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Admission criteria in picu

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https://www.readbyqxmd.com/read/30105516/-systematic-analysis-of-airway-registries-in-emergency-medicine
#1
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...
August 13, 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
#2
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasi, 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...
August 7, 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
#3
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
#4
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...
August 7, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/30036234/differences-between-pulmonary-and-extrapulmonary-pediatric-acute-respiratory-distress-syndrome-a-multicenter-analysis
#5
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...
July 20, 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
#6
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)...
July 17, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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...
June 1, 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
#13
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
https://www.readbyqxmd.com/read/29712717/long-term-mortality-after-acute-kidney-injury-in-the-pediatric-icu
#14
Erin Hessey, Geneviève Morissette, Jacques Lacroix, Sylvie Perreault, Susan Samuel, Marc Dorais, Philippe Jouvet, Jean-Philippe Lafrance, Jacques LeLorier, Véronique Phan, Ana Palijan, Michael Pizzi, Louise Roy, Michael Zappitelli
OBJECTIVES: (1) To evaluate the association between acute kidney injury (AKI) in the PICU and long-term mortality and (2) to determine the extent to which adding the urine output (UO)-defined AKI alters the association. METHODS: A 2-center retrospective cohort study of children (≤18 years old) admitted to the PICU between 2003 and 2005 for noncardiac surgery, with follow-up until 2010. Patients with end stage renal disease, no provincial health insurance number, who died during hospitalization, or could not be linked to administrative data were excluded...
May 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29700200/external-validation-of-the-pedibirn-clinical-prediction-rule-for-abusive-head-trauma
#15
Helena Pfeiffer, Anne Smith, Alison Mary Kemp, Laura Elizabeth Cowley, John A Cheek, Stuart R Dalziel, Meredith L Borland, Sharon O'Brien, Megan Bonisch, Jocelyn Neutze, Ed Oakley, Louise Crowe, Stephen J C Hearps, Mark D Lyttle, Silvia Bressan, Franz E Babl
BACKGROUND AND OBJECTIVES: A 4-variable abusive head trauma (AHT) clinical prediction rule (CPR) for use in the PICU was derived and validated for children <3 years of age by the Pediatric Brain Injury Research Network (PediBIRN). We aimed to externally validate PediBIRN as designed (PICU only) as well as using broader inclusion criteria (admitted children with head injuries). METHODS: This was a secondary analysis of a prospective multicenter study of pediatric head injuries at 5 Australian and New Zealand tertiary pediatric centers...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29686979/comparison-of-prevalence-and-outcomes-of-pediatric-acute-respiratory-distress-syndrome-using-pediatric-acute-lung-injury-consensus-conference-criteria-and-berlin-definition
#16
Samriti Gupta, Jhuma Sankar, Rakesh Lodha, Sushil K Kabra
Objectives: Our objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria and Berlin definitions. Methods: We screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU) over a 3-year period (2015-2017) for presence of any respiratory difficulty at admission or during PICU stay...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#17
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
July 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29485220/factors-that-influenced-undergoing-renal-replacement-therapy-and-survival-in-children-with-acute-kidney-injury
#18
Fatma Zehra Oztek-Celebi, Sare Gulfem Ozlu, Ozlem Aydog
BACKGROUND: Acute kidney injury (AKI) is an important clinical condition which is associated with increased mortality and morbidity. This study was performed to identify the factors that influence AKI stage, undergoing renal replacement therapy (RRT) and mortality. METHODS: This study was retrospectively conducted on 219 children with AKI who had been referred to paediatric nephrology division of Dr. Sami Ulus Teaching Hospital during their inpatient treatment from 2008 to 2012...
February 27, 2018: Nephrology
https://www.readbyqxmd.com/read/29484848/treatment-of-severe-bronchiolitis-a-survey-of-canadian-pediatric-intensivists
#19
Matthew L Bradshaw, Alexandre Déragon, Pramod Puligandla, Guillaume Emeriaud, Anne-Marie Canakis, Patricia S Fontela
OBJECTIVE: To describe management practices and the factors guiding admission and treatment decisions for viral bronchiolitis across Canadian pediatric intensive care units (PICUs). DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists. MEASUREMENTS AND MAIN RESULTS: A survey using two case scenarios (non-intubated vs intubated patients) was developed using focus groups and a literature review...
May 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29479186/general-paediatric-inpatient-deaths-over-a-15-year-period
#20
Amanda Roth, Adam Rapoport, Kimberley Widger, Jeremy N Friedman
Objective: To retrospectively review trends of general paediatric inpatient deaths at a tertiary care children's hospital over a 15-year period. Methods: Data were collected for all patients who died on the general paediatric wards or paediatric intensive care unit (PICU) during 1998, 2005 or 2012 and had a 'general paediatric condition'-an underlying condition or diagnosis that would normally result in admission to a general paediatric ward. Data were related to: demographics, health services utilization, information about provision and orders related to cardiopulmonary resuscitation (CPR) at time of death and involvement of palliative care services...
May 2017: Paediatrics & Child Health
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