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https://www.readbyqxmd.com/read/29046100/analysis-of-intensive-care-admissions-among-paediatric-obstructive-sleep-apnoea-referrals
#1
S D Sharma, S Gupta, M Wyatt, D Albert, B Hartley
Introduction The aim of this study was to identify the proportion of children referred to a paediatric tertiary referral centre who required admission to the paediatric intensive care unit (PICU) following surgery for obstructive sleep apnoea (OSA) and to establish risk factors for these admissions. Methods Retrospective review of case notes and the operative database was performed for all children undergoing adenotonsillectomy for sleep disordered breathing and OSA symptoms in Great Ormond Street Hospital over a 10-year period...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29032019/-experience-with-infections-in-the-use-of-extracorporeal-membrane-oxygenation
#2
Rosa María Calderón Checa, Pablo Rojo Conejo, Aranzazu Flavia González-Posada Flores, Ana María Llorente de la Fuente, Alba Palacios Cuesta, Juan Miguel Aguilar, Sylvia Belda Hofheinz
OBJECTIVE: To identify risk factors associated with infectious complications acquired by paediatric patients during extracorporeal life support (ECLS). PATIENTS AND METHODS: Patients under ECLS from January 2011 to December 2014 have been retrospectively reviewed and data on demographics, care and infectious complications were collected. RESULTS: There were 50 ECLS assistances in the study period, of which 20 patients had 23 infectious complications: 16 were bloodstream infections, with coagulase negative staphylococci being the predominant isolate (there were 2 cases of candidaemia)...
October 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29031787/assessing-prediction-accuracy-for-outcomes-of-ventilator-associated-events-and-infections-in-critically-ill-children-a-prospective-cohort-study
#3
Yolanda Peña-López, Montserrat Pujol, Magda Campins, Leonel Lagunes, Joan Balcells, Jordi Rello
OBJECTIVES: To assess the prediction accuracy of 2008 Center for Disease Control and Prevention (CDC) definitions for ventilator-associated pneumonia (VAP)/ventilator-associated tracheobronchitis (VAT), 2013-CDC definitions for ventilator-associated events (VAE) and a new VAE algorithm (Ped-VAE) in children. METHODS: Prospective 13-month cohort study at a multidisciplinary Pediatric Intensive Care Unit (PICU). Primary end-points were duration of ventilation episode, PICU/hospitalization length of stay from episode (LOS), and episode mortality...
October 11, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29028420/the-effect-of-telemedicine-on-resource-utilization-and-hospital-disposition-in-critically-ill-pediatric-transport-patients
#4
Kimberly Fugok, Nicholas B Slamon
PURPOSE: Pediatric transport teams rely on communication to report patient data to medical command officers, who create care plans and determine disposition. Common destinations are the emergency department (ED), pediatric intensive care unit (PICU), or regular inpatient care area (RIPCA). Telephone report does not result in complete understanding of the patient's condition. Further workup in the ED is often required. Telemedicine allows the patient to be directly seen; parents to be interviewed; and laboratory studies, radiographs, and vital signs to be reviewed...
October 13, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/29026133/morphology-and-mechanics-of-fungal-mycelium
#5
M R Islam, G Tudryn, R Bucinell, L Schadler, R C Picu
We study a unique biomaterial developed from fungal mycelium, the vegetative part and the root structure of fungi. Mycelium has a filamentous network structure with mechanics largely controlled by filament elasticity and branching, and network density. We report the morphological and mechanical characterization of mycelium through an integrated experimental and computational approach. The monotonic mechanical behavior of the mycelium is non-linear both in tension and compression. The material exhibits considerable strain hardening before rupture under tension, it mimics the open cell foam behavior under compression and exhibits hysteresis and the Mullins effect when subjected to cyclic loading...
