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https://www.readbyqxmd.com/read/29452150/cerebral-blood-flow-velocity-and-autoregulation-in-paediatric-patients-following-a-global-hypoxic-ischaemic-insult
#1
Marlina E Lovett, Tensing Maa, Melissa G Chung, Nicole F O'Brien
AIM: To describe the cerebral blood flow velocity pattern and investigate cerebral autoregulation using transcranial Doppler ultrasonography (TCD) following a global hypoxic-ischaemic (HI) event in children. METHODS: This was a prospective, observational study in a quaternary-level paediatric intensive care unit. Intubated children, newborn to 17 years admitted to the PICU following HI injury (asphyxia, drowning, cardiac arrest) were eligible for inclusion. TCD was performed daily until post-injury day 8, discharge, or death, whichever occurred earliest...
February 13, 2018: Resuscitation
https://www.readbyqxmd.com/read/29449963/the-nsight1-randomized-controlled-trial-rapid-whole-genome-sequencing-for-accelerated-etiologic-diagnosis-in-critically-ill-infants
#2
Josh E Petrikin, Julie A Cakici, Michelle M Clark, Laurel K Willig, Nathaly M Sweeney, Emily G Farrow, Carol J Saunders, Isabelle Thiffault, Neil A Miller, Lee Zellmer, Suzanne M Herd, Anne M Holmes, Serge Batalov, Narayanan Veeraraghavan, Laurie D Smith, David P Dimmock, J Steven Leeder, Stephen F Kingsmore
Genetic disorders are a leading cause of morbidity and mortality in infants in neonatal and pediatric intensive care units (NICU/PICU). While genomic sequencing is useful for genetic disease diagnosis, results are usually reported too late to guide inpatient management. We performed an investigator-initiated, partially blinded, pragmatic, randomized, controlled trial to test the hypothesis that rapid whole-genome sequencing (rWGS) increased the proportion of NICU/PICU infants receiving a genetic diagnosis within 28 days...
2018: NPJ Genomic Medicine
https://www.readbyqxmd.com/read/29449317/it-takes-a-village-to-move-a-hospital-simulation-improves-intensive-care-team-preparedness-for-a-move-to-a-new-site
#3
Conall Francoeur, Sarah Shea, Margaret Ruddy, Patricia Fontela, Farhan Bhanji, Saleem Razack, Ronald Gottesman, Tanya Di Genova
OBJECTIVES: To evaluate in-situ simulation to prepare a PICU to move to a new, redesigned unit. METHODS: The study setting is an academic PICU. This is a cross-sectional study using in-situ simulations of common PICU admissions. Postsimulation, participants completed a survey comparing the perception of preparedness pre- and postsimulation (via a 10-point Likert scale). Participants were resurveyed 6 months postmove to assess whether effects persisted. Qualitative data were obtained via thematic review of the survey comment section and from postsimulation debriefing...
February 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29444748/aortopulmonary-collaterals-in-neonates-with-d-transposition-of-the-great-arteries-clinical-significance-early-after-arterial-switch-operation
#4
Alexandra Wipf, Martin Christmann, Susanne Navarini-Meury, Hitendu Dave, Daniel Quandt, Walter Knirsch, Oliver Kretschmar
OBJECTIVES: Purpose of this study is to evaluate the clinical significance of major aortopulmonary collateral arteries (MAPCAs) during the early postoperative course after arterial switch operation (ASO) in d-transposition of the great arteries (dTGA). METHODS: Clinical data of 98 patients with simple dTGA between January 2007 and December 2016 at the University Children's Hospital Zurich, Switzerland were analyzed retrospectively. RESULTS: 37 from 98 patients (38%) required cardiac catheterization (CC) due to an early complicated postoperative course or difficult coronary transfer due to special coronary anatomy...
February 2, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29439683/elevated-central-venous-pressure-is-associated-with-increased-mortality-in-pediatric-septic-shock-patients
#5
Seung Jun Choi, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
BACKGROUND: Central venous pressure (CVP) is an important factor affecting capillary blood flow, and it is associated with poor outcomes in adult septic shock patients. However, whether a similar association exists in pediatric patients remains unclear. METHODS: We retrospectively analyzed data from patients admitted to our pediatric intensive care unit (PICU) between February 2009 and July 2015. Patients were divided into two groups-survivors and nonsurvivors-according to 28-day mortality...
February 13, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29436391/associations-between-pediatric-palliative-care-consultation-and-end-of-life-preparation-at-an-academic-medical-center-a-retrospective-ehr-analysis
#6
Matthew Stutz, Roy L Kao, Leanna Huard, Jonathan Grotts, Javier Sanz, Mindy K Ross
OBJECTIVES: Our aim in this study was to understand usage patterns of pediatric palliative care (PPC) consultation and associations with end-of-life preparation among pediatric patients who are deceased. METHODS: We reviewed 233 pediatric mortalities. Data extraction from the electronic health record included determination of PPC consultation by using Current Procedural Terminology codes. Diagnoses were identified by International Classification of Disease codes and were classified into categories of life-threatening complex chronic conditions (LT-CCCs)...
