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pediatric critical care intensive care children

Hai Peng Yan, Miao Li, Xiu Lan Lu, Yi Min Zhu, Wen-Xian Ou-Yang, Zheng Hui Xiao, Jun Qiu, Shuang Jie Li
BACKGROUND: The mortality rate due to severe sepsis is approximately 30-60%. Sepsis readily progresses to septic shock and multiple organ dysfunction, representing a significant problem in the pediatric intensive care unit (PICU). The aim of this study was to explore the value of plasma mitochondrial DNA (mtDNA) for early diagnosis and prognosis in children with sepsis. METHODS: A total of 123 children with sepsis who were hospitalized in the Hunan Children's Hospital PICU from July 2013 to December 2014 were divided into the general sepsis group (n = 70) and severe sepsis group (n = 53) based on diagnostic standards...
August 9, 2018: BMC Pediatrics
Tareq Al-Ayed, Naveed Ur Rahman, Abdullah Alturki, Fahad Aljofan
BACKGROUND: Continuous renal replacement therapy (CRRT) has become the preferred mode of dialysis to support critically ill children with acute kidney injury. However, there are limited pediatric data on CRRT use, especially in our region. OBJECTIVE: Determine the outcome of CRRT among critically ill children. DESIGN: Retrospective cohort study. SETTING: Pediatric intensive care unit. PATIENTS AND METHODS: The study included critically ill children 1-14 years of age who underwent CRRT from July 2009 to June 2015...
July 2018: Annals of Saudi Medicine
Marisa Tucci, Jacques Lacroix, Dean Fergusson, Allan Doctor, Paul Hébert, Robert A Berg, Jaime Caro, Cassandra D Josephson, Stéphane Leteurtre, Kusum Menon, Kenneth Schechtman, Marie E Steiner, Alexis F Turgeon, Lucy Clayton, Tina Bockelmann, Philip C Spinella
BACKGROUND: The "Age of Blood in Children in Pediatric Intensive Care Unit" (ABC PICU) study is a randomized controlled trial (RCT) that aims to determine if red blood cell (RBC) unit storage age affects outcomes in critically ill children. While RBCs can be stored for up to 42 days in additive solutions, their efficacy and safety after long-term storage have been challenged. Preclinical and clinical observational evidence suggests loss of efficacy and lack of safety of older RBC units, especially in more vulnerable populations such as critically ill children...
July 28, 2018: Trials
Adam P Ostendorf, Kelsey Merison, T Arthur Wheeler, Anup D Patel
BACKGROUND: Rapid, effective treatment for status epilepticus reduces associated morbidity and mortality, yet medication delivery remains slow in many hospitalized patients. We utilized quality improvement (QI) methodology to improve treatment times for hospitalized children with status epilepticus. We hypothesized rapid initial seizure treatment would decrease seizure morbidity. METHODS: We utilized QI and statistical process control analysis in a nonintensive care setting within a tertiary care pediatric hospital...
June 2, 2018: Pediatric Neurology
Giulia M Benedetti, Faye S Silverstein, Stephanie M Rau, Shannon G Lester, Marco H Benedetti, Renée A Shellhaas
OBJECTIVES: We assessed neuroactive medication use in critically ill children who require neurological consultation and evaluated the associations between administration of these medications and continuous electroencephalography (cEEG) utilization and seizure frequency. METHODS: We evaluated exposure to sedatives, analgesics, anesthetics, and paralytics in consecutive patients (0 days to 18 years) for whom neurological consultation was requested in three intensive care units (ICUs) [neonatal (NICU), pediatric (PICU), and cardiothoracic (PCTU)]) at one children's hospital...
May 18, 2018: Pediatric Neurology
Robert M Sutton, Ron W Reeder, William Landis, Kathleen L Meert, Andrew R Yates, John T Berger, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, Daniel A Notterman, Richard Holubkov, J Michael Dean, Vinay M Nadkarni, Robert A Berg
AIM: The primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR). METHODS: Prospective observational study of children ≥37 weeks gestation and <19 years old who received CPR in an intensive care unit (ICU) as part of the Pediatric Intensive Care Unit Quality of CPR Study (PICqCPR) of the Collaborative Pediatric Critical Care Research Network (CPCCRN)...
