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Pediatric intensive carr

Danny A Milner, Jonathan J Lee, Charles Frantzreb, Richard O Whitten, Steve Kamiza, Richard A Carr, Alana Pradham, Rachel E Factor, Krupa Playforth, George Liomba, Charles Dzamalala, Karl B Seydel, Malcolm E Molyneux, Terrie E Taylor
Children in sub-Saharan Africa continue to acquire and die from cerebral malaria, despite efforts to control or eliminate the causative agent, Plasmodium falciparum. We present a quantitative histopathological assessment of the sequestration of parasitized erythrocytes in multiple organs obtained during a prospective series of 103 autopsies performed between 1996 and 2010 in Blantyre, Malawi, on pediatric patients who died from cerebral malaria and controls. After the brain, sequestration of parasites was most intense in the gastrointestinal tract, both in patients with cerebral malaria and those with parasitemia in other organs...
October 15, 2015: Journal of Infectious Diseases
Danny A Milner, Richard O Whitten, Steve Kamiza, Richard Carr, George Liomba, Charles Dzamalala, Karl B Seydel, Malcolm E Molyneux, Terrie E Taylor
Pediatric cerebral malaria carries a high mortality rate in sub-Saharan Africa. We present our systematic analysis of the descriptive and quantitative histopathology of all organs sampled from a series of 103 autopsies performed between 1996 and 2010 in Blantyre, Malawi on pediatric cerebral malaria patients and control patients (without coma, or without malaria infection) who were clinically well characterized prior to death. We found brain swelling in all cerebral malaria patients and the majority of controls...
2014: Frontiers in Cellular and Infection Microbiology
Laura Carney, Jennifer Kendrick, Roxane Carr
BACKGROUND: Critically ill children require sedation for comfort and to facilitate mechanical ventilation and interventions. Dexmedetomidine is a newer sedative with little safety data in pediatrics, particularly for therapy lasting longer than 48 h. OBJECTIVE: To quantify the frequency of adverse events and withdrawal syndromes associated with dexmedetomidine and to describe the use of this drug for continuous sedation in critically ill children. METHODS: In this retrospective study of patients who received dexmedetomidine for sedation in the pediatric intensive care unit, adverse events were assessed with the Naranjo scale to determine the likelihood of association with dexmedetomidine...
January 2013: Canadian Journal of Hospital Pharmacy
Janet A Lafreniere, Donald P Hamilton, Roxane R Carr
OBJECTIVE: To examine the practice of potassium chloride (KCl) replacement in pediatric oncology patients receiving amphotericin B (amp-B). METHODS: A retrospective observational chart review was conducted of patients who received amp-B on the oncology unit between August 2000 and May 2001. A survey was distributed to pediatric oncology pharmacists at other pediatric institutions to assess KCl infusion guidelines across North America. RESULTS: Twenty hypokalemic episodes were identified within 22 patient admissions...
October 2006: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
Sonia A Jeffries, Rumi McGloin, Alexander F Pitfield, Roxane R Carr
BACKGROUND: Opioids are commonly administered to critically ill children for analgesia and sedation, but many patients experience opioid withdrawal upon discontinuation. The authors' institution developed a protocol for using methadone to prevent opioid withdrawal in children who have received morphine by continuous IV infusion for 5 days or longer in the pediatric intensive care unit (PICU). OBJECTIVES: The primary objectives were to determine if opioids were tapered according to the protocol and to determine the conversion ratio for IV morphine to oral methadone that was used...
January 2012: Canadian Journal of Hospital Pharmacy
Vanessa Paquette, Rumi McGloin, Tracie Northway, Pia Dezorzi, Avash Singh, Roxane Carr
BACKGROUND: Extravasation, the inadvertent leakage of intravenous (IV) medication from the vein into the surrounding tissue, is a iatrogenic cause of patient injury. Extravasation has been reported to occur in 0.1% to 6.5% of hospital inpatients. The incidence may be higher among children because they have multiple risk factors, including small and fragile veins, decreased peripheral circulation, capillary leakage, and flexible subcutaneous tissue. OBJECTIVES: To describe the incidence of extravasation at a pediatric tertiary care hospital, to identify the agents causing extravasation, and to describe the use of antidotes to manage identified cases...
September 2011: Canadian Journal of Hospital Pharmacy
Warren Rodrigues, Michelle Carr, Deborah Ridout, Katherine Carter, Sara Louise Hulme, Jacob Simmonds, Martin Elliott, Aparna Hoskote, Michael Burch, Kate L Brown
OBJECTIVE: Single-center studies have failed to link modest increases in total donor ischemic time to mortality after pediatric orthotopic heart transplant. We aimed to investigate whether prolonged total donor ischemic time is linked to pediatric intensive care morbidity after orthotopic heart transplant. DESIGN: Retrospective cohort review. SETTING: Tertiary pediatric transplant center in the United Kingdom. PATIENTS: Ninety-three pediatric orthotopic heart transplants between 2002 and 2006...
