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pediatric critical care intensive care children

Seham Awad El-Sherbini, Huda Marzouk, Riham El-Sayed, Sarah Hosam-ElDin
OBJECTIVE: This study aimed to study the incidence of stress hyperglycemia in critically ill children and to investigate the etiological basis of the hyperglycemia based on homeostasis model assessment. METHODS: This was a prospective cohort study in one of the pediatric intensive care units of Cairo University, including 60 critically ill children and 21 healthy controls. Serum blood glucose, insulin, and C-peptide levels were measured within 24 hours of admission...
July 2018: Revista Brasileira de Terapia Intensiva
Leila Khajavi, Gholamreza Khademi, Mehraneh Mehramiz, Abdolreza Norouzy, Mohammad Safarian
Khajavi L, Khademi G, Mehramiz M, Norouzy A, Safarian M. Association of dysglycemia with mortality in children receiving parenteral nutrition in pediatric intensive care unit. Turk J Pediatr 2018; 60: 134-141. One of the most important complications of parenteral nutrition (PN) is a high incidence of hyperglycemia. The aim of this study was to assess the effect of parenteral nutrition dysglycemia on clinical outcomes among critically ill children in pediatric intensive care unit (PICU). Charts of 201 critically ill children admitted in PICU during 2012-2015 were reviewed retrospectively...
2018: Turkish Journal of Pediatrics
Başak Akyıldız, Sedat Öztürk, Nazan Ülgen-Tekerek, Selim Doğanay, Süreyya Burcu Görkem
Akyıldız B, Öztürk S, Ülgen-Tekerek N, Doğanay S, Görkem SB. Comparison between high-flow nasal oxygen cannula and conventional oxygen therapy after extubation in pediatric intensive care unit. Turk J Pediatr 2018; 60: 126-133. The aim of this study was to compare the efficiency, safety, and outcomes of the high-flow nasal oxygen cannula (HFNC) and conventional oxygen therapy (COT) after extubation in children. A randomized controlled trial was conducted in a 13 bed pediatric intensive care unit. One-hundred children who underwent extubation were eligible for the study...
2018: Turkish Journal of Pediatrics
Fang Fang, Xiaohan Hu, Xiaomei Dai, Sanfeng Wang, Zhenjiang Bai, Jiao Chen, Jian Pan, Xiaozhong Li, Jian Wang, Yanhong Li
BACKGROUND: Research on acute kidney injury (AKI) has focused on identifying early biomarkers. However, whether AKI could be diagnosed in the absence of the classic signs of clinical AKI and whether the condition of subclinical AKI, identified by damage or functional biomarkers in the absence of oliguria or increased serum creatinine (sCr) levels, is clinically significant remains to be elucidated in critically ill children. The aims of the study were to investigate the associations between urinary cystatin C (uCysC) levels and AKI and mortality and to determine whether uCysC-positive subclinical AKI is associated with adverse outcomes in critically ill neonates and children...
October 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
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
Kate Madden, Kinza Hussain, Robert C Tasker
OBJECTIVES: It is important to describe and understand the prevalence and risk factors for the syndrome of delirium in critical illness. Since anticholinergic medication may contribute to the development of delirium in the PICU, we have sought to quantify anticholinergic medication exposure in patients with prolonged admission. We have used Anticholinergic Drug Scale scores to quantify the magnitude or extent of this burden. DESIGN: Retrospective cohort study, January 2011 to December 2015...
October 2018: Pediatric Critical Care Medicine
Jamileh Ramazani, Mohammad Hosseini
INTRODUCTION: The SOFA (Sequential Organ Failure Assessment), GCS (Glasgow Coma Scale), and FOUR (Full Outline of UnResponsiveness) scores are the most commonly used scoring systems to predict the risk of mortality and morbidity in intensive care units (ICUs). The aim of the current study was to compare the predictive ability of these three models for predicting medical/surgical ICU mortality in critically ill children. METHODS: In the current observational and prospective study, a total of 90 consecutive patients, age ≤18 years, admitted to medical and surgical ICUs, were enrolled...