February 7, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29432405/interhospital-transport-of-critically-ill-children-to-picus-in-the-united-kingdom-and-republic-of-ireland-analysis-of-an-international-dataset
#7
Padmanabhan Ramnarayan, Konstantinos Dimitriades, Lynsey Freeburn, Aravind Kashyap, Michaela Dixon, Peter W Barry, Kathryn Claydon-Smith, Allan Wardhaugh, Caroline R Lamming, Elizabeth S Draper
OBJECTIVES: International data on characteristics and outcomes of children transported from general hospitals to PICUs are scarce. We aimed to 1) describe the development of a common transport dataset in the United Kingdom and Ireland and 2) analyze transport data from a recent 2-year period. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Specialist pediatric critical care transport teams and PICUs in the United Kingdom and Ireland...
February 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29432403/neutrophil-extracellular-traps-in-children-with-meningococcal-sepsis
#8
Tamara Hoppenbrouwers, Navin P Boeddha, Ebru Ekinci, Marieke Emonts, Jan A Hazelzet, Gertjan J Driessen, Moniek P de Maat
OBJECTIVES: Children with meningococcal sepsis are highly at risk for fulminant disease, multiple organ failure, and death. Recently, neutrophil extracellular traps levels have been indicated as a marker for severity in different kinds of sepsis. Our aim was to study the role of neutrophil extracellular traposis in meninogococcal sepsis in children. DESIGN: We measured myeloperoxidase-DNA, a marker for neutrophil extracellular traps, in serum of meningococcal sepsis patients upon admission to PICU, at 24 hours, and at 1 month and studied the association with clinical outcome...
February 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29429556/infection-with-gram-negative-bacteria-among-children-in-a-tertiary-pediatric-hospital-in-egypt
#9
John Rene Labib, Sally K Ibrahim, Marwa Rashad Salem, Meray Rene L Youssef, Basant Meligy
BACKGROUND: Patients in pediatric intensive care units (PICUs) are susceptible to infections with gram-negative bacteria (GNB). METHODS: A prospective observational study was conducted in 2 PICUs at Cairo University Hospitals to determine the incidence and outcome of GNB infections over 1 year. Variables of interest included age, gender, isolated organism, susceptibility to antibiotics, and final outcome. RESULTS: During the study period, 1420 patients were admitted to the PICU; of these, 291 developed GNB infections...
February 9, 2018: American Journal of Infection Control
https://www.readbyqxmd.com/read/29429528/changes-in-lipid-metabolism-in-pediatric-patients-with-severe-sepsis-and-septic-shock
#10
Ana Carolina G Bermudes, Werther B de Carvalho, Patricia Zamberlan, Giovana Muramoto, Raul C Maranhão, Artur F Delgado
OBJECTIVES: Limited knowledge exists regarding the lipid profiles of critically ill pediatric patients with systemic inflammatory response syndrome. The aim of this study was to evaluate the relationship between the intensity of the inflammatory response and changes in the lipid profiles of critically ill pediatric patients admitted to a pediatric intensive care unit (PICU) with severe sepsis/septic shock. METHODS: This was a prospective and observational study at a 15-bed PICU at a public university hospital...
March 2018: Nutrition
https://www.readbyqxmd.com/read/29429458/-burkholderia-cepacia-infection-in-children-a-clinical-analysis-of-16-cases
#11
Fang Peng, Li-Li Zhong, Xiao-Juan Lin, Min Chen, Miao Zhou
OBJECTIVE: To investigate the distribution characteristics and clinical features of Burkholderia cepacia infection in children. METHODS: A retrospective analysis was performed for the clinical data of 16 children with Burkholderia cepacia infection who were hospitalized between June 2012 and September 2017. RESULTS: All 16 children with Burkholderia cepacia infection were sporadic cases. A total of 16 strains of Burkholderia cepacia were isolated, among which 8 were detected by sputum culture, 5 were detected by blood culture, 2 were detected by tracheal intubation tip culture, and 1 was detected by lung biopsy culture...
February 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#12
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29428918/predictors-and-outcome-of-acute-kidney-injury-in-children-with-diabetic-ketoacidosis
#13
Mullai Baalaaji, Muralidharan Jayashree, Karthi Nallasamy, Sunit Singhi, Arun Bansal
OBJECTIVE: To identify predictors and outcome of acute kidney injury (AKI) in children with diabetic ketoacidosis (DKA) admitted to a Pediatric Intensive Care Unit (PICU). METHODS: Retrospective case review of 79 children with DKA admitted between 2011-2014. RESULTS: Twenty eight children developed AKI during the hospital stay; 20 (71.4%) recovered with hydration alone. Serum chloride at 24 hours was independently associated with AKI. Children with AKI had prolonged acidosis and PICU stay and higher mortality...
