Craik, Martha Mpunga, Shawna Mann, Queen Dube, Gavin Dreyer, Ulla Hemmila
INTRODUCTION: The epidemiology of acute kidney injury (AKI) in children in sub-Sahara Africa (SSA) is poorly described. The aim of this study was to establish the incidence, etiology, and outcomes of community-acquired AKI in pediatric admissions in Southern Malawi. METHODS: We conducted a prospective observational study of pediatric admissions to a tertiary hospital in Blantyre between 5 February and 30 April 2016. Children were screened for kidney disease on admission with measurement of serum creatinine and assessment of urine output...
September 25, 2018: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Karin E Thompson, Ramesh M Ray, Shanta Alli, Wenbo Ge, Alyssa Boler, W Shannon McCool, Avtar S Meena, Pradeep K Shukla, Radakrishna Rao, Leonard R Johnson, Mark A Miller, Gabor J Tigyi
Diarrheal disease is a severe global health problem. It is estimated that secretory diarrhea causes 2.5 million deaths annually among children under the age of five in the developing world. A critical barrier in treating diarrheal disease is lack of easy-to-use effective treatments. While antibiotics may shorten the length and severity of diarrhea, oral rehydration remains the primary approach in managing secretory diarrhea. Existing treatments mostly depend on reconstituting medicines with water that is often contaminated which can be an unresolved problem in the developing world...
September 25, 2018: Experimental Biology and Medicine
Charles D Voigt, Gabriel Hundeshagen, Ioannis Malagaris, Kaitlin Watson, Ruth N Obiarinze, Houman Hasanpour, Lee C Woodson, Karel D Capek, Jong O Lee, Omar A Nunez Lopez, Janos Cambiaso-Daniel, Ludwik K Branski, William B Norbury, Celeste C Finnerty, David N Herndon
BACKGROUND: Blood transfusion is costly and associated with various medical risks. Studies in critically ill adult and pediatric patients suggest that implementation of more restrictive transfusion protocols based on lower threshold hemoglobin concentrations can be medically and economically advantageous. The purpose of this study was to evaluate the implications of a hemoglobin threshold change in pediatric burn patients. METHODS: We implemented a change in hemoglobin threshold from 10 to 7 g/dL and compared data from patients before and after this protocol change in a retrospective review...
September 24, 2018: Journal of Trauma and Acute Care Surgery
F Schaltz-Buchholzer, S Biering-Sørensen, N Lund, I Monteiro, P Umbasse, A Bærent Fisker, A Andersen, A Rodrigues, P Aaby, C S Benn
Objective: To examine effects of early Bacille Calmette-Guérin (BCG) vaccination on the risk, cause and severity of infant hospitalizations. Design: Analysis of three trials randomizing low-weight neonates to early-BCG(intervention) versus no-BCG(usual practice in low-weight neonates, control), with hospitalizations as secondary outcome. Methods: Hospitalization data was collected at the pediatric ward of the National Hospital. Effects of BCG on hospitalization risk were assessed in Cox-models providing overall and major disease-group incidence rate ratios(IRRs)...
September 18, 2018: Journal of Infectious Diseases
Matthias Görges, Cheryl Peters, Srinivas Murthy, Shanshan Pi, Niranjan Kissoon
OBJECTIVES: A quick Pediatric Logistic Organ Dysfunction 2 score on day 1, consisting of tachycardia, hypotension, and altered mentation, was shown to predict mortality with an area under the receiver operating characteristic curve of 82% (95% CI, 76-87%) in children admitted to a PICU with suspected infection. We performed an external validation of the quick Pediatric Logistic Organ Dysfunction 2, including its performance in predicting mortality in specific age groups. DESIGN: Analysis of retrospective data obtained from the Virtual Pediatric Systems PICU registry...
September 18, 2018: Pediatric Critical Care Medicine
Douglas F Willson, Mark Hall, Andrew Beardsley, Michelle Hoot, Aileen Kirby, Spencer Hays, Simon Erickson, Edward Truemper, Robinder Khemani
OBJECTIVES: To compare the prevalence of infection applying the proposed pediatric ventilator-associated events criteria versus clinician-diagnosed ventilator-associated infection to subjects in the pediatric ventilator-associated infection study. DESIGN: Analysis of prospectively collected data from the pediatric ventilator-associated infection study. SETTING: PICUs of 47 hospitals in the United States, Canada, and Australia. PATIENTS: Two-hundred twenty-nine children ventilated for greater than 48 hours who had respiratory secretion cultures performed to evaluate for suspected ventilator-associated infection...
September 18, 2018: Pediatric Critical Care Medicine
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