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Pediatric Mechanical Ventilation

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https://www.readbyqxmd.com/read/29243536/variation-in-pediatric-organ-donor-management-practices-among-us-organ-procurement-organizations
#1
Robert S Ream, Eric S Armbrecht
INTRODUCTION: Reports of actual pediatric organ donor management practice among US organ procurement organizations are sparse, and the use of standardized management guidelines is unknown. A recent consensus statement from the Society of Critical Care Medicine, the American College of Chest Physicians, and the Association of Organ Procurement Organizations offers guidelines for the management of the pediatric organ donor. RESEARCH QUESTION: To describe the use of guidelines and routine practices in the management of the pediatric organ donor with respect to hemodynamics, lung and ventilator management, fluid and electrolytes, hormonal replacement therapy, the use of blood products, thermoregulation, and prophylactic antibiotics...
January 1, 2017: Progress in Transplantation
https://www.readbyqxmd.com/read/29236844/functional-evaluation-of-pediatric-patients-after-discharge-from-the-intensive-care-unit-using-the-functional-status-scale
#2
Gabriela Alves Pereira, Camila Wohlgemuth Schaan, Renata Salatti Ferrari
OBJECTIVE: To evaluate the functional status of pediatric patients after discharge from the pediatric intensive care unit using the Functional Status Scale and to compare the time of invasive mechanical ventilation, length of stay in the pediatric intensive care unit, and Pediatric Index of Mortality 2 results among individuals with different degrees of functional impairment. METHODS: A cross-sectional study was conducted on patients who were discharged from a pediatric intensive care unit...
December 7, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29234146/practices-surrounding-pulmonary-hypertension-and-bronchopulmonary-dysplasia-amongst-neonatologists-caring-for-premature-infants
#3
Gabriel Altit, Henry C Lee, Susan Hintz, Theresa A Tacy, Jeffrey A Feinstein, Shazia Bhombal
OBJECTIVE: Pulmonary hypertension (PH) is associated with bronchopulmonary dysplasia (BPD). Screening strategies, a thorough investigation of co-morbidities, and multidisciplinary involvement prior to anti-PH medications have been advocated by recent guidelines. We sought to evaluate current practices of neonatologists caring for premature infants with PH. DESIGN: Electronic survey of American Academy of Pediatrics neonatology members. RESULTS: Among 306 neonatologist respondents, 38% had an institutional screening protocol for patients with BPD; 83% screened at 36 weeks for premature neonates on oxygen/mechanical ventilation...
December 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29226187/tracheobronchial-foreign-bodies-in-children-the-role-of-emergency-rigid-bronchoscopy
#4
Aram Baram, Hewa Sherzad, Sara Saeed, Fahmi H Kakamad, Adnan M H Hamawandi
Foreign body aspiration (FBA) is a common and lethal accident in the pediatric age group. It requires early recognition and treatment by rigid bronchoscopy to avoid fatal outcomes. Objective. The aim of this study was to study the pattern of FBA in the tracheobronchial tree as well as the success rate of rigid bronchoscopy in children admitted to a single center and to analyze the relationship of the type of foreign body (FB) with patients' age, presentation, and complications. Methods. A retrospective cross-sectional study of FBA was conducted in children in the Sulaimani/Kurdistan region, Iraq, admitted to the emergency teaching hospital of the University of Sulaimani from January 2014 to March 2016...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/29226117/pediatric-anti-n-methyl-d-aspartate-receptor-encephalitis-a-review-with-pooled-analysis-and-critical-care-emphasis
#5
REVIEW
Kenneth E Remy, Jason W Custer, Joshua Cappell, Cortney B Foster, Nan A Garber, L Kyle Walker, Liliana Simon, Dayanand Bagdure
Purpose: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is being recognized with increasing frequency among children. Given the paucity of evidence to guide the critical care management of these complex patients, we provide a comprehensive review of the literature with pooled analysis of published case reports and case series. Methods: We performed a comprehensive literature search using PubMed, Scopus, EMBASE, and Web of Science for relevant published studies...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#6
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29218773/illness-and-end-of-life-experiences-of-children-with-cancer-who-receive-palliative-care
#7
Erica C Kaye, Courtney A Gushue, Samantha DeMarsh, Jonathan Jerkins, April Sykes, Zhaohua Lu, Jennifer M Snaman, Lindsay Blazin, Liza-Marie Johnson, Deena R Levine, R Ray Morrison, Justin N Baker
