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Pediatric Mechanical Ventilation

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https://www.readbyqxmd.com/read/29443114/causes-and-circumstances-of-death-in-a-neonatal-unit-over-20-years
#1
Marissa C Michel, Tarah T Colaizy, Jonathan M Klein, Jeffrey L Segar, Edward F Bell
BackgroundWe examined changes in the causes and circumstances of death in our neonatal intensive care unit (NICU) over 20 years.MethodsFor 551 infants who died between 1993 and 2013, the principal cause of death was recorded. Circumstances of death were assigned to one of the following four categories: death following cardiopulmonary resuscitation (CPR), death while being mechanically ventilated without CPR, death after withholding life-support interventions, and death after withdrawal of life support. Data were compared across four 5-year epochs...
February 14, 2018: Pediatric Research
https://www.readbyqxmd.com/read/29440830/impact-of-intensive-care-unit-attending-physician-training-background-on-outcomes-in-children-undergoing-heart-operations
#2
Priya Bhaskar, Mallikarjuna Rettiganti, Jeffrey M Gossett, Punkaj Gupta
Background: The existing training pathways to become a pediatric cardiac intensivist are very variable with physicians coming from varied training backgrounds of pediatric critical care, pediatric cardiology, neonatology, or pediatric anesthesia. Aim: To evaluate the impact of cardiac Intensive Care Unit (ICU) attending physician training background on outcomes in children undergoing heart operations. Setting and Design: Patients in the age group from 1 day to 18 years undergoing heart operation at a Pediatric Health Information System database participating hospital were included (2010-2015)...
January 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/29439683/elevated-central-venous-pressure-is-associated-with-increased-mortality-in-pediatric-septic-shock-patients
#3
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/29434764/pediatric-acute-respiratory-distress-syndrome-current-views
#4
Jinfeng Liu, Wei Wang, Fengli Liu, Zhenguang Li
Acute respiratory distress syndrome (ARDS) mainly involves acute respiratory failure. In addition to this affected patients feel progressive arterial hypoxemia, dyspnea, and a marked increase in the work of breathing. The only clinical solution for the above pathological state is ventilation. Mechanical ventilation is necessary to support life in ARDs but it itself worsen lung injury and the term is known clinically as 'ventilation induced lung injury' (VILI). At the cellular level, respiratory epithelial cells are subjected to cyclic stretch, i...
February 2018: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29433792/clinical-characteristics-of-influenza-virus-induced-lower-respiratory-infection-during-the-2015-to-2016-season
#5
Kazuhiro Uda, Kensuke Shoji, Chitose Koyama-Wakai, Munehiro Furuichi, Noriyasu Iwase, Seiichiro Fujisaki, Shinji Watanabe, Isao Miyairi
BACKGROUND: Influenza A(H1N1)pdm09 virus infections often manifest severe respiratory symptoms, particularly in patients with a past history of allergic disease. Most of these findings were reported during the 2009 pandemic. The purpose of this study was to detail the clinical characteristics of influenza virus-induced lower respiratory infection (LRI) during the A(H1N1)pdm09-predominant 2015-2016 season. METHODS: We retrospectively reviewed the clinical characteristics of influenza-induced LRI cases in children admitted to a tertiary children's hospital...
February 9, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29422737/heart-rate-variability-in-children-following-drowning-injury
#6
Madhuradhar Chegondi, Jun Sasaki, Sayed Naqvi, Wei-Chiang Lin, Andre Raszynski, Balagangadhar R Totapally
Heart rate variability (HRV) has been used as prognostic tool in various disorders in pediatric and adult patients. In our study we aimed to evaluate heart rate variability indices and their association with neurological outcome in three children with anoxic brain injury following drowning. Three children included in the study were admitted following drowning and required mechanical ventilation and targeted temperature management. All physiologic data, including electrocardiography (ECG) and EEG were collected for a period of 3-5 days after enrollment...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29422730/acute-renal-failure-adversely-affects-survival-in-pediatric-dengue-infection
#7
Biswanath Basu, Birendranath Roy
Aims: Dengue is currently one of the most important mosquito-borne viral infections. Acute renal failure (ARF) is a serious complication among children suffering from dengue infection. Subjects and Methods: A retrospective cohort review of baseline characteristics, disease outcomes, and risk factors of dengue-infected patients, with and without renal failure (RF), were compared. Results: Among 97 children with dengue, 13.4% had RF (estimated glomerular filtration rate <60 ml/min/1...
