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https://www.readbyqxmd.com/read/27933693/heart-transplantation-in-children-with-intellectual-disability-an-analysis-of-the-unos-database
#1
Alexander N Goel, Amit Iyengar, Kenneth Schowengerdt, Andrew C Fiore, Charles B Huddleston
Heart transplantation in children with intellectual disability (ID) is an issue of debate due to the shortage of available donor organs. We sought to perform the first large-scale retrospective cohort study describing the prevalence and outcomes of heart transplantation in this population. The United Network of Organ Sharing database was queried from 2008 to 2015 for pediatric patients (age <19 years) receiving first, isolated heart transplant. Recipients were divided into three subgroups: definite ID, probable ID, and no ID...
December 9, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27927871/severity-of-respiratory-syncytial-virus-lower-respiratory-tract-infection-with-viral-coinfection-in-hiv-uninfected-children
#2
Natalie I Mazur, Louis Bont, Adam L Cohen, Cheryl Cohen, Anne von Gottberg, Michelle J Groome, Orienka Hellferscee, Kerstin Klipstein-Grobusch, Omphile Tschegofatso Mekgoe, Fathima Naby, Jocelyn Moyes, Stefano Tempia, Florette K Treurnicht, Marietje Venter, Sibongile Walaza, Nicole Wolter, Shabir A Madhi
BACKGROUND: Molecular diagnostics enable sensitive detection of respiratory viruses but their clinical significance remains unclear in pediatric lower respiratory tract infections (LRTI). We aimed to determine whether viral coinfections increased life-threatening disease in a large cohort. METHODS: Molecular testing was performed for respiratory viruses in nasopharyngeal aspirates collected from children aged <5 years within 24 hours of hospital admission during sentinel surveillance for Severe Acute Respiratory Illness (SARI) hospitalisation conducted in South Africa during February 2009-December 2013...
December 7, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#3
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27917707/management-of-pneumonia-in-the-pediatric-critical-care-unit-an-area-for-antimicrobial-stewardship
#4
Aimee M Dassner, David P Nicolau, Jennifer E Girotto
Pediatric pneumonia is one of the most common causes of childhood infection requiring hospitalization and is a substantial driver of antimicrobial use among hospitalized children. About 12-20% of pediatric patients hospitalized with community-acquired pneumonia (CAP) require critical care. Additionally, nosocomial pneumonias (i.e. hospital-acquired and ventilator-associated pneumonias) are responsible for 15-53% of hospital-associated infections and are the most common indication for empiric antibiotics in the pediatric intensive care unit...
December 4, 2016: Current Pediatric Reviews
https://www.readbyqxmd.com/read/27914588/obesity-in-pediatric-trauma
#5
Cordelie E Witt, Saman Arbabi, Avery B Nathens, Monica S Vavilala, Frederick P Rivara
BACKGROUND/PURPOSE: The implications of childhood obesity on pediatric trauma outcomes are not clearly established. Anthropomorphic data were recently added to the National Trauma Data Bank (NTDB) Research Datasets, enabling a large, multicenter evaluation of the effect of obesity on pediatric trauma patients. METHODS: Children ages 2 to 19years who required hospitalization for traumatic injury were identified in the 2013-2014 NTDB Research Datasets. Age and gender-specific body mass indices (BMI) were calculated...
November 23, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27914127/impact-of-initial-vancomycin-trough-concentration-on-clinical-and-microbiological-outcomes-of-methicillin-resistant-staphylococcus-aureus-bacteremia-in-children
#6
Ree Nar Yoo, Seo Hee Kim, Jina Lee
It is important to use vancomycin in a proper manner to ensure optimal drug exposure. Despite extensive use of vancomycin in children, studies on its optimal trough concentration (Ctrough) in the pediatric population remained rare. This retrospective study included children < 18 years old with culture-confirmed methicillin-resistant Staphylococcus aureus (MRSA) bacteremia who were hospitalized in our institute from January 2010 to April 2014. Clinical characteristics, initial vancomycin dose, Ctrough and clinical/microbiological outcomes were retrospectively collected from medical records...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27910005/doppler-images-of-intra-pulmonary-shunt-within-atelectasis-in-anesthetized-children
#7
Cecilia M Acosta, Gerardo Tusman, Mauro Costantini, Camila Echevarría, Sergio Pollioto, Diego Abrego, Fernando Suarez-Sipmann, Stephan H Böhm
BACKGROUND: Doppler images of pulmonary vessels in pulmonary diseases associated with subpleural consolidations have been described. Color Doppler easily identifies such vessels within consolidations while spectral Doppler analysis allows the differentiation between pulmonary and bronchial arteries. Thus, Doppler helps in diagnosing the nature of consolidations. To our knowledge, Doppler analysis of pulmonary vessels within anesthesia-induced atelectasis has never been described before...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27899105/non-invasive-mechanical-ventilation-after-heart-surgery-in-children
#8
Sarah Fernández Lafever, Blanca Toledo, Miguel Leiva, Maite Padrón, Marina Balseiro, Angel Carrillo, Jesús López-Herce
BACKGROUND: The purpose of the study was to analyze the characteristics and evolution of non-invasive mechanical ventilation (NIV) in the postoperative period of heart surgery in children. METHODS: Retrospective observational study including all children requiring NIV after heart surgery in a single center pediatric intensive care unit (PICU) between 2001 and 2012. Demographic characteristics, ventilation parameters and outcomes were registered, comparing the first 6 years of the study with the last 6 years...