October 1, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Despoina Tzira, Anargyroula Prezerakou, Ioannis Papadatos, Artemis Vintila, Anastasia Bartzeliotou, Filia Apostolakou, Ioannis Papassotiriou, Vassiliki Papaevangelou
Objective: Measurement of salivary biomarkers can provide important information regarding hypothalamic-pituitary-adrenal axis activity both under normal conditions as well as in response to psychological or physical stress. Our aim was to correlate salivary stress markers, such as cortisol, α-amylase and immunoglobulin A, with the Pediatric Risk Index Score of Mortality, underlying disease (pathologic, trauma and postoperative), need for mechanical ventilation/sedation and time lag between onset of illness and admission in children admitted in the pediatric intensive care unit...
2018: SAGE Open Medicine
Murray M Pollack, Richard Holubkov, Robert A Berg, Christopher J L Newth, Kathleen L Meert, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, J Michael Dean
BACKGROUND: Early identification of children at risk for cardiac arrest would allow for skill training associated with improved outcomes and provides a prevention opportunity. OBJECTIVE: Develop and assess a predictive model for cardiopulmonary arrest using data available in the first 4 h. METHODS: Data from PICU patients from 8 institutions included descriptive, severity of illness, cardiac arrest, and outcomes. RESULTS: Of the 10074 patients, 120 satisfying inclusion criteria sustained a cardiac arrest and 67 (55...
September 25, 2018: Resuscitation
Ayfer Ekim
Improvements in devices and techniques used to provide life support for patients at intensive care units have reduced patient mortality. Increases in the number of survivors from a critical illness have brought long-term complications experienced during the post-intensive care period into question. The term post-intensive care syndrome (PICS) is defined as a new and deteriorating disorder in the cognitive, mental, and physical health status experienced by the survivor after intensive care unit discharge that might continue for months or even years...
September 25, 2018: Comprehensive Child and Adolescent Nursing
Maryline Chomton, David Brossier, Michaël Sauthier, Emilie Vallières, Josée Dubois, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVES: Ventilator-associated pneumonia is the second most common nosocomial infection in pediatric intensive care. The Centers for Disease Control and Prevention recently issued diagnosis criteria for pediatric ventilator-associated pneumonia and for ventilator-associated events in adults. The objectives of this pediatric study were to determine the prevalence of ventilator-associated pneumonia using these new Centers for Disease Control and Prevention criteria, to describe the risk factors and management of ventilator-associated pneumonia, and to assess a simpler method to detect ventilator-associated pneumonia with ventilator-associated event in critically ill children...
September 17, 2018: Pediatric Critical Care Medicine
Benjamin I Siegel, Janet Figueroa, Jana A Stockwell
Introduction: In critically ill children, inappropriate urinary catheter (UC) utilization is associated with increased morbidity, including catheter-associated urinary tract infections (CAUTIs). Checklists are effective for reducing medical errors, but there is little data on their impact on device utilization in pediatric critical care. In this study, we evaluated UC utilization trends and CAUTI rate after implementing a daily rounding checklist. Methods: A retrospective review of our checklist database from 2006 through 2016 was performed...
May 2018: Pediatric Quality & Safety
Amélie Marsot
Providing a safe and efficacious drug therapy for large and often heterogeneous populations is a challenging objective in clinical drug development and routine clinical practice. It has been known for years that the optimum dose required for many therapeutic agents among individuals is quite variable. A wide interindividual pharmacokinetic variability was described in clinically relevant populations such as pediatrics and critically ill patients. The aim of this article was to present the main individual factors influencing variability in these two populations and their applications...
2018: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Martin Schlegel, Andreas Körner, Torsten Kaussen, Urs Knausberg, Carmen Gerber, Georg Hansmann, Hulda Soffia Jónasdóttir, Martin Giera, Valbona Mirakaj
The resolution of inflammation is an active process that is coordinated by endogenous mediators. Previous studies have demonstrated the immunomodulatory properties of the axonal guidance proteins in the initial phase of acute inflammation. We hypothesized that the neuronal guidance protein neogenin (Neo1) modulates mechanisms of inflammation resolution. In murine peritonitis, Neo1 deficiency (Neo1-/-) resulted in higher efficacies in reducing neutrophil migration into injury sites, increasing neutrophil apoptosis, actuating PMN phagocytosis, and increasing the endogenous biosynthesis of specialized proresolving mediators, such as lipoxin A4, maresin-1, and protectin DX...
