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https://www.readbyqxmd.com/read/30328385/predictors-of-mortality-in-children-with-nosocomial-bloodstream-infection
#1
Indah K Murni, Trevor Duke, Andrew J Daley, Sharon Kinney, Yati Soenarto
BACKGROUND: Nosocomial bloodstream infection (BSI) is associated with high mortality rates. Evaluating factors to predict mortality is important for prevention and improving clinical outcomes. AIM: To evaluate the clinical predictors of mortality in paediatric nosocomial bloodstream infection. METHODS: A prospective cohort study was conducted from 1 December 2010 until 28 February 2013 in a teaching hospital in Yogyakarta, Indonesia. All patients admitted consecutively to the paediatric ICU (PICU) and paediatric wards after > 48 h of hospitalisation were eligible...
October 17, 2018: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/30327759/translating-sepsis-3-criteria-in-children-prognostic-accuracy-of-age-adjusted-quick-sofa-score-in-children-visiting-the-emergency-department-with-suspected-bacterial-infection
#2
Sietske C van Nassau, Ron H van Beek, Gertjan J Driessen, Jan A Hazelzet, Herbert M van Wering, Navin P Boeddha
Background: Recent attempts to translate Sepsis-3 criteria to children have been restricted to PICU patients and did not target children in emergency departments (ED). We assessed the prognostic accuracy of the age-adjusted quick Sequential Organ Failure Assessment score (qSOFA) and compared the performance to SIRS and the quick Pediatric Logistic Organ Dysfunction-2 score (qPELOD-2). We studied whether the addition of lactate (qSOFA-L) would increase prognostic accuracy. Methods: Non-academic, single-center, retrospective study in children visiting the ED and admitted with suspected bacterial infection between March 2013 and January 2018...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/30261219/predicting-cardiac-arrests-in-pediatric-intensive-care-units
#3
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
https://www.readbyqxmd.com/read/30211759/accuracy-comparison-between-age-adapted-sofa-and-sirs-in-predicting-in-hospital-mortality-of-infected-children-at-china-s-picu
#4
Zhiyuan Wu, Yafeng Liang, Zhihao Li, Guangjian Liu, Jianbin Zheng, Yunlong Zuo, Lijuan Li, Xiaojun Cao, Jianhui Zhang, Huiying Liang
OBJECTIVES: Sepsis-3 consensus suggests "the need to develop similar updated definitions for pediatric populations". Sequential organ failure assessment (SOFA) and systemic inflammatory response syndrome (SIRS) criteria are two systems widely used to define the status of infection. However, It is still unclear whether SOFA is more accurate than SIRS in predicting children mortality in low- and middle-income countries. Thus, we validated the accuracy of age-adapted SOFA and SIRS in predicating the poor prognosis of infected children in China's pediatric intensive care unit (PICU)...
September 11, 2018: Shock
https://www.readbyqxmd.com/read/30211019/clinical-characteristics-and-outcomes-associated-with-nasal-intermittent-mandatory-ventilation-in-acute-pediatric-respiratory-failure
#5
Billy C Wang, Theodore Pei, Cheryl B Lin, Rong Guo, David Elashoff, James A Lin, Carol Pineda
AIM: To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation (NIMV) use in acute pediatric respiratory failure. METHODS: We identified all patients treated with NIMV in the pediatric intensive care unit (PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers. Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included. Data included demographics, vital signs on admission and prior to initiation of NIMV, pediatric risk of mortality III (PRISM-III) scores, complications, respiratory support characteristics, PICU and hospital length of stays, duration of respiratory support, and complications...
September 7, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/30189782/effects-of-medical-transport-on-outcomes-in-children-requiring-intensive-care
#6
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
https://www.readbyqxmd.com/read/30152422/heat-shock-protein-60-as-a-biomarker-for-acute-kidney-injury-secondary-to-septic-shock-in-pediatric-patients-egyptian-multicenter-experience
#7
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
https://www.readbyqxmd.com/read/30105516/-systematic-analysis-of-airway-registries-in-emergency-medicine
#8
F F Girrbach, F Hilbig, M Michael, M Bernhard
BACKGROUND: A myriad of publications have contributed to an evidence-based approach to airway management in emergency services and admissions in recent years; however, it remains unclear which international registries on airway management in emergency medicine currently exist and how they are characterized concerning inclusion criteria, patient characteristics and definition of complications. METHODS: A systematic literature research was carried out in PubMed with respect to publications from 2007-2017...
