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Pediatric Mechanical Ventilation

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https://www.readbyqxmd.com/read/28821360/development-and-implementation-of-an-early-mobility-program-for-mechanically-ventilated-pediatric-patients
#1
Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, Mary L deAlmeida
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28816920/similar-metabolic-innate-immunity-and-adipokine-profiles-in-adult-and-pediatric-sepsis-versus-systemic-inflammatory-response-syndrome-a-pilot-study
#2
Theonymfi Tavladaki, Anna Maria Spanaki, Helen Dimitriou, Efmorfia Kondili, Christianna Choulaki, Dimitris Georgopoulos, George Briassoulis
OBJECTIVES: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28807197/perioperative-blood-transfusion-and-complications-in-children-undergoing-surgery-for-solid-tumors
#3
Dani O Gonzalez, Jennifer N Cooper, Erica Mantell, Peter C Minneci, Katherine J Deans, Jennifer H Aldrink
BACKGROUND: The objective was to assess whether perioperative blood transfusion (PBT) is associated with postoperative complications in children undergoing surgery for a solid tumor. METHODS: Using 2012-2014 National Surgical Quality Improvement Program Pediatric data, we identified patients aged 0-18 years who underwent surgery (biopsy or resection) for solid tumors. We compared demographic, clinical, and 30-day outcome characteristics between children who did and did not receive a PBT within 72 hours after surgery...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28803432/quality-of-life-in-home-ventilated-children-and-their-families
#4
Rafael González, Amaya Bustinza, Sarah N Fernandez, Miriam García, Silvia Rodriguez, Ma Ángeles García-Teresa, Mirella Gaboli, Silvia García, Olaia Sardón, Diego García, Antonio Salcedo, Antonio Rodríguez, Ma Carmen Luna, Arturo Hernández, Catalina González, Alberto Medina, Estela Pérez, Alicia Callejón, Juan D Toledo, Mercedes Herranz, Jesús López-Herce
HMV (home mechanical ventilation) in children has increased over the last years. The aim of the study was to assess perceived quality of life (QOL) of these children and their families as well as the problems they face in their daily life.We performed a multicentric cross-sectional study using a semi-structured interview about the impact of HMV on families and an evaluation questionnaire about perceived QOL by the patient and their families (pediatric quality of life questionnaire (PedsQL4.0)). We studied 41 subjects (mean age 8...
August 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28793199/impact-of-obesity-on-outcomes-in-critically-ill-children
#5
Esther T Davis, Li Xie, Yosef Levenbrown
PURPOSE: To examine whether obesity confers a protective effect on critically ill pediatric patients, similar to what has been reported in critically ill adults. METHODS: A retrospective cohort study including patients aged 2-18 years admitted to a 24-bed pediatric intensive care unit from 2009 to 2014. Patients were divided into 1 of 3 weight categories: normal weight (body mass index [BMI], 5%-84.9%), overweight (BMI, 85%-94.9%), and obese (BMI ≥95%). Outcomes investigated included mortality, need for intubation, need for inotropic support, and duration of mechanical ventilation...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28777139/fluid-bolus-over-15-20-versus-5-10-minutes-each-in-the-first-hour-of-resuscitation-in-children-with-septic-shock-a-randomized-controlled-trial
#6
Jhuma Sankar, Javed Ismail, M Jeeva Sankar, Suresh C P, Rameshwar S Meena
OBJECTIVES: To compare the effect of administration of 40-60 mL/kg of fluids as fluid boluses in aliquots of 20 mL/kg each over 15-20 minutes with that over 5-10 minutes each on the composite outcome of need for mechanical ventilation and/or impaired oxygenation-increase in oxygenation index by 5 from baseline in the initial 6 and 24 hours in children with septic shock. DESIGN: Randomized controlled trial. SETTING: Pediatric emergency and ICU of a tertiary care institute...