November 29, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27894559/helicopter-transport-in-regionalized-burn-care-one-program-s-perspective
#9
Benjamin Nicholson, Harinder Dhindsa
BACKGROUND: The decision to use helicopter EMS (HEMS) for the transport of burn patients is a complex decision. This analysis sought to evaluate burn patients flown to burn centers who met predetermined criteria for patients who likely benefit from HEMS care. METHODS: A retrospective transport chart review of all burn transports covering the preceding nine and a half years was conducted to evaluate for HEMS appropriate criteria defined as patients requiring advanced airway management, ventilator support, facial burns, inhalation injury, circumferential burns, electrical or chemical burn, or major burns...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27889726/prolonged-infusion-of-dexmedetomidine-in-critically-ill-children
#10
Cinara Andreolio, Jefferson Pedro Piva, Elisa Baldasso, Roberta Ferlini, Rafaela Piccoli
OBJECTIVE: To describe main indications, doses, length of infusion and side effects related to dexmedetomidine infusion. METHODS: Observational and retrospective study evaluating dexmedetomidine use in pediatric intensive care unit. RESULTS: 77 children received dexmedetomidine infusion longer than 6 hours for mechanical ventilation weaning (32.5%), post- neurosurgery and post-upper airway surgery (24.7%), non-invasive ventilation (13%), refractory tachycardia (6...
November 15, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27889372/-non-invasive-ventilation-in-children-do-we-need-more-evidence
#11
G Mortamet, G Emeriaud, P Jouvet, B Fauroux, S Essouri
Respiratory failure is the leading cause of hospital admissions in the pediatric intensive care unit (PICU) and is associated with significant morbidity and mortality. Mechanical ventilation, preferentially delivered by a non-invasive route (NIV), is currently the first-line treatment for respiratory failure since it is associated with a reduction in the intubation rate. This ventilatory support is increasingly used in the PICU, but its wider use contrasts with the paucity of studies in this field. This review aims to describe the main indications of NIV in acute settings: (i) bronchiolitis; (ii) postextubation respiratory failure; (iii) acute respiratory distress syndrome; (iv) pneumonia; (v) status asthmaticus; (vi) acute chest syndrome; (vii) left heart failure; (viii) exacerbation of chronic respiratory failure; (ix) upper airway obstruction and (x) end-of-life care...
November 23, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27887916/interfaces-for-noninvasive-ventilation-in-the-acute-setting-in-children
#12
REVIEW
Guillaume Mortamet, Alessandro Amaddeo, Sandrine Essouri, Sylvain Renolleau, Guillaume Emeriaud, Brigitte Fauroux
The use of noninvasive ventilation (NIV) is very specific in the acute setting as compared to its use in a chronic setting. In the Pediatric Intensive care Unit (PICU), NIV may be required around the clock and initiation has to be fast and easy. Despite the increasing use of non-invasive ventilation (NIV) and the larger choice of interfaces, data comparing the use of different interfaces for pediatric patients are scarce and recommendations for the most appropriate choice of interface are lacking. However, this choice in acute settings is crucial and a major contributor of the success of NIV...
October 21, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27886037/hospital-acquired-infection-in-public-hospital-buildings-in-the-philippines-is-the-type-of-ventilation-increasing-the-risk
#13
Godofreda Ruiz Vergeire-Dalmacion, Jill Rafols Itable, Emmanuel Saporna Baja
INTRODUCTION: Hospital-acquired infections (HAIs) are associated with increased morbidity and mortality, especially in developing countries. However, limited information is available about the risk of HAIs in naturally ventilated wards (NVWs) and mechanically ventilated intensive care units (MVICUs) of public hospitals in the Philippines. We aimed to assess the association between HAIs and type of ventilation in an urban tertiary care hospital in the Philippines. METHODOLOGY: A cross-sectional point-prevalence survey of infections was done in NVWs and MVICUs of a tertiary care hospital in December 2013...