July 18, 2018: Resuscitation
Martha A Q Curley, R Scott Watson, Amy M Cassidy, Cheryl Burns, Rachel L Delinger, Derek C Angus, Lisa A Asaro, David Wypij, Sue R Beers
There is increasing concern that sedatives commonly used during critical illness may be neurotoxic during the period of early brain development. The Sedation strategy and cognitive outcome after critical illness in early childhood (RESTORE-cognition) study is a prospective cohort study designed to examine the relationships between sedative exposure during pediatric critical illness and long-term neurocognitive outcomes. We assess multiple domains of neurocognitive function 2.5-5 years post-hospital discharge, at a single time point and depending on participant and clinician availability, in up to 500 subjects who had normal baseline cognitive function, were aged 2 weeks to 8 years at pediatric intensive care unit admission, and were enrolled in a cluster randomized controlled trial of a sedation protocol (the RESTORE trial; U01 HL086622 and HL086649)...
July 11, 2018: Contemporary Clinical Trials
Yu Wang, Changsong Shi, Zhongwen Yang, Fengmin Chen, Li Gao
PURPOSE: Low vitamin D blood levels are related to many clinical outcomes in children with critically illness. However, the relationship of it and septic shock has not been systematically analyzed. The objective of this review was to evaluate the effect of vitamin D on septic shock and predict if vitamin D administration can improve prognosis of it. MATERIALS AND METHODS: Online databases were searched up to June 1st, 2017 for studies on the relation of vitamin D deficiency (VDD) and clinical outcomes on septic shock in children with critical illness...
July 13, 2018: European Journal of Clinical Nutrition
Marlina E Lovett, Zubin S Shah, Melissa Moore-Clingenpeel, Eric Sribnick, Adam Ostendorf, Melissa G Chung, Jeffrey Leonard, Nicole F O'Brien
OBJECTIVE Focal intracranial infections such as intraparenchymal abscesses or localized infections in the epidural or subdural spaces are relatively rare infections associated with both morbidity and mortality in children. Although children with these infections frequently require surgical intervention, there is a paucity of literature describing the critical care resources required to manage these cases. This retrospective chart review was performed to evaluate the resources necessary to care for critically ill children with focal intracranial infections at the authors' institution...
July 13, 2018: Journal of Neurosurgery. Pediatrics
Theresa A Mikhailov, Shira J Gertz, Evelyn M Kuhn, Matthew C Scanlon, Thomas B Rice, Praveen S Goday
BACKGROUND: Previous studies have shown that early enteral nutrition (EEN) is associated with lower mortality in critically ill children. The purpose of this study was to determine the association between EEN (provision of 25% of goal calories enterally over the first 48 hours) and pediatric intensive care unit (PICU) and hospital charges in critically ill children. METHODS: We conducted a supplementary study to our previous multicenter retrospective study of nutrition and outcomes in critically ill patients who had a PICU length of stay (LOS) ≥96 hours for the years 2007-2008...
July 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Rachel M Landisch, Sheila J Hanson, Rowena C Punzalan, Kristin Braun, Laura D Cassidy, David M Gourlay
INTRODUCTION: Venous thromboembolism (VTE) is increasingly prevalent in injured children admitted to the intensive care unit (ICU). Few data exist to support VTE pharmacologic prophylaxis or ultrasound (US) surveillance in children with high bleeding risk. After implementation of screening US guidelines, we sought to describe our experience, hypothesizing that screening US of children at highest risk for VTE results in earlier detection and management. STUDY DESIGN: A retrospective analysis was conducted on prospectively collected data of injured children admitted to an American College of Surgeons Verified level 1 Pediatric Trauma Center from 2010 to 2015...
June 20, 2018: Journal of Pediatric Surgery
Caroline Abud Drumond Costa, Pedro Celiny Ramos Garcia, Daiane Drescher Cabral, Cristian Tedesco Tonial, Francisco Bruno, Paulo Roberto Enloft, Kelly Daiane Stochero Velozo
OBJECTIVE: To compare the prevalence of malnutrition during two time periods in a pediatric intensive care unit. METHODS: This was a retrospective cross-sectional study of patients admitted to the pediatric intensive care unit of a university hospital during two one-year periods with an interval of four years between them. Nutritional evaluation was conducted based on weight and height measured at admission. The body mass index-for-age was the parameter chosen to evaluate nutritional status, as classified according to the World Health Organization, according to age group...
April 2018: Revista Brasileira de Terapia Intensiva
Shariq Nawaz, Kamran Afzal
The conducted study aimed to determine the incidence and clinical profile of acute kidney injury (AKI) in hospitalized patients using the AKI Network (AKIN) criteria. This prospective observational study was conducted at the Pediatric ward and pediatric Intensive Care Unit of a tertiary level teaching hospital in North India. The participants were 763 consecutive patients aged three months to 12 years from January 2014 to October 2015 and were assessed for eligibility. Of these, 163 patients were excluded from the study...