BACKGROUND: The field of pediatric palliative oncology is newly emerging. Little is known about the characteristics and illness experiences of children with cancer who receive palliative care (PC). METHODS: A retrospective cohort study of 321 pediatric oncology patients enrolled in PC who died between 2011 and 2015 was conducted at a large academic pediatric cancer center using a comprehensive standardized data extraction tool. RESULTS: The majority of pediatric palliative oncology patients received experimental therapy (79...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29207322/identification-of-a-vte-rich-population-in-pediatrics-critically-ill-children-with-central-venous-catheters
#8
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
November 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29194281/rbc-transfusions-are-associated-with-prolonged-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#9
Michael E Zubrow, Neal J Thomas, David F Friedman, Nadir Yehya
OBJECTIVES: Blood products are often transfused in critically ill children, although recent studies have recognized their potential for harm. Translatability to pediatric acute respiratory distress syndrome is unknown given that hypoxemia has excluded pediatric acute respiratory distress syndrome patients from clinical trials. We aimed to determine whether an association exists between blood product transfusion and survival or duration of ventilation in pediatric acute respiratory distress syndrome...
November 30, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29189706/unplanned-extubations-in-intensive-care-unit-evidences-for-risk-factors-a-literature-review
#10
Chiara Cosentino, Mattia Fama, Chiara Foà, Giorgia Bromuri, Serena Giannini, Marco Saraceno, Angela Spagnoletta, Mbemo Tenkue, Elena Trevisi, Leopoldo Sarli
BACKGROUND AND AIM: Unplanned extubations (UE) are getting more and more relevant in Critical Care, becoming a quality and care safeness outcome. This happens because after an UE the patient can face some complications concerning the airway management, respiratory and hemodynamic problems, lengthen in the hospital stay and in the mechanical ventilation time.  The aim of this review is identify and classify the factors that could increase UE risk. METHODOLOGY: A systematic review of scientific articles was performed consulting the databases PubMed, Cinahl, Medline, EBSCOhost and Google Scholar...
November 30, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29189669/measurement-of-dead-space-fraction-upon-icu-admission-predicts-length-of-stay-and-clinical-outcomes-following-bidirectional-cavopulmonary-anastomosis
#11
Claire L Cigarroa, Sarah J van den Bosch, Xiaoqi Tang, Kimberlee Gauvreau, Christopher W Baird, James A DiNardo, John Nagi Kheir
OBJECTIVES: Increased alveolar dead space fraction has been associated with prolonged mechanical ventilation and increased mortality in pediatric patients with respiratory failure. The association of alveolar dead space fraction with clinical outcomes in patients undergoing bidirectional cavopulmonary anastomosis for single ventricle congenital heart disease has not been reported. We describe an association of alveolar dead space fraction with postoperative outcomes in patients undergoing bidirectional cavopulmonary anastomosis...
November 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29179574/life-sustaining-treatment-status-at-the-time-of-death-in-a-japanese-pediatric-intensive-care-unit
#12
Fumiko Suzuki, Muneyuki Takeuchi, Kazuya Tachibana, Kanako Isaka, Yu Inata, Keiko Kinouchi
BACKGROUND: Substantial variability exists among countries regarding the modes of death in pediatric intensive care units (PICUs). However, there is limited information on end-of-life care in Japanese PICUs. Thus, this study aimed to elucidate the characteristics of end-of-life care practice for children in a Japanese PICU. METHODS: We examined life-sustaining treatment (LST) status at the time of death based on medical chart reviews from 2010 to 2014. All deaths were classified into 3 groups: limitation of LST (limitation group, death after withholding or withdrawal of LST or a do not attempt resuscitation order), no limitation of LST (no-limitation group, death following failed resuscitation attempts), or brain death (brain death group)...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29167075/provider-beliefs-regarding-early-mobilization-in-the-pediatric-intensive-care-unit
#13
Christine L Joyce, Cosme Taipe, Brittany Sobin, Marissa Spadaro, Batsheva Gutwirth, Larissa Elgin, Gabrielle Silver, Bruce M Greenwald, Chani Traube
PURPOSE: Critically ill patients are at risk for short and long term morbidity. Early mobilization (EM) of critically ill adults is safe and feasible, with improvement in outcomes. There are limited studies evaluating EM in pediatric critical care patients. Provider beliefs and concerns must be evaluated prior to EM implementation in the pediatric intensive care unit (PICU). DESIGN AND METHODS: A survey was distributed to PICU providers assessing beliefs and concerns with regards to EM of PICU patients...