August 2, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28767913/spontaneous-breathing-test-in-the-prediction-of-extubation-failure-in-the-pediatric-population
#7
Milena Siciliano Nascimento, Celso Moura Rebello, Luciana Assis Pires Andrade Vale, Érica Santos, Cristiane do Prado
Objective: To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. Methods: A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test...
April 2017: Einstein
https://www.readbyqxmd.com/read/28760436/impact-of-the-structure-and-dose-of-protein-intake-on-clinical-and-metabolic-outcomes-in-critically-ill-children-a-systematic-review
#8
REVIEW
Daniela B Hauschild, Julia C Ventura, Nilesh M Mehta, Yara M F Moreno
OBJECTIVE: The aim of this study was to describe the effects of structure/type and total amount of protein intake on protein balance and clinical outcomes in critically ill children. METHODS: We conducted a systematic review of relevant literature on Embase, PubMed/Medline, Web of Science, Scopus, and Latin American and Caribbean Health Sciences. A partial gray literature search was undertaken and the reference lists of the selected articles were searched manually...
September 2017: Nutrition
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#9
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28757869/factors-associated-with-postoperative-prolonged-mechanical-ventilation-in-pediatric-liver-transplant-recipients
#10
Olubukola O Nafiu, Katari Carello, Anjana Lal, John Magee, Paul Picton
INTRODUCTION: Almost all pediatric orthotopic liver transplant (OLT) recipients require mechanical ventilation in the early postoperative period. Prolonged postoperative mechanical ventilation (PPMV) may be a marker of severe disease and may be associated with morbidity and mortality. We determined the incidence and risk factors for PPMV in children who underwent OLT. METHODS: This was a retrospective analysis of data collected on 128 pediatric OLT recipients. PPMV was defined as postoperative ventilation ≥ 4 days...
2017: Anesthesiology Research and Practice
https://www.readbyqxmd.com/read/28754485/prevalence-and-incidence-of-pressure-injuries-in-pediatric-hospitals-in-the-city-of-s%C3%A3-o-paulo-sp-brazil
#11
Donata Maria de Souza Pellegrino, Julieta Maria Ferreira Chacon, Leila Blanes, Lydia Masako Ferreira
OBJECTIVE: To identify the incidence and prevalence of pressure injuries (PIs) in children admitted to hospitals in the city of São Paulo, and assess the association between sociodemographic and clinical characteristics with hospital-acquired pressure injuries (HAPIs). MATERIALS AND METHODS: A total of 543 children were evaluated, and their sociodemographic and clinical data were recorded. Student's t, Wilcoxon, chi-square, and Fisher's exact tests were used to assess associations between risk factors and the occurrence of HAPIs...
July 12, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28754002/pediatric-respiratory-support-technology-and-practices-a-global-survey
#12
Amélie O von Saint André-von Arnim, Shelina M Jamal, Grace C John-Stewart, Ndidiamaka L Musa, Joan Roberts, Larissa I Stanberry, Christopher R A Howard
OBJECTIVE: This global survey aimed to assess the current respiratory support capabilities for children with hypoxemia and respiratory failure in different economic settings. METHODS: An online, anonymous survey of medical providers with experience in managing pediatric acute respiratory illness was distributed electronically to members of the World Federation of Pediatric Intensive and Critical Care Society, and other critical care websites for 3 months. RESULTS: The survey was completed by 295 participants from 64 countries, including 28 High-Income (HIC) and 36 Low- and Middle-Income Countries (LMIC)...
July 21, 2017: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/28749962/severe-imported-malaria-in-children-in-france-a-national-retrospective-study-from-1996-to-2005
#13
Pierre Mornand, Catherine Verret, Philippe Minodier, Albert Faye, Marc Thellier, Patrick Imbert
BACKGROUNDS: Malaria is a leading cause of imported febrile illnesses in pediatric travelers, but few studies have addressed severe imported pediatric malaria. We aimed to determine the risk factors and the features of imported pediatric severe malaria. METHODS: We conducted a retrospective, descriptive study using the French National Reference Center for Imported Malaria database, in children aged 0-15 years who were hospitalized with a falciparum malaria from January 1st 1996 to December 31th 2005...