January 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29419604/assessment-of-recovery-following-pediatric-traumatic-brain-injury
#8
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/29410290/one-thousand-pediatric-liver-transplants-during-thirty-years-lessons-learned
#9
Robert S Venick, Douglas G Farmer, Jose R Soto, Jorge Vargas, Hasan Yersiz, Fady M Kaldas, Vatche G Agopian, Jonathan R Hiatt, Sue V McDiarmid, Ronald W Busuttil
BACKGROUND: Pediatric liver transplantation (pLTx) has been the standard of care for children with liver failure since the 1980s. This study examined the world's largest single-center experiences and aimed to identify unique pre-operative predictors of early graft and patient survival for primary (1º-pLTx) and re-transplantation (Re-pLTx). STUDY DESIGN: An IRB approved, retrospective study of all consecutive, isolated pLTx patients ≤ 18 years of age was conducted...
February 1, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29406471/life-threatening-accidental-intravenous-epinephrine-overdose-in-a-12-year-old-boy
#10
Maya Caroline André, Jürg Hammer
Reports on accidental intravenous epinephrine overdose in children are extremely rare, although medication errors in the management of pediatric anaphylaxis seem to be frequent. We report a case of a 12-year-old boy presenting with a long-lasting skin rash and dyspnea who was incorrectly diagnosed with early anaphylactic shock and was treated with 10-fold the recommended dose administered by the wrong route (intravenous instead of intramuscular). He reacted with acute loss of consciousness and acute cardiorespiratory failure due to arterial hypotension, ischemic heart failure, and severe pulmonary edema...
February 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29406422/equilibration-time-required-for-respiratory-system-compliance-and-oxygenation-response-following-changes-in-positive-end-expiratory-pressure-in-mechanically-ventilated-children
#11
Craig D Smallwood, Brian K Walsh, John H Arnold, Andrew Gouldstone
OBJECTIVES: Increases in positive end-expiratory pressure are implemented to improve oxygenation through the recruitment and stabilization of collapsed alveoli. However, the time it takes for a positive end-expiratory pressure change to have maximum effect upon oxygenation and pulmonary compliance has not been adequately described in children. Therefore, we sought to quantify the time required for oxygenation and pulmonary system compliance changes in children requiring mechanical ventilation...
February 5, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29406380/progressive-diaphragm-atrophy-in-pediatric-acute-respiratory-failure
#12
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/29405616/flow-volume-loops-measured-with-electrical-impedance-tomography-in-pediatric-patients-with-asthma
#13
Chuong Ngo, Falk Dippel, Klaus Tenbrock, Steffen Leonhardt, Sylvia Lehmann
BACKGROUND: Electrical impedance tomography (EIT) provides information on global and regional ventilation during tidal breathing and mechanical ventilation. During forced expiration maneuvers, the linearity of EIT and spirometric data has been documented in healthy persons. The present study investigates the potential diagnostic use of EIT in pediatric patients with asthma. METHODS: EIT and spirometry were performed in 58 children with asthma (average age ± SD: 11...
February 6, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29404795/prolonged-extracorporeal-membrane-oxygenation-for-pediatric-necrotizing-pneumonia-due-to-streptococcus-pneumonia-and-influenza-h1n1-co-infection-how-long-should-we-wait-for-native-lung-recovery
#14
Gerard Cortina, Christian Niederwanger, Uwe Klingkowski, Corinna Velik-Salchner, Nikolaus Neu
Most children with severe respiratory failure require extracorporeal membrane oxygenation (ECMO) for 7-10 days. However, some may need prolonged duration ECMO (> 14 days). To date, no consensus exists on how long to wait for native lung recovery. Here we report the case of a 3-year-old boy who developed severe necrotizing pneumonia requiring venovenous (VV) ECMO after 19 days of mechanical ventilation. In the first 4 weeks of his ECMO run, he showed no lung aeration, requiring total extracorporeal support...
February 5, 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/29401139/therapeutic-plasma-exchange-in-critically-ill-children-requiring-intensive-care
#15
Gerard Cortina, Rosemary McRae, Roberto Chiletti, Warwick Butt
OBJECTIVE: To characterize the clinical indications, procedural safety, and outcome of critically ill children requiring therapeutic plasma exchange. DESIGN: Retrospective observational study based on a prospective registry. SETTING: Tertiary and quaternary referral 30-bed PICU. PATIENTS: Forty-eight critically ill children who received therapeutic plasma exchange during an 8-year period (2007-2014) were included in the study...