October 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28993802/glycemia-is-related-to-impaired-cerebrovascular-autoregulation-after-severe-pediatric-traumatic-brain-injury-a-retrospective-observational-study
#6
Adam M H Young, Hadie Adams, Joseph Donnelly, Mathew R Guilfoyle, Helen Fernandes, Mathew R Garnett, Marek Czosnyka, Peter Smielewski, Mark Plummer, Shruti Agrawal, Peter J Hutchinson
INTRODUCTION: A strong association exists between hyperglycemia and outcome in pediatric traumatic brain injury (TBI). Herein, we describe observations of serum markers of glucose metabolism in a cohort of pediatric TBI patients and how these variables are related to parameters of intracranial pathophysiology. METHODS: A retrospective analysis was performed on pediatric severe TBI patients admitted to Addenbrookes Hospital Paediatric Intensive Care Unit (PICU) between January 2001 and December 2013...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28991832/adaptation-of-a-biomarker-based-sepsis-mortality-risk-stratification-tool-for-pediatric-acute-respiratory-distress-syndrome
#7
Nadir Yehya, Hector R Wong
OBJECTIVES: The original Pediatric Sepsis Biomarker Risk Model and revised (Pediatric Sepsis Biomarker Risk Model-II) biomarker-based risk prediction models have demonstrated utility for estimating baseline 28-day mortality risk in pediatric sepsis. Given the paucity of prediction tools in pediatric acute respiratory distress syndrome, and given the overlapping pathophysiology between sepsis and acute respiratory distress syndrome, we tested the utility of Pediatric Sepsis Biomarker Risk Model and Pediatric Sepsis Biomarker Risk Model-II for mortality prediction in a cohort of pediatric acute respiratory distress syndrome, with an a priori plan to revise the model if these existing models performed poorly...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#8
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28987826/orbital-compartment-syndrome-after-frontotemporal-craniotomy-case-report-and-review-of-literature
#9
F H Pahl, M F Oliveira, J E Dal Col Lucio, E F Souza E Castro
INTRODUCTION: Orbital compartment syndrome (OCS) is a rare condition characterized by increased intraorbital pressure and hypoperfusion of critical neural structures and usually associated with external ophthalmoplegia. We report a case of postoperative OCS following a frontotemporal craniotomy and review pertinent literature. CASE DESCRIPTION: A 3-year-old female patient presented with a 3-year history of refractory epilepsy and diagnosis of right frontobasal cortical dysplasia...
October 4, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28985727/respiratory-mechanics-in-infants-with-severe-bronchiolitis-on-controlled-mechanical-ventilation
#10
Pablo Cruces, Sebastián González-Dambrauskas, Julio Quilodrán, Jorge Valenzuela, Javier Martínez, Natalia Rivero, Pablo Arias, Franco Díaz
BACKGROUND: Analysis of respiratory mechanics during mechanical ventilation (MV) is able to estimate resistive, elastic and inertial components of the working pressure of the respiratory system. Our aim was to discriminate the components of the working pressure of the respiratory system in infants on MV with severe bronchiolitis admitted to two PICU's. METHODS: Infants younger than 1 year old with acute respiratory failure caused by severe bronchiolitis underwent neuromuscular blockade, tracheal intubation and volume controlled MV...
October 6, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28984751/bla-oxa48-gene-microorganisms-outbreak-in-a-tertiary-children-s-hospital-over-3-years-2012-2014-case-report
#11
Rafael Herruzo, Guillermo Ruiz, Veronica Perez-Blanco, Sara Gallego, Eduardo Mora, Maria Jose Vizcaino, Felix Omeñaca
RATIONALE: Carbapenem-resistant Enterobacteriaceae are an emerging problem in children. Nosocomial spread remains the principal risk factor for acquisition of these microorganisms. PATIENTS CONCERNS: We describe an outbreak of Klebsiella pneumoniae OXA48 (KOXA48) in a tertiary children's hospital during the years 2012 to 2014, as well as the preventive measures put in place in colonized and infected cases. DIAGNOSES: We studied, "in vitro," the KOXA48 susceptibility to antiseptics and surface disinfectants...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28982349/critical-care-rotation-impact-on-pediatric-resident-mental-health-and-burnout
#12
Katie K Wolfe, Sharon M Unti
BACKGROUND: Burnout and depression are common among medical trainees and intensive care unit providers, negatively impacting both providers and patients. We hypothesized that at the end of the pediatric intensive care unit (PICU) rotation, there would be an increased prevalence of depression and burnout in pediatric residents when compared to the beginning. METHODS: Pediatric residents were assessed prior to and following their PICU rotation using the Maslach Burnout Inventory, the Center for Epidemiologic Studies Depression Screen and a survey assessing positive and negative aspects of the rotation...
October 5, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28975473/why-are-there-so-few-ethics-consults-in-children-s-hospitals
#13
Brian Carter, Manuel Brockman, Jeremy Garrett, Angie Knackstedt, John Lantos
In most children's hospitals, there are very few ethics consultations, even though there are many ethically complex cases. We hypothesize that the reason for this may be that hospitals develop different mechanisms to address ethical issues and that many of these mechanisms are closer in spirit to the goals of the pioneers of clinical ethics than is the mechanism of a formal ethics consultation. To show how this is true, we first review the history of collaboration between philosophers and physicians about clinical dilemmas...
