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https://www.readbyqxmd.com/read/29677032/landiolol-hydrochloride-rapidly-controls-junctional-ectopic-tachycardia-after-pediatric-heart-surgery
#1
Fumiya Yoneyama, Chiho Tokunaga, Hideyuki Kato, Tomomi Nakajima, Bryan J Mathis, Hiroaki Sakamoto, Yuji Hiramatsu
OBJECTIVES: Junctional ectopic tachycardia is a supraventricular tachyarrhythmia with atrioventricular dissociation that causes life-threatening postsurgical conditions in pediatric heart patients. This study evaluates the efficacy of landiolol hydrochloride for managing junctional ectopic tachycardia. DESIGN: A single-center retrospective study. SETTING: PICU at the university hospital. PATIENTS: Of 561 pediatric patients who underwent open-heart surgery between 2006 and 2017, 10 patients developed sustained junctional ectopic tachycardia and were selected for landiolol treatment...
April 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#2
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...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29670762/rolling-refresher-simulation-improves-performance-and-retention-of-paediatric-intensive-care-unit-nurse-code-cart-management
#3
Marcy N Singleton, Kimberly F Allen, Zhongze Li, Kevin McNerney, Urs H Naber, Matthew S Braga
Introduction: Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. Methods: An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29664873/effects-of-a-picu-status-asthmaticus-de-escalation-pathway-on-length-of-stay-and-albuterol-use
#4
Steven Brennan, Lia Lowrie, Jamie Wooldridge
OBJECTIVES: Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus. DESIGN: Time series quality improvement trial. SETTING: PICU in a tertiary care children's hospital. PATIENTS: Children age 2-18 years old with a known diagnosis of asthma presenting with status asthmaticus. INTERVENTION: One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29664502/hospital-acquired-hyponatremia-does-the-type-of-fluid-therapy-affect-children-admitted-to-intensive-care
#5
Pilar Velasco, Andrés J Alcaraz, Niki Oikonomopoulou, Marina Benito, Raquel Moya, Álvaro Sánchez
INTRODUCTION: The objective of this study was to evaluate the association between the type of initial fluid therapy used (isotonic or hypotonic solutions) and the development of hyponatremia, the plas ma chlorine values and the tolerance of venous access. PATIENTS AND METHOD: Retrospective cohort study in a Pediatric Intensive Care Unit (PICU) of a high complexity hospital. There were included children younger than 15 years old hospitalized during the first semester of 2010 and 2013 who recei ved intravenous maintenance fluid therapy, excluding patients undergoing cardiac surgery, kidney transplant and admissions that lasted less than 24 hours...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29660840/the-effectiveness-of-magnesium-sulfate-for-status-asthmaticus-outside-the-intensive-care-setting
#6
Ryan L DeSanti, Nisha Agasthya, Krystal Hunter, Mohammed J Hussain
AIM: Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. METHODS: We performed a retrospective cohort analysis of children ages 2-18 years admitted to the pediatric unit on continuous albuterol between January 2014 and December 2015 in a tertiary care children's hospital...
April 16, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29659467/a-standard-push-pull-protocol-for-waste-free-sampling-in-the-pediatric-intensive-care-unit
#7
Clare McBride, Suzan Miller-Hoover, James A Proudfoot
Blood sampling is a major source of blood loss in the pediatric intensive care unit (PICU). Blood-sparing sampling techniques such as the push-pull method can significantly reduce sampling-related blood loss and protect patients from anemia and blood transfusions. The push-pull method is supported by research evidence for central venous catheter (CVC) sampling, but research protocols differ and not all CVCs and laboratory tests have been studied. A standard push-pull protocol for the PICU was developed, implemented, and evaluated in this evidence-based practice project...
May 2018: Journal of Infusion Nursing: the Official Publication of the Infusion Nurses Society
https://www.readbyqxmd.com/read/29659416/a-pilot-randomized-controlled-trial-of-an-intervention-to-promote-psychological-well-being-in-critically-ill-children-soothing-through-touch-reading-and-music
#8
Janet E Rennick, Robyn Stremler, Linda Horwood, Marilyn Aita, Tanya Lavoie, Annette Majnemer, Marie Antonacci, Alyssa Knox, Evelyn Constantin
OBJECTIVES: To examine the feasibility and acceptability of a PICU Soothing intervention using touch, reading, and music. DESIGN: Nonblinded, pilot randomized controlled trial. SETTING: The PICU and medical-surgical wards of one Canadian pediatric hospital. PATIENTS: Twenty PICU patients age 2-14 years old and their parents, randomized to an intervention group (n = 10) or control group (n = 10). INTERVENTION: PICU Soothing consisted of: 1) parental comforting (touch and reading), followed by 2) a quiet period with music via soft headbands, administered once daily throughout hospitalization...