September 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/30095746/randomized-study-of-early-continuous-positive-airways-pressure-in-acute-respiratory-failure-in-children-with-impaired-immunity-scarf-isrctn82853500
#9
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasni, Amy Jones, Christine Mackerness, Susan George, Paul Veys, Samiran Ray, Paul R Mouncey, David A Harrison, Kathy Rowan
OBJECTIVES: Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children. DESIGN: We undertook an open, parallel-group randomized trial in three pediatric hospitals. SUBJECTS: Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates...
October 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30087153/restricted-fluid-bolus-volume-in-early-septic-shock-results-of-the-fluids-in-shock-pilot-trial
#10
David Philip Inwald, Ruth Canter, Kerry Woolfall, Paul Mouncey, Zohra Zenasni, Caitlin O'Hara, Anjali Carter, Nicola Jones, Mark D Lyttle, Simon Nadel, Mark J Peters, David A Harrison, Kathryn M Rowan
OBJECTIVE: To determine the feasibility of Fluids in Shock, a randomised controlled trial (RCT) of restricted fluid bolus volume (10 mL/kg) versus recommended practice (20 mL/kg). DESIGN: Nine-month pilot RCT with embedded mixed-method perspectives study. SETTING: 13 hospitals in England. PATIENTS: Children presenting to emergency departments with suspected infection and shock after 20 mL/kg fluid. INTERVENTIONS: Patients were randomly allocated (1:1) to further 10 or 20 mL/kg fluid boluses every 15 min for up to 4 hours if still in shock...
August 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/30087098/here-and-gone-rapid-transfer-from-the-general-care-floor-to-the-picu
#11
Kathryn O Mansel, Sophia W Chen, April A Mathews, M David Gothard, Michael T Bigham
BACKGROUND: Children admitted to the general care floor sometimes require acute escalation of care and rapid transfer (RT) to the PICU shortly after admission. In this study, we aim to investigate the characteristics of RTs and the impact RTs have on patient outcomes, including PICU length of stay (LOS), mortality, and emergency transfer defined as critical care interventions occurring within 1 hour on either side of transfer to the PICU. METHODS: We conducted a 2-year, single-center, retrospective analysis including all patients admitted to the general care floor of a tertiary children's hospital that were subsequently transferred to the PICU, with attention to those transferred within 4 hours of admission, meeting criteria as RTs...
September 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/30036234/differences-between-pulmonary-and-extrapulmonary-pediatric-acute-respiratory-distress-syndrome-a-multicenter-analysis
#12
Chin Seng Gan, Judith Ju-Ming Wong, Rujipat Samransamruajkit, Soo Lin Chuah, Yek Kee Chor, Suyun Qian, Nattachai Anantasit, Xu Feng, Jacqueline Soo May Ong, Phan Huu Phuc, Suwannee Phumeetham, Rehena Sultana, Tsee Foong Loh, Lucy Chai See Lum, Jan Hau Lee
OBJECTIVES: Extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome are poorly described in the literature. We aimed to describe and compare the epidemiology, risk factors for mortality, and outcomes in extrapulmonary pediatric acute respiratory distress syndrome and pulmonary pediatric acute respiratory distress syndrome. DESIGN: This is a secondary analysis of a multicenter, retrospective, cohort study...
October 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30024570/the-pediatric-index-of-mortality-as-a-trigger-tool-for-the-detection-of-serious-errors-and-adverse-events
#13
Christoph M Rüegger, Bernhard Frey
OBJECTIVES: To test the hypothesis that patients who die in a PICU despite a low predicted mortality at PICU admission are affected by serious errors and adverse events. DESIGN: Retrospective cross-sectional review of medical records for serious errors and adverse events. SETTING: Tertiary interdisciplinary neonatal PICU. PATIENTS: All admissions to our PICU who died despite a low expected mortality (Pediatric Index of Mortality) of less than 10% (trigger-positive admissions)...