October 14, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29162982/future-directions-and-molecular-basis-of-ventilator-associated-pneumonia
#14
REVIEW
Kubra Aykac, Yasemin Ozsurekci, Sevgen Tanir Basaranoglu
Mechanical ventilation is a lifesaving treatment and has complications such as ventilator associated pneumonia (VAP) that lead to high morbidity and mortality. Moreover VAP is the second most common hospital-acquired infection in pediatric intensive care units. Although it is still not well understood, understanding molecular pathogenesis is essential for preventing and treating pneumonia. A lot of microbes are detected as a causative agent of VAP. The most common isolated VAP pathogens in pediatric patients are Staphylococcus aureus, Pseudomonas aeruginosa, and other gram negative bacteria...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#15
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29144275/the-effect-of-level-of-care-on-gastroschisis-outcomes
#16
Jordan C Apfeld, Zachary J Kastenberg, Karl G Sylvester, Henry C Lee
OBJECTIVE: To examine the relationship between level of care in neonatal intensive care units (NICUs) and outcomes for newborns with gastroschisis. STUDY DESIGN: A retrospective cohort study was conducted at 130 California Perinatal Quality Care Collaborative NICUs from 2008 to 2014. All gastroschisis births were examined according to American Academy of Pediatrics NICU level of care at the birth hospital. Multivariate analyses examined odds of mortality, duration of mechanical ventilation, and duration of stay...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#17
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29132458/-efficacy-of-analgesic-and-sedative-treatments-in-children-with-mechanical-ventilation-in-the-pediatric-intensive-care-unit
#18
Xiao-Fang Cai, Fu-Rong Zhang, Long Zhang, Ji-Min Sun, Wen-Bin Li
OBJECTIVE: To compare the efficacy and safety of different analgesic and sedative treatments in children with mechanical ventilation in the pediatric intensive care unit (PICU). METHODS: Eighty children with mechanical ventilation in the PICU who needed analgesic and sedative treatments were equally and randomly divided into midazolam group and remifentanil+midazolam group. The sedative and analgesic effects were assessed using the Ramsay Scale and the Face, Legs, Activity, Cry and Consolability (FLACC) Scale...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29114700/invasive-candidiasis-in-pediatric-patients-at-king-fahad-medical-city-in-central-saudi-arabia-a-5-year-retrospective-study
#19
Zainab Almooosa, Gasmelseed Y Ahmed, Abeer Omran, Ayah AlSarheed, Afnan Alturki, Abdulaziz Alaqeel, Mohammed Alshehri, Tariq Alfawaz, Dayel AlShahrani
To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29113508/outcomes-of-children-with-critical-bronchiolitis-living-in-poor-communities
#20
Katherine N Slain, Steven L Shein, Anne G Stormorken, Meredith C G Broberg, Alexandre T Rotta
There are established associations between adverse health outcomes and poverty, but little is known regarding these associations in critically ill children. We hypothesized that living in poorer communities would be associated with unfavorable outcomes in children with critical bronchiolitis. This retrospective study included children with bronchiolitis admitted to a pediatric intensive care unit (PICU) over a 2-year period. Median household income was estimated from patient ZIP codes and 2014 US Census Bureau data...
November 1, 2017: Clinical Pediatrics
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