October 1, 2018: Journal of Clinical Investigation
Yang Chen, Guo-Ping Lu
Pediatric acute respiratory distress syndrome (ARDS) is an important cause of deaths in critically ill children admitted to the pediatric intensive care unit. Although lung-protective ventilation improves the prognosis of pediatric ARDS, the mortality rate of children with moderate or severe ARDS is still high. Given that the epidemiology, treatment, and prognosis of pediatric ARDS are different from those of adult ARDS, pediatric ARDS was first defined in the 2015 Pediatric Acute Lung Injury Consensus Conference...
September 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Atsushi Kawaguchi, L Duncan Saunders, Yutaka Yasui, Allan DeCaen
BACKGROUND AND OBJECTIVES: The need to centralize patients for specialty care in the setting of regionalization may delay access to specialist services and compromise outcomes, particularly in a large geographic area. The aim of this study was to explore the effects of interhospital transferring of children requiring intensive care in a Canadian regionalization model. METHODS: A retrospective cohort design with a matched pair analysis was adopted to compare the outcomes in children younger than 17 years admitted to a pediatric intensive care unit (PICU) of a Canadian children's hospital by a specialized transport team (pediatric critical care transported [PCCT] group) and those children admitted directly to PICU from its pediatric emergency department (PED group)...
September 6, 2018: Journal of Intensive Care Medicine
F Wang, Y Cui, C X Wang, T T Xiao, R X Chen, Y C Zhang
Objective: To explore the effects of continuous veno-venous hemodiafiltration (CVVHDF) as a rescue therapy in children with Kawasaki disease (KD) complicated with multiple organ dysfunction syndrome (MODS). Methods: The medical records of 5 patients diagnosed as KD with MODS treated with CVVHDF, who were admitted to pediatric intensive care unit (PICU) of Shanghai Children's Hospital from November 2015 to October 2017 were retrospectively collected. The inflammatory factors and parameters of organ function before and after CVVHDF treatment were analyzed...
September 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Carlos A Cuello-Garcia, Safiah Hwai Chuen Mai, Racquel Simpson, Samah Al-Harbi, Karen Choong
OBJECTIVE: To characterize how early mobilization is defined in the published literature and describe the evidence on safety and efficacy on early mobilization in critically ill children. STUDY DESIGN: Systematic search of randomized and nonrandomized studies assessing early mobilization-based physical therapy in critically ill children under 18 years of age in MEDLINE, Embase, CINAHL, CENTRAL, the National Institutes of Health, Evidence in Pediatric Intensive Care Collaborative, Physiotherapy Evidence Database, and the Mobilization-Network...
August 29, 2018: Journal of Pediatrics
Mckenna M Longacre, Brian M Cummings, Angela M Bader
Despite the aligned histories, development, and contemporary practices, today, pediatric anesthesiologists are largely absent from pediatric intensive care units. Contributing to this divide are deficits in exposure to pediatric intensive care at all levels of training in anesthesia and significant credentialing barriers. These observations have led us to consider, does the current structure of training lead to the ability to optimally innovate and collaborate in the delivery of pediatric critical care? We consider how redesigning the pediatric critical care training pathway available for pediatric anesthesiologists may improve care of children both in and out of the operating room by facilitating further sharing of skills, research, and clinical experience...
August 29, 2018: Anesthesia and Analgesia
Mohamed A El-Gamasy, Akram E El-Sadek, Ahmed R Fakhreldin, Ashraf Kamel, Eman G Elbehery
Acute kidney injury (AKI) is an independent predictor of morbidity and mortality for critically ill children at pediatric Intensive Care Units (PICU). It is proposed that heat shock protein 60 (HSP60) may be either a biomarker or a co-factor of survival in PICU. The aim of this work is to assess plasma levels of HSP60 in critically ill pediatric patients with AKI secondary to septic shock within the first 24 h of admission. This study was carried out on 120 pediatric patients admitted to PICUs of four university hospitals...
July 2018: Saudi Journal of Kidney Diseases and Transplantation
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