September 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/30004311/intensive-care-resources-required-to-care-for-critically-ill-children-with-focal-intracranial-infections
#14
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
https://www.readbyqxmd.com/read/29945586/implementation-of-preemptive-fluid-strategy-as-a-bundle-to-prevent-fluid-overload-in-children-with-acute-respiratory-distress-syndrome-and-sepsis
#15
Franco Díaz, María José Nuñez, Pablo Pino, Benjamín Erranz, Pablo Cruces
BACKGROUND: Fluid overload (FO) is associated with unfavorable outcomes in critically ill children. Clinicians are encouraged to avoid FO; however, strategies to avoid FO are not well-described in pediatrics. Our aim was to implement a bundle strategy to prevent FO in children with sepsis and pARDS and to compare the outcomes with a historical cohort. METHODS: A quality improvement initiative, known as preemptive fluid strategy (PFS) was implemented to prevent early FO, in a 12-bed general PICU...
June 26, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29912842/severe-mycoplasma-pneumoniae-infection-in-children-admitted-to-pediatric-intensive-care
#16
Katie M Moynihan, Andrew Barlow, Clare Nourse, Claire Heney, Sanmarié Schlebusch, Luregn J Schlapbach
Mycoplasma pneumoniae is a common cause of community-acquired pneumonia and may cause life-threatening disease in children. We identified 30 (0.3%) confirmed M. pneumoniae cases by clinical and laboratory criteria in 11,526 PICU admissions. Outcomes were comparable to patients admitted with other infections (n=3,005, p>0.1). Our findings indicate that empiric antimicrobial coverage for M. pneumoniae infection in PICU is rarely needed.
June 15, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29908681/the-impact-of-early-enteral-nutrition-on-pediatric-acute-respiratory-failure
#17
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
https://www.readbyqxmd.com/read/29907141/serum-and-urine-fgf23-and-igfbp-7-for-the-prediction-of-acute-kidney-injury-in-critically-ill-children
#18
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
https://www.readbyqxmd.com/read/29882415/acute-kidney-injury-in-children-with-acute-respiratory-failure
#19
Sindy M Villacrés, Shivanand S Medar, Scott I Aydin
BACKGROUND: Acute kidney injury (AKI) is common in critically ill children and develops in association with organ system dysfunction, with acute respiratory failure (ARF) one of the most common. We aim to study AKI in the pediatric ARF population. METHODS: Data were retrospectively collected on children aged 1 day to 18 years admitted to the pediatric intensive care unit (PICU) with ARF between 2010 and 2013. Descriptive statistics and multivariate analyses utilizing Mann-Whitney U, Wilcoxon signed rank, χ2 , or Fisher's exact tests were performed to identify risk factors associated with AKI...
October 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29872971/influence-of-implementing-a-protocol-for-an-intravenously-administered-ammonia-scavenger-on-the-management-of-acute-hyperammonemia-in-a-pediatric-intensive-care-unit
#20
David Brossier, Isabelle Goyer, Lydia Ziani, Christopher Marquis, Grant Mitchell, Bruno Ozanne, Philippe Jouvet
The purpose of the study was to evaluate the influence of establishing a protocol for the use of combined sodium benzoate and sodium phenylacetate (SBSP) (Ammonul®) to treat acute hyperammonemia. This was a retrospective, single-center study in a 24-bed medical and surgical pediatric intensive care unit (PICU) in a tertiary care teaching maternal-child hospital in Canada. Inclusion criteria were age <18 years, PICU admission between 1 January 2000 and 30 June 2016, and SBSP treatment. An SBSP delivery protocol was implemented in our hospital on 30 August 2008 in order to improve management of acute hyperammonemia...
June 5, 2018: Journal of Inherited Metabolic Disease
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