May 2018: Saudi Journal of Kidney Diseases and Transplantation
Daniela B Hauschild, Luna D A Oliveira, Mirelle S Farias, Eliana Barbosa, Nilzete L Bresolin, Nilesh M Mehta, Yara M F Moreno
BACKGROUND: Loss of muscle mass in critically ill children can negatively impact outcomes. The aims of this study were to conduct a pilot randomized control trial (RCT) to examine the difference in protein delivery and nitrogen balance in critically ill children with enteral protein supplementation vs controls. We also aimed to assess the feasibility, safety, and tolerance of the pilot trial. METHODS: This is a 3-arm RCT in critically ill children eligible for enteral nutrition (EN) therapy...
June 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
Kusum Menon, Dayre McNally, Anand Acharya, Katharine O'Hearn, Karen Choong, Hector R Wong, Lauralyn McIntyre, Margaret Lawson
Background The aim of the study was to examine the relationship between serum total cortisol (TC) and free cortisol (FC) levels in children with septic shock and the relationship of these levels with baseline illness severity. Methods A sub-study of a randomized controlled trial (RCT) of hydrocortisone vs. placebo in pediatric septic shock conducted in seven academic pediatric intensive care units (PICUs) in Canada on children aged newborn to 17 years. Thirty children with septic shock had serum sent for TC and FC measurement within 6 h of meeting the study eligibility criteria...
July 26, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
Won Kyoung Jhang, EunJu Ha, Seong Jong Park
PURPOSE: To evaluated the outcome predictability of DIC scores in critically ill children with septic shock. MATERIALS AND METHODS: Pediatric patients with septic shock who were admitted to the pediatric intensive care unit of a tertiary care children's hospital between January 2013 and December 2017 were enrolled. We analyzed the association between DIC and clinical outcomes. DIC was diagnosed based on the International Society on Thrombosis and Hemostasis (ISTH), Japanese Association for Acute Medicine (JAAM), and modified JAAM DIC criteria...
June 19, 2018: Journal of Critical Care
Bongjin Lee, Soo Jung Kim, June Dong Park, Jiun Park, Ae Hee Jung, Sun Hoi Jung, Yu Hyeon Choi, Hee Gyung Kang, Il Soo Ha, Hae Il Cheong
Vancomycin is known to be unintentionally eliminated by continuous renal replacement therapy, and the protein bound fraction of vancomycin is also known to be different in adults and children. However, there are only a few studies investigating the relationship between the dose of continuous venovenous hemodiafiltration (CVVHDF) parameters and serum concentration of vancomycin in pediatric patients. The aim of this study was to determine clinical and demographic parameters that significantly affect serum vancomycin concentrations...
2018: PloS One
Emily Morell Balkin, Matt S Zinter, Satish K Rajagopal, Roberta L Keller, Jeffrey R Fineman, Martina A Steurer
OBJECTIVES: The disease burden and mortality of children with pulmonary hypertension are significantly higher than for the general PICU population. We aimed to develop a risk-adjustment tool predicting PICU mortality for pediatric pulmonary hypertension patients: the Pediatric Index of Pulmonary Hypertension Intensive Care Mortality score. DESIGN: Retrospective analysis of prospectively collected multicenter pediatric critical care data. SETTING: One-hundred forty-three centers submitting data to Virtual Pediatric Systems database between January 1, 2009, and December 31, 2015...
June 19, 2018: Pediatric Critical Care Medicine
Amanda Haney, Emily Burritt, Christopher J Babbitt
BACKGROUND AND AIMS: Children who are critically ill undergo metabolic stress and it is important that they receive adequate calories and protein in order to recover. Our objective was to investigate the impact of early enteral nutrition (EEN) on pediatric intensive care (PICU) patients with acute respiratory failure. METHODS: A retrospective cohort study was performed on all patients admitted to a 20 bed PICU at a tertiary children's hospital over a 30 month period...
August 2018: Clinical Nutrition ESPEN
Zhenjiang Bai, Fang Fang, Zhong Xu, Chunjiu Lu, Xueqin Wang, Jiao Chen, Jian Pan, Jian Wang, Yanhong Li
BACKGROUND: Fibroblast growth factor 23 (FGF23) and insulin-like growth factor binding protein 7 (IGFBP-7) are suggested to be biomarkers for predicting acute kidney injury (AKI). We compared them with proposed AKI biomarker of cystatin C (CysC), and aimed (1) to examine whether concentrations of these biomarkers vary with age, body weight, illness severity assessed by pediatric risk of mortality III score, and kidney function assessed by estimated glomerular filtration rate (eGFR), (2) to determine the association between these biomarkers and AKI, and (3) to evaluate whether these biomarkers could serve as early independent predictors of AKI in critically ill children...
June 15, 2018: BMC Pediatrics
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