April 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29658056/bone-toughening-through-stress-induced-non-collagenous-protein-denaturation
#9
Z Wang, D Vashishth, R C Picu
Bone toughness emerges from the interaction of several multiscale toughening mechanisms. Recently, the formation of nanoscale dilatational bands and hence the accumulation of submicron diffuse damage were suggested as an important energy dissipation processes in bone. However, a detailed mechanistic understanding of the effect of this submicron toughening mechanism across multiple scales is lacking. Here, we propose a new three-dimensional ultrastructure volume element model showing the formation of nanoscale dilatational bands based on stress-induced non-collagenous protein denaturation and quantify the total energy released through this mechanism in the vicinity of a propagating crack...
April 16, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29657170/picu-doctor-in-the-family
#10
Alexander A Kon
No abstract text is available yet for this article.
2018: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/29655596/validation-of-the-nursing-workload-scoring-systems-nursing-activities-score-nas-and-therapeutic-intervention-scoring-system-for-critically-ill-children-tiss-c-in-a-greek-paediatric-intensive-care-unit
#11
Alexandra-Stavroula Nieri, Kalliopi Manousaki, Maria Kalafati, Katia Grilio Padilha, Siv K Stafseth, Theodoros Katsoulas, Vasiliki Matziou, Margarita Giannakopoulou
OBJECTIVES: To assess the reliability and validity of the Greek version of Nursing Activities Score (NAS), and Therapeutic Intervention Scoring System for Critically Ill Children (TISS-C) in a Greek Paediatric Intensive Care Unit (PICU). RESEARCH METHODOLOGY: A methodological study was performed in one PICU of the largest Paediatric Hospital in Athens-Greece. The culturally adapted and validated Greek NAS version, enriched according to the Norwegian paediatric one (P-NAS), was used...
April 11, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29652752/practice-change-from-intermittent-medication-boluses-to-bolusing-from-a-continuous-infusion-in-pediatric-critical-care-a-quality-improvement-project
#12
Jessica L Hochstetler, A Jill Thompson, Natalie M Ball, Melissa C Evans, Shaun C Frame, A Lauren Haney, Amelia K Little, Jaime L O'Donnell, Bryna M Rickett, Elizabeth H Mack
OBJECTIVES: To determine whether implementing a guideline to bolus medications from continuous infusions in PICUs affects nursing satisfaction, patient safety, central line entries, medication utilization, or cost. DESIGN: This is a pre- and postimplementation quality improvement study. SETTING: An 11-bed ICU and 14-bed cardiac ICU in a university-affiliated children's hospital. PATIENTS: Patients less than 18 years old admitted to the PICU or pediatric cardiac ICU receiving a continuous infusion of dexmedetomidine, midazolam, fentanyl, morphine, vecuronium, or cisatracurium from May 2015 to May 2016, excluding November 2015 (washout period), were eligible for inclusion...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652751/igniting-innovation-in-healthcare-a-novel-collaborative-multidisciplinary-approach-in-a-picu
#13
Marcelo R Malakooti
Generating innovation in the healthcare setting faces a number of challenges when compared with industry counterparts. More than ever, innovation occupies a critical element for healthcare organizations aspiring toward clinical, research and strategic excellence, although it may not exist as a priority due to a number of barriers. There are several strategies in other industries from which healthcare organizations can borrow, such as using nontraditional methods of problem solving, group ideation, and cross-pollination...
April 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29649021/impressions-of-early-mobilization-of-critically-ill-children-clinician-patient-and-family-perspectives
#14
Katina Zheng, Aimee Sarti, Sama Boles, Saoirse Cameron, Robert Carlisi, Heather Clark, Adeeb Khawaji, Saif Awladthani, Samah Al-Harbi, Karen Choong
OBJECTIVES: To understand patient, family caregiver, and clinician impressions of early mobilization, the perceived barriers and facilitators to its implementation, and the use of in-bed cycling as a method of mobilization. DESIGN: A qualitative study, conducted as part of the Early Exercise in Critically ill Youth and Children, a preliminary Evaluation (wEECYCLE) Pilot randomized controlled trial. SETTING: McMaster Children's Hospital PICU, Hamilton, ON, Canada...