November 2011: Pediatric Critical Care Medicine
Scott A Lorch, Sage Myers, Brendan Carr
Regionalization of health care is a method of providing high-quality, cost-efficient health care to the largest number of patients. Within pediatric medicine, regionalization has been undertaken in 2 areas: neonatal intensive care and pediatric trauma care. The supporting literature for the regionalization of these areas demonstrates the range of studies within this field: studies of neonatal intensive care primarily compare different levels of hospitals, whereas studies of pediatric trauma care primarily compare the impact of institutionalizing a trauma system in a single geographic region...
December 2010: Pediatrics
Alison Polk-Williams, Brendan G Carr, Thane A Blinman, Peter T Masiakos, Douglas J Wiebe, Michael L Nance
BACKGROUND: Blunt cervical spine injury (CSI) is rare in the pediatric population. The objective of this study was to better characterize the incidence and type of CSI in young children (age <3 years) using a large, trauma center-based data set. METHODS: The National Trauma Data Bank (NTDB) was reviewed for the period January 2001 to December 2005 for patients younger than 3 years of age with a blunt CSI (International Classification of Diseases, Ninth Revision, 805x, 806x, 952x)...
September 2008: Journal of Pediatric Surgery
Ponni Sivaprakasam, Trevor F Carr, Mary Coussons, Tasneem Khalid, Andrew S Bailey, Malcolm Guiver, Kenneth J Mutton, Andrew J Turner, John D Grainger, Robert F Wynn
Adenovirus is a common cause of morbidity and mortality after hemopoietic stem cell transplantation in children. Recently the incidence, risk factors, and outcome of such infections have been better defined using improved virologic detection methods, in particular polymerase chain reaction. We have introduced intensive virologic surveillance for adenovirus in our institution including at least weekly polymerase chain reaction testing of blood and stool samples. We report on 71 prospectively monitored transplants, including 40 from unrelated donors...
February 2007: Journal of Pediatric Hematology/oncology
Michael L Nance, Nicolas Lutz, Michael C Carr, Douglas A Canning, Perry W Stafford
BACKGROUND: Nonoperative management of radiographically defined solid organ injuries has proven highly successful in children with blunt splenic and hepatic injuries. The role of nonoperative management protocols is less well defined for blunt renal injuries. The purpose of this study was to review the management and outcome of a consecutive series of children with blunt renal injury. METHODS: The trauma registry from a Level I pediatric trauma center was reviewed to identify all children (age < 19 years) who were treated for a blunt renal injury for the period January 1995 through December 2002...
September 2004: Journal of Trauma
Sarah K Dudley, Jeanine M Carr
Although the incorporation of a family-centered model of care delivery and open visitation policies have supported parents at the bedside of hospitalized children, little research has been conducted exploring the daily experience of vigilant parents. The purpose of this qualitative ethnographic study was to explore the experience of vigilance and specifically to examine the meaning, patterns, and day-to-day rhythms of parents who stay at the bedside of their hospitalized children. Ten parents of hospitalized children on a general pediatric unit were purposively selected to participate in the study...
August 2004: Journal of Pediatric Nursing
Ann M Carr, Julian E Bailes, James C Helmkamp, Charles L Rosen, Vincent J Miele
OBJECTIVE: The purpose of this study was to profile all-terrain vehicle crash victims with neurological injuries who were treated at a Level I trauma center. METHODS: We retrospectively reviewed trauma registry data for 238 patients who were admitted to the Jon Michael Moore Trauma Center at the West Virginia University School of Medicine after all-terrain vehicle crashes, between January 1991 and December 2000. Age, helmet status, alcohol and drug use, head injuries, length of stay, disposition, and hospital costs were studied...
April 2004: Neurosurgery
Daniel L Toweill, W Daniel Kovarik, Richard Carr, Danny Kaplan, Susanna Lai, Susan Bratton, Brahm Goldstein
OBJECTIVE: To determine whether heart rate variability metrics provide an accurate method of monitoring depth of anesthesia, assessing the response to painful stimuli, and assessing neuroautonomic regulation of cardiac activity in children receiving propofol anesthesia for short-duration procedures. DESIGN: Prospective, case series. SETTING: Sixteen-bed pediatric intensive care unit, oncology unit, and endoscopy suite in a tertiary care children's hospital and ophthalmology examination rooms in an associated eye institute...
July 2003: Pediatric Critical Care Medicine
D B Carr, I D Todres
No abstract text is available yet for this article.
May 1994: Critical Care Medicine
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