February 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29398628/association-between-oxygenation-and-ventilation-indices-with-the-time-on-invasive-mechanical-ventilation-in-infants
#16
D A Camargo Barros Rocha, F A L Marson, C C B Almeida, A A Almeida Junior, J D Ribeiro
BACKGROUND: Invasive mechanical ventilation (IMV) is a common practice in pediatric intensive care unit (PICU). However, the role of oxygenation (OI) and ventilation (VI) indices regarding the time on IMV has not been fully understood. BASIC PROCEDURES: The study was conducted with infants up to 24 months of age, hospitalized in PICU for two consecutive years. The values of ventilatory parameters, OI, VI, and blood gas of infants, collected in the first seven days in IMV, were associated with the time on IMV...
February 2, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29397933/associations-between-unplanned-cardiac-reinterventions-and-outcomes-after-pediatric-cardiac-operations
#17
John M Costello, Michael C Mongé, Kevin D Hill, Sunghee Kim, Sara K Pasquali, Babatunde A Yerokun, Jeffrey P Jacobs, Carl L Backer, Mjaye L Mazwi, Marshall L Jacobs
BACKGROUND: After pediatric heart operations, we sought to determine the incidence of unplanned cardiac reinterventions during the same hospitalization, assess risk factors for these reinterventions, and explore associations between reinterventions and outcomes. We hypothesized that younger patients undergoing more complex operations would be at greater risk for unplanned cardiac reinterventions and that operative mortality and postoperative length of stay (PLOS) would be greater in patients who undergo reintervention than in those who do not...
February 1, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29395177/delirium-is-a-common-and-early-finding-in-patients-in-the-pediatric-cardiac-intensive-care-unit
#18
Rita V Alvarez, Claire Palmer, Angela S Czaja, Chris Peyton, Gabrielle Silver, Chani Traube, Peter M Mourani, Jon Kaufman
OBJECTIVE: To determine incidence, associated risk factors, and characteristics of delirium in a pediatric cardiac intensive care unit (CICU). Delirium is a frequent and serious complication in adults after cardiac surgery, but there is limited understanding of its impact in children with critical cardiac disease. STUDY DESIGN: Single-center prospective observational study of CICU patients ≤21 years old. All were screened for delirium using the Cornell Assessment for Pediatric Delirium each 12-hour shift...
January 29, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29386758/challenges-in-management-of-pediatric-life-threatening-neck-and-chest-trauma
#19
Shilpa Sharma, Biplab Mishra, Amit Gupta, Kapil Dev Soni, Richa Aggarwal, Subodh Kumar
Introduction: Neck and thoracic trauma in children pose unforeseen challenges requiring variable management strategies. Here, we describe some unusual cases. Patients and Methods: Pediatric cases of unusual neck and thoracic trauma prospectively managed from April 2012 to March 2014 at a Level 1 trauma center were studied for management strategies, outcome, and follow-up. Results: Six children with a median age of 5.5 (range 2-10) years were managed...
January 2018: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/29380954/mechanical-ventilation-strategies-alter-cardiovascular-biomarkers-in-an-infant-rat-model
#20
Philipp Baumann, Susanne Wiegert, Francesco Greco, Sven Wellmann, Pietro L'Abate, Vincenzo Cannizzaro
Mechanical ventilation (MV) is routinely used in pediatric general anesthesia and critical care, but may adversely affect the cardiocirculatory system. Biomarkers are increasingly measured to assess cardiovascular status and improve clinical treatment decision-making. As the impact of mechanical ventilation strategies on cardiovascular biomarkers in ventilated infants is largely unknown, we conducted this retrospective study in a healthy in vivo infant rat ventilation model using 14-days old Wistar rats. We hypothesized that 2 h of mechanical ventilation with high and low positive end-expiratory pressure (PEEP), hyperoxemia, hypoxemia, hypercapnia, and hypocapnia would significantly impact B-type natriuretic peptide (BNP), vascular endothelial growth factor (VEGF), and endothelin-1 (ET-1)...
January 2018: Physiological Reports
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