April 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29643888/spectrum-of-complications-of-severe-dka-in-children-in-pediatric-intensive-care-unit
#15
Qalab Abbas, Saba Arbab, Anwar Ul Haque, Khadija Nuzhat Humayun
Objectives: To describe the spectrum of complications of Diabetic Ketoacidosis (DKA) observed in children admitted with severe DKA. Methods: Retrospective review of the medical records of all children admitted with the diagnosis of severe DKA in Pediatric Intensive Care Unit (PICU) of the Aga Khan University Hospital, from January 2010 to December 2015 was done. Data was collected on a structured proforma and descriptive statistics were applied. Results: Total 37 children were admitted with complicated DKA (1...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29628400/-prevalence-and-prognostic-value-of-non-thyroidal-illness-syndrome-among-critically-ill-children
#16
Sohair Sayed Abu El-Ella, Muhammad Said El-Mekkawy, Mohamed Abdelrahman El-Dihemey
INTRODUCTION: Alterations in thyroid hormones during critical illness, known as non-thyroidal illness syndrome (NTIS), were suggested to have a prognostic value. However, pediatric data is limited. The aim of this study was to assess prevalence and prognostic value of NTIS among critically ill children. MATERIALS AND METHODS: A prospective observational study conducted on 70 critically ill children admitted into pediatric intensive care unit (PICU). Free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) were measured within 24hours of PICU admission...
April 5, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29621235/survival-after-picu-admission-the-impact-of-multiple-admissions-and-complex-chronic-conditions
#17
Håkan Kalzén, Björn Larsson, Staffan Eksborg, Lars Lindberg, Karl Erik Edberg, Claes Frostell
OBJECTIVE: Factors predicting survival over time after pediatric intensive care unit (PICU) admissions are not fully understood. The primary aim of the current study was to investigate whether multiple admissions (MADM) compared to single PICU admissions (SADM) were associated with poor survival over time after being admitted to PICU facilities. Our secondary aim was to investigate if the presence of a complex chronic condition (CCC) would further impair prognosis. DESIGN: A closed cohort of all children up to 16 years of age admitted to the three PICUs in Sweden between 2008 and 2010 was prospectively collected and followed until 2012, providing survival data for at least one but up to four years of follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29618485/ultrasound-guidance-for-internal-jugular-vein-cannulation-in-picu-a-randomised-controlled-trial
#18
Tiago Henrique de Souza, Marcelo Barciela Brandão, Thiago Martins Santos, Ricardo Mendes Pereira, Roberto José Negrão Nogueira
OBJECTIVE: We investigated whether ultrasound guidance was advantageous over the anatomical landmark technique when performed by inexperienced paediatricians. DESIGN: Randomised controlled trial. SETTING: A paediatric intensive care unit of a teaching hospital. PATIENTS: 80 children (aged 28 days to <14 years). INTERVENTIONS: Internal jugular vein cannulation with ultrasound guidance in real time or the anatomical landmark technique...
April 4, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29616405/ventilator-associated-pneumonia-in-pediatric-intensive-care-unit-incidence-risk-factors-and-etiological-agents
#19
Gnanaguru Vijay, Anirban Mandal, Jhuma Sankar, Arti Kapil, Rakesh Lodha, S K Kabra
OBJECTIVES: To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS: This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC)...
April 4, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29616202/pediatric-critical-care-in-resource-limited-settings-overview-and-lessons-learned
#20
REVIEW
Tina M Slusher, Andrew W Kiragu, Louise T Day, Ashley R Bjorklund, Arianna Shirk, Colleen Johannsen, Scott A Hagen
Pediatric critical care is an important component of reducing morbidity and mortality globally. Currently, pediatric critical care in low middle-income countries (LMICs) remains in its infancy in most hospitals. The majority of hospitals lack designated intensive care units, healthcare staff trained to care for critically ill children, adequate numbers of staff, and rapid access to necessary medications, supplies and equipment. In addition, most LMICs lack pediatric critical care training programs for healthcare providers or certification procedures to accredit healthcare providers working in their pediatric intensive care units (PICU) and high dependency areas...
2018: Frontiers in Pediatrics
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