February 9, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29419605/ceftaroline-for-suspected-or-confirmed-invasive-methicillin-resistant-staphylococcus-aureus-a-pharmacokinetic-case-series
#14
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To describe the ceftaroline pharmacokinetics in critically ill children treated for suspected or confirmed methicillin-resistant Staphylococcus aureus infections, including blood stream infection and describe the microbiological and clinical outcomes. DESIGN: Retrospective electronic medical record review. SETTINGS: Free-standing tertiary/quaternary pediatric children's hospital. PATIENTS: Critically ill children receiving ceftaroline monotherapy or combination therapy for suspected or confirmed methicillin-resistant S...
February 6, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29419604/assessment-of-recovery-following-pediatric-traumatic-brain-injury
#15
Julia C Slovis, Nachi Gupta, Natasha Y Li, Steven G Kernie, Darryl K Miles
OBJECTIVES: We analyzed a prospective database of pediatric traumatic brain injury patients to identify predictors of outcome and describe the change in function over time. We hypothesized that neurologic status at hospital discharge would not reflect the long-term neurologic recovery state. DESIGN: This is a descriptive cohort analysis of a single-center prospective database of pediatric traumatic brain injury patients from 2001 to 2012. Functional outcome was assessed at hospital discharge, and the Glasgow Outcome Scale Extended Pediatrics or Glasgow Outcome Scale was assessed on average at 15...
February 6, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29417215/organ-and-tissue-donation-in-a-regional-paediatric-intensive-care-unit-evaluation-of-practice
#16
Laura Carone, Shrirang Alurkar, Phoebe Kigozi, Harish Vyas
Approximately 2% of those on the organ transplant list in the UK are children. Early identification of donors and referral to organ donation teams (ODT) has proven to increase both the success rate of gaining consent and the number of organs actually retrieved. To evaluate the practice relating to organ donation for children receiving end-of-life care on a paediatric intensive care unit (PICU) measured against the National Guidelines. All children 0-18 who received their end-of-life care and died on the PICU...
February 7, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29410951/a-review-of-the-integrated-model-of-care-an-opportunity-to-respond-to-extensive-palliative-care-needs-in-pediatric-intensive-care-units-in-under-resourced-settings
#17
REVIEW
Michelle Grunauer, Caley Mikesell
It is estimated that 6.3 million children who die annually need pediatric palliative care (PPC) and that only about 10% of them receive the attention they need because about 98% of them live in under-resourced settings where PPC is not accessible. The consultative model and the integrated model of care (IMOC) are the most common strategies used to make PPC available to critically ill children. In the consultative model, the pediatric intensive care unit (PICU) team, the patient, or their family must request a palliative care (PC) consultation with the external PC team for a PICU patient to be evaluated for special care needs...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29406380/progressive-diaphragm-atrophy-in-pediatric-acute-respiratory-failure
#18
Christie L Glau, Thomas W Conlon, Adam S Himebauch, Nadir Yehya, Scott L Weiss, Robert A Berg, Akira Nishisaki
OBJECTIVES: Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm atrophy in children with acute respiratory failure. DESIGN: Prospective, observational study. SETTING: Single-center tertiary noncardiac PICU in a children's hospital. PATIENTS: Invasively ventilated children with acute respiratory failure...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29406378/downward-trend-in-pediatric-resident-laryngoscopy-participation-in-picus
#19
Aayush Gabrani, Taiki Kojima, Ronald C Sanders, Asha Shenoi, Vicki Montgomery, Simon J Parsons, Sandeep Gangadharan, Sholeen Nett, Natalie Napolitano, Keiko Tarquinio, Dennis W Simon, Anthony Lee, Guillaume Emeriaud, Michelle Adu-Darko, John S Giuliano, Keith Meyer, Ana Lia Graciano, David A Turner, Conrad Krawiec, Adnan M Bakar, Lee A Polikoff, Margaret Parker, Ilana Harwayne-Gidansky, Benjamin Crulli, Paula Vanderford, Ryan K Breuer, Eleanor Gradidge, Aline Branca, Lily B Grater-Welt, David Tellez, Lisa V Wright, Matthew Pinto, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. DESIGN: Prospective cohort study. SETTING: Twenty-five PICUs at various children's hospitals across the United States. PATIENTS: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children)...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29406376/blood-cultures-drawn-from-arterial-catheters-are-reliable-for-the-detection-of-bloodstream-infection-in-critically-ill-children
#20
Itay Berger, Merav Gil Margolis, Elhanan Nahum, Ovdi Dagan, Itzhak Levy, Eytan Kaplan, Eran Shostak, Esther Shmuelov, Ofer Schiller, Gili Kadmon
OBJECTIVES: Arterial catheters may serve as an additional source for blood cultures in children when peripheral venipuncture is challenging. The aim of the study was to evaluate the accuracy of cultures obtained through indwelling arterial catheters for the diagnosis of bloodstream infections in critically ill pediatric patients. DESIGN: Observational and comparative. SETTING: General and cardiac ICUs of a tertiary, university-affiliated pediatric medical center...
February 5, 2018: Pediatric Critical Care Medicine
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