October 3, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28970661/hospital-acquired-hyponatremia-in-pediatric-intensive-care-unit
#14
Anil Sachdev, Nagaraj Pandharikar, Dhiren Gupta, Neeraj Gupta, Suresh Gupta, Shekhar T Venkatraman
OBJECTIVE: The objective of the study was to evaluate the etiology of hospital-acquired hyponatremia (HAH) and its effects on morbidity and mortality in the Pediatric Intensive Care Unit (PICU) patients. DESIGN: This study design was a prospective observational case-control study. SETTING: this study was conducted at tertiary care PICU. MATERIALS AND METHODS: All consecutive cases admitted with at least one measured serum sodium (PNa) value were evaluated...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28959892/the-collocation-of-ischemia-modified-albumin-and-blood-gas-parameters-in-the-picu-setting
#15
Celebi Kocaoglu
Ischemia modified albumin (IMA) is a marker that has been determined to be elevated in hypoxic conditions. This study aimed to investigate the relationships between serum IMA and blood gas parameters (BGPs) and evaluate whether IMA can be used as a parameter clinically in terms of reflecting tissue hypoxia in ventilator management. BGPs and serum IMA level were measured in blood samples drawn simultaneously from patients. Mean serum IMA levels, mean pCO2, mean pO2, and lactate levels were 82.56 ± 25.47 ng/mL, 47...
September 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28952745/stiffness-percolation-in-stochastically-fragmented-continua
#16
Anirban Pal, Catalin R Picu
We study the mechanical behavior of three-dimensional, randomly microcracked continua for crack densities up to and above the transport percolation threshold. We show the existence of a fully fragmented material state in which stiffness is preserved due to topological interlocking of fragments. In this regime, the mechanical behavior is controlled by the contacts between fragments and becomes nonlinear. The upper limit of crack densities for which this behavior is observed, the stiffness percolation threshold, is identified...
August 25, 2017: Physical Review Letters
https://www.readbyqxmd.com/read/28949771/delirium-in-the-critically-ill-child-assessment-and-sequelae
#17
Rebecca S Paterson, Justin A Kenardy, Alexandra C De Young, Belinda L Dow, Debbie A Long
Delirium is a common and serious neuropsychiatric complication in critically ill patients of all ages. In the context of critical illness, delirium may emerge as a result of a cascade of underlying pathophysiologic mechanisms and signals organ failure of the brain. Awareness of the clinical importance of delirium in adults is growing as emerging research demonstrates that delirium represents a serious medical problem with significant sequelae. However, our understanding of delirium in children lags significantly behind the adult literature...
2017: Developmental Neuropsychology
https://www.readbyqxmd.com/read/28938289/discussing-benefits-and-risks-of-tracheostomy-what-physicians-actually-say
#18
Lauren M Hebert, Anne C Watson, Vanessa Madrigal, Tessie W October
OBJECTIVES: When contemplating tracheostomy placement in a pediatric patient, a family-physician conference is often the setting for the disclosure of risks and benefits of the procedure. Our objective was to compare benefits and risks of tracheostomy presented during family-physician conferences to an expert panel's recommendations for what should be presented. DESIGN: We conducted a retrospective review of 19 transcripts of audio-recorded family-physician conferences regarding tracheostomy placement in children...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28935428/predictive-factors-for-the-outcome-of-high-flow-nasal-cannula-therapy-in-a-pediatric-intensive-care-unit-is-the-spo2-fio2-ratio-useful
#19
Fulya Kamit Can, Ayşe Berna Anil, Murat Anil, Neslihan Zengin, Fatih Durak, Caner Alparslan, Zeynep Goc
OBJECTIVES: To determine the predictive factors for the outcome of high-flow nasal cannula (HFNC) therapy in a pediatric intensive care unit (PICU). MATERIALS AND METHODS: We prospectively included all patients with acute respiratory distress/failure aged 1month to 18years who were admitted to the PICU between January 2015 and May 2016 and treated with HFNC as a primary support and for postextubation according to our pre-established protocol. HFNC failure was defined as the need for escalation to non-invasive ventilation (NIV) or invasive mechanical ventilation (MV)...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28935354/anti-n-methyl-d-aspartate-receptor-encephalitis-in-children-of-central-south-china-clinical-features-treatment-influencing-factors-and-outcomes
#20
Ying Wang, Weixi Zhang, Jinghua Yin, Qianjin Lu, Fei Yin, Fang He, Jing Peng
BACKGROUND AND PURPOSE: We analyzed the clinical manifestations of children with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis in Central South China and the factors influencing the effectiveness of treatment. METHODS: A retrospective study of children (0-14years old) with anti-NMDAR encephalitis in Central South China was carried out from March 2014 to November 2016. Demographics, clinical features, treatment, outcome, and the factors influencing the effectiveness of treatment were reviewed...
November 15, 2017: Journal of Neuroimmunology
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