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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
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
Katharine J O'Hearn, Dori-Ann Martin, Maryse Dagenais, Kusum Menon
OBJECTIVES: To determine the number of patients considered not appropriate to approach for assent within the first 24 hours of PICU admission. DESIGN: Exploratory prospective 1-month environmental scan. SETTING: Two tertiary Canadian PICUs. PATIENTS: Ninety patients age newborn to 17 years old admitted to the PICU during September 2016 (Site 1) or May 2017 (Site 2). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: At PICU admission, 81% of patients were deemed not appropriate to approach for assent most commonly due to age, influence of psychotropic medications, and/or mechanical ventilation...
June 13, 2018: Pediatric Critical Care Medicine
Kahoru Fukuoka, Mihoko Furuichi, Kenta Ito, Yoshihiko Morikawa, Ichiro Watanabe, Naoki Shimizu, Yuho Horikoshi
OBJECTIVES: Catheter-associated urinary tract infections account for 30% of healthcare-associated infections. To date, few studies have addressed pediatric catheter-associated urinary tract infection in PICUs. The aim of our study was to assess the risk of catheter-associated urinary tract infection in relation to the duration of catheterization in the PICU. DESIGN: Retrospective cohort study. SETTING: PICU at a tertiary children's hospital...
June 13, 2018: Pediatric Critical Care Medicine
Erin D Paquette, Sabrina F Derrington, Avani Shukla, Neha Sinha, Sarah Oswald, Lauren Sorce, Kelly N Michelson
Biorepository research in children raises numerous ethical questions that are heightened in the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents of PICU patients to elucidate perspectives on biorepository research. A/YAs had a positive attitude toward biobanking. In young adults, comprehension was higher for knowledge of a choice to withdraw and participate in the research and lower for purpose, procedures, risks, and benefits of participation...
June 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
Nina Acharya, Dermot R Doherty, Nick Barrowman, Gyaandeo Maharajh, Tara Girolamo, Katie O'Hearn, J Dayre McNally
BACKGROUND: Consistent with accepted practice in stable ambulatory populations, the majority of ICU research has evaluated vitamin D status using a single blood 25-hydroxyvitamin D (25(OH)D) level. Only a limited number of ICU studies have measured the active hormone, 1,25-dihydroxyvitamin D (calcitriol) and none have used change in calcitriol levels to evaluate axis functioning. The objective of this study was to describe the impact of Congenital Heart Disease (CHD) surgery on calcitriol levels and evaluate the relationship between change in postoperative levels and clinical course...
June 13, 2018: Pediatric Research
Jennifer R Foster, Farhana I AlOthmani, Jamie A Seabrook, Tariq AlOfisan, Yasser M AlGarni, Amrita Sarpal
OBJECTIVES: To determine the percentage of time that critically ill children have a parent at the bedside and to identify extrinsic factors that are associated with percent of time with parental presence at the bedside. DESIGN: Prospective cohort study. SETTING: PICU in a single tertiary care children's hospital. SUBJECTS: Primary two parents of all children admitted to the PICU on 12 preselected days during a 1-year period from 2014 to 2015...
June 11, 2018: Pediatric Critical Care Medicine
Fady M El Gendy, Muhammad S El-Mekkawy, Nagwan Y Saleh, Mona Salah El-Din Habib, Faten Ezzelarab Younis
PURPOSE: To assess the value of Presepsin and Pentraxin3 measurement in critically ill children. MATERIALS AND METHODS: Prospective observational study conducted on 80 children admitted into Pediatric Intensive Care Unit (PICU) and 80 healthy controls. Patients were evaluated for presence of sepsis. Pediatric Risk of Mortality (PRISM) and Pediatric Index of Mortality (PIM2) were calculated. Serum Presepsin and Pentraxin3 were measured within 24 h of admission...
June 3, 2018: Journal of Critical Care
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
Ryan J Good, Matthew K Leroue, Angela S Czaja
OBJECTIVES: Noninvasive positive pressure ventilation (NIPPV) is increasingly used in critically ill pediatric patients, despite limited data on safety and efficacy. Administrative data may be a good resource for observational studies. Therefore, we sought to assess the performance of the International Classification of Diseases, Ninth Revision procedure code for NIPPV. METHODS: Patients admitted to the PICU requiring NIPPV or heated high-flow nasal cannula (HHFNC) over the 11-month study period were identified from the Virtual PICU System database...