2017: PloS One
https://www.readbyqxmd.com/read/28749854/risk-stratification-in-pediatric-acute-respiratory-distress-syndrome-a-multicenter-observational-study
#14
Judith Ju-Ming Wong, Huu Phuc Phan, Suwannee Phumeetham, Jacqueline Soo May Ong, Yek Kee Chor, Suyun Qian, Rujipat Samransamruajkit, Nattachai Anantasit, Chin Seng Gan, Feng Xu, Rehena Sultana, Tsee Foong Loh, Jan Hau Lee
OBJECTIVES: The Pediatric Acute Lung Injury Consensus Conference developed a pediatric specific definition for acute respiratory distress syndrome (PARDS). In this definition, severity of lung disease is stratified into mild, moderate, and severe groups. We aim to describe the epidemiology of patients with PARDS across Asia and evaluate whether the Pediatric Acute Lung Injury Consensus Conference risk stratification accurately predicts outcome in PARDS. DESIGN: A multicenter, retrospective, descriptive cohort study...
July 26, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28742724/epidemiology-of-noninvasive-ventilation-in-pediatric-cardiac-icus
#15
Ryan A Romans, Steven M Schwartz, John M Costello, Nikhil K Chanani, Parthak Prodhan, Avihu Z Gazit, Andrew H Smith, David S Cooper, Jeffrey Alten, Kshitij P Mistry, Wenying Zhang, Janet E Donohue, Michael Gaies
OBJECTIVE: To describe the epidemiology of noninvasive ventilation therapy for patients admitted to pediatric cardiac ICUs and to assess practice variation across hospitals. DESIGN: Retrospective cohort study using prospectively collected clinical registry data. SETTING: Pediatric Cardiac Critical Care Consortium clinical registry. PATIENTS: Patients admitted to cardiac ICUs at PC4 hospitals. INTERVENTIONS: None...
July 22, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#16
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28731651/fluid-balance-and-length-of-mechanical-ventilation-in-children-admitted-to-a-single-pediatric-intensive-care-unit
#17
Solange Vidal, Augusto Pérez, Pablo Eulmesekian
INTRODUCTION: Associations between cumulative fluid balance and a prolonged duration of assisted mechanical ventilation have been described in adults. The aim of this study was to evaluate whether fluid balance in the first 48 hours of assisted mechanical ventilation initiation was associated with a prolonged duration of this process among children in the Pediatric Intensive Care Unit (PICU). METHODS: Retrospective cohort of patients in the PICU of Hospital Italiano de Buenos Aires, between 1/1/2010 and 6/30/2012...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28730574/mechanical-ventilation-guided-by-electrical-impedance-tomography-in-pediatric-acute-respiratory-distress-syndrome
#18
Jeffrey Dmytrowich, Tanya Holt, Karen Schmid, Gregory Hansen
Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to assess regional tidal volumes in real time at the bedside. Here we report the utilization of thoracic electrical impedance tomography to guide daily PEEP settings and recruitment maneuvers in a child with pARDS...
July 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#19
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28720673/challenges-with-implementation-of-a-respiratory-therapist-driven-protocol-of-spontaneous-breathing-trials-in-the-pediatric-icu
#20
Conrad Krawiec, Dale Carl, Christy Stetter, Lan Kong, Gary D Ceneviva, Neal J Thomas
BACKGROUND: Timely ventilator liberation is crucial in the pediatric ICU. In many pediatric ICUs, the decision to initiate weaning is driven by the physician, which may lead to delays in ventilator liberation. The objectives of this quality improvement project were to develop and implement a respiratory therapist (RT)-led protocol for screening for spontaneous breathing trial (SBT) readiness, to test protocol feasibility, and to evaluate its impact on SBT timing. METHODS: A retrospective chart review was performed on all intubated patients in the pediatric ICU for 18 months prior to protocol institution...
July 18, 2017: Respiratory Care
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