November 24, 2016: Journal of Infection in Developing Countries
https://www.readbyqxmd.com/read/27882804/a-comparison-of-high-frequency-chest-wall-oscillation-and-intrapulmonary-percussive-ventilation-for-airway-clearance-in-pediatric-patients-with-tracheostomy
#14
Aneela Bidiwala, Linda Volpe, Claudia Halaby, Melissa Fazzari, Christina Valsamis, Melodi Pirzada
OBJECTIVES: The aim of this study was to compare two modes of airway clearance, the intrapulmonary percussive ventilation system (IPV) to high frequency chest wall oscillation system (HFCWO) in medically complex pediatric patients with tracheostomy requiring long term care. METHODS: This was a single center, retrospective study comparing the number of respiratory illnesses, lower respiratory tract infections (LRTI), utilization of bronchodilator and systemic steroids, and respiratory illnesses requiring acute care hospitalizations...
November 24, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27881562/total-anomalous-pulmonary-venous-connection-the-current-management-strategies-in-a-pediatric-cohort-of-768-patients
#15
Guocheng Shi, Zhongqun Zhu, Jimei Chen, Yanqiu Ou, Haifa Hong, Zhiqiang Nie, Haibo Zhang, Xiaoqing Liu, Jinghao Zheng, Qi Sun, Jinfen Liu, Huiwen Chen, Jian Zhuang
BACKGROUND: -Total anomalous pulmonary venous connection (TAPVC) is a rare form of congenital heart disease. This study describes current surgical treatment strategies and experiences for a cohort of patients from two congenital cardiac centers in Shanghai and Guangdong, China. METHODS: -This retrospective study included 768 patients operated on between 2005 and 2014. While most patients (n=690) underwent conventional repair, a sutureless technique was employed in 10% (n=78) of cases...
November 15, 2016: Circulation
https://www.readbyqxmd.com/read/27879381/pediatric-prolonged-mechanical-ventilation-considerations-for-definitional-criteria
#16
REVIEW
Michaël Sauthier, Louise Rose, Philippe Jouvet
A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥21 consecutive days for ≥6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27878830/clinical-assessment-of-histidine-tryptophan-ketoglutarate-solution-and-modified-st-thomas-solution-in-pediatric-cardiac-surgery-of-tetralogy-of-fallot
#17
Zhao-Hui Wang, Yong An, Ming-Cheng Du, Ting-Jiang Qin, Yin-Bei Liu, Hong-Zhen Xu, Li-Qun Yang
The objective of this study is to compare the myocardium protective effect of Bretschneider's histidine-tryptophan-ketoglutarate (HTK) solution versus Modified St. Thomas' (STH) solution in pediatric cardiac surgery of Tetralogy of Fallot (TOF). Seventy-seven pediatric patients of TOF who received the total surgical repair were reviewed, from January 2014 to October 2015. A horizontal comparison between HTK solution and modified STH solution has been made since the HTK solutions were started to be used in our hospital...
November 22, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27877098/accidental-epidural-injection-of-rocuronium-in-a-pediatric-patient-a-case-report-and-literature-review
#18
Ting-Ting Wu, David S Hoff
Accidental administration of non-epidural drugs into the epidural or subarachnoid spaces may be associated with unexpected pain, morbidity, adverse effects, increased level of care, prolonged hospital stay, and mortality. We describe a 12-month-old admitted for secondary-stage hypospadias reconstruction. General anesthesia was induced with sevofiurane and a peripheral catheter was placed. Instead of ropivacaine, rocuronium (80 mg; 6.3 mg/kg) was injected into the epidural space by the caudal route. Surgery was uneventful and was completed 160 minutes after rocuronium was given...
September 2016: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/27875593/enterovirus-d68-in-hospitalized-children-sequence-variation-viral-loads-and-clinical-outcomes
#19
Katherine Moyer, Huanyu Wang, Douglas Salamon, Amy Leber, Asuncion Mejias
BACKGROUND: An outbreak of enterovirus D68 (EV-D68) caused severe respiratory illness in 2014. The disease spectrum of EV-D68 infections in children with underlying medical conditions other than asthma, the role of EV-D68 loads on clinical illness, and the variation of EV-D68 strains within the same institution over time have not been described. We sought to define the association between EV-D68 loads and sequence variation, and the clinical characteristic in hospitalized children at our institution from 2011 to 2014...
2016: PloS One
https://www.readbyqxmd.com/read/27872996/surgical-repair-of-ventricular-septal-defect-contemporary-results-and-risk-factors-for-a-complicated-course
#20
Maartje Schipper, Martijn G Slieker, Paul H Schoof, Johannes M P J Breur
Surgical closure of the ventricular septal defect is the most commonly performed procedure in pediatric cardiac surgery. There are conflicting data on weight at operation as risk factor for a complicated course. We performed a retrospective evaluation of mortality and morbidity in all patients undergoing surgical ventricular septal defect closure at our institution between 2004 and 2012 to identify risk factor for a complicated course. Multivariate logistic regression modeling was performed to identify risk factors for a complicated course...
November 21, 2016: Pediatric Cardiology
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