June 7, 2018: Hospital Pediatrics
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
Mark J Peters, Gareth A L Jones, Daisy Wiley, Jerome Wulff, Padmanabhan Ramnarayan, Samiran Ray, David Inwald, Michael Grocott, Michael Griksaitis, John Pappachan, Lauran O'Neill, Simon Eaton, Paul R Mouncey, David A Harrison, Kathryn M Rowan
BACKGROUND: Oxygen saturation monitoring for children receiving respiratory support is standard worldwide. No randomised clinical trials have compared peripheral oxygen saturation (SpO2 ) targets for critically ill children. The harm of interventions to raise SpO2 to > 94% may exceed their benefits. METHODS: We undertook an open, parallel-group randomised trial of children > 38 weeks completed gestation and < 16 years of age receiving invasive or non-invasive respiratory support and supplemental oxygen who were admitted urgently to one of three paediatric intensive care units...
June 4, 2018: Intensive Care Medicine
Simone Trist, Emily Horsley, Hala Katf, Natalie Tasker, Mona Mostaghim
AIM: Palivizumab prevents respiratory syncytial virus (RSV) in children at high risk of severe disease. This paper reviews the use and effectiveness of palivizumab at two tertiary paediatric hospitals (hospitals A and B) in New South Wales, Australia. METHODS: Children prescribed palivizumab during the pre-intervention period, 1 January 2013 until 31 December 2014, were compared with children under 2 years of age who were admitted to paediatric intensive care units (PICUs) with an RSV infection...
June 4, 2018: Journal of Paediatrics and Child Health
José Colleti, Werther Brunow de Carvalho
No abstract text is available yet for this article.
June 2018: Pediatric Critical Care Medicine
Jamie M Schwartz, John J McCloskey, Donald H Shaffner
No abstract text is available yet for this article.
June 2018: Pediatric Critical Care Medicine
Nobuaki Shime
No abstract text is available yet for this article.
June 2018: Pediatric Critical Care Medicine
Taiki Kojima, Ilana Harwayne-Gidansky, Asha N Shenoi, Erin B Owen, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ron C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: Cricoid pressure is often used to prevent regurgitation during induction and mask ventilation prior to high-risk tracheal intubation in critically ill children. Clinical data in children showing benefit are limited. Our objective was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in PICU. DESIGN: A retrospective cohort study of a multicenter pediatric airway quality improvement registry...
June 2018: Pediatric Critical Care Medicine
Jacqueline M Evans, Parul Dayal, Douglas L Hallam, JoAnne E Natale, Pranav Kodali, Hadley S Sauers-Ford, James P Marcin
OBJECTIVES: To compare patient factors and outcomes among children admitted to PICUs from referring versus children's hospital emergency departments (EDs). METHODS: Pediatric patients (<19 years old) admitted to PICUs from referring and children's hospital EDs from July 1, 2011 to June 30, 2013. We compared demographic and clinical factors, including severity of illness as measured by a recalibrated Pediatric Index of Mortality, version 2 score. RESULTS: Of 80 045 children from 109 PICUs, 35...
June 1, 2018: Hospital Pediatrics
Danielle Van Damme, Heidi Flori, Tonie Owens
Physical activity in acute and critical care has been recognized as a successful method of improving patient outcomes. Challenges lie, however, in mobilizing pediatric critically ill patients and establishing consensus among health care providers about the safety and feasibility. The challenge of mobilizing pediatric patients is balancing developmental level, functional ability, and level of acuity; therefore, a mobility guideline was developed for use in the pediatric intensive care unit (PICU). The unique population and challenges in the PICU led to the development of a PICU-specific set of medical criteria within a PICU mobility guideline...
July 2018: Critical Care Nursing Quarterly
Rebecca L Hascall, R Serene Perkins, Lauren Kmiecik, Priya R Gupta, Carolyn F Shelak, Shaban Demirel, Mark T Buchholz
OBJECTIVE: We investigated the proportion of encounters that were interrupted during family-centered rounds in the pediatric intensive care unit (PICU) to determine whether the use of a physician assistant (PA) significantly affected the proportion of interrupted encounters. METHODS: We evaluated 2,657 rounding encounters in our 24-bed regional referral unit. The duration of each rounding encounter and total rounding duration were recorded. The presence or absence of a PA during each rounding encounter, the occurrence of an interruption, and other potential predictors of interruptions were recorded...
June 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
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