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https://www.readbyqxmd.com/read/29774549/extracorporeal-membrane-oxygenation-characteristics-and-outcomes-in-adult-patients-with-down-syndrome
#1
Vicky Duffy, Daniel Gomez, Peter Rycus, Brian Rivera, Stephanie L Santoro, Carl H Backes, Clifford L Cua
Patients with Down syndrome (DS) may have multiple medical issues that place them at risk for requiring extracorporeal membrane oxygenation. Use of extracorporeal membrane oxygenation in pediatric patients with Down syndrome has been described, but minimal data exist for extracorporeal membrane oxygenation use in adults with Down syndrome. The goal of this study was to describe the clinical characteristics and to determine if there were differences between adult extracorporeal membrane oxygenation patients with Down syndrome that were alive (aDS) versus those that died (dDS) prior to hospital discharge...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29766676/identification-of-hospitalized-tracheostomy-and-ventilator-dependent-patients-in-administrative-data
#2
Barbara K Giambra, Colleen Mangeot, Dan T Benscoter, Maria T Britto
BACKGROUND: Patients with established tracheostomy and ventilator dependence are hospitalized more frequently and use more healthcare resources than other patients with complex chronic conditions. However, data to compare variation in hospitalization and resource use among patients in this population across the United States is deficient, partly due to the lack of structured methods to query national databases. AIM: Determine the best method for identifying the subset of children with established tracheostomy and ventilator dependence in Pediatric Health Information System (PHIS)...
May 15, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29766326/the-change-in-management-of-bronchiolitis-in-the-intensive-care-unit-between-2000-and-2015
#3
Minna Mecklin, Paula Heikkilä, Matti Korppi
This case-control study evaluated interventions for bronchiolitis in relation to time in the pediatric intensive care unit (PICU) during a 16-year surveillance period. Together, 105 infants aged < 12 months were treated for bronchiolitis in the PICU, and for them, we selected 210 controls admitted for bronchiolitis closest to cases. We collected data on treatments in the PICU, at the ward and in the emergency department for three periods: years 2000-2005, 2006-2010, and 2011-2015. Median hospital length of stay for PICU patients were 7 days (interquartile range 5-12), 5 days (4-8) and 8 days (4-12...
May 15, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29765932/fluid-overload-and-renal-angina-index-at-admission-are-associated-with-worse-outcomes-in-critically-ill-children
#4
Sidharth K Sethi, Veena Raghunathan, Shilpi Shah, Maninder Dhaliwal, Pranaw Jha, Maneesh Kumar, Sravanthi Paluri, Shyam Bansal, Maroun J Mhanna, Rupesh Raina
Objectives: We investigated the association of fluid overload and oxygenation in critically sick children, and their correlation with various outcomes (duration of ventilation, ICU stay, and mortality). We also assessed whether renal angina index (RAI) at admission can predict mortality or acute kidney injury (AKI) on day 3 after admission. Design and setting: Prospective study, pediatric intensive care in a tertiary hospital. Duration: June 2013-June 2014. Patients: Patients were included if they needed invasive mechanical ventilation for >24 h and had an indwelling arterial catheter...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29764778/lower-beclin-1-mrna-levels-in-pediatric-compared-with-adult-patients-with-otitis-media-with-effusion
#5
Kim Sang Hoon, Kim Myung Gu, Shim Haeng Seon, Kim Sung Su, Kim Young Il, Yeo Seung Geun
OBJECTIVES: The role of autophagy in the pathophysiology of otitis media with effusion (OME) remains unclear, particularly regarding the difference between pediatric and adult patients. The present study analyzed the expression levels of autophagy-associated mRNAs in effusion fluids obtained from pediatric and adult patients with OME. MATERIALS AND METHODS: Middle ear fluid samples were collected from 76 pediatric patients and 41 adult patients with OME, and the levels of mRNAs encoding autophagy-related genes were measured using real-time reverse transcription-polymerase chain reaction...
April 2018: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/29764391/practice-and-outcomes-of-neonatal-resuscitation-for-newborns-with-birth-asphyxia-at-kakamega-county-general-hospital-kenya-a-direct-observation-study
#6
Duncan N Shikuku, Benson Milimo, Elizabeth Ayebare, Peter Gisore, Gorrette Nalwadda
BACKGROUND: About three - quarters of all neonatal deaths occur during the first week of life, with over half of these occurring within the first 24 h after birth. The first minutes after birth are critical to reducing neonatal mortality. Successful neonatal resuscitation (NR) has the potential to prevent these perinatal mortalities related to birth asphyxia. This study described the practice of NR and outcomes of newborns with birth asphyxia in a busy referral hospital. METHODS: Direct observations of 138 NRs by 28 healthcare providers (HCPs) were conducted using a predetermined checklist adapted from the national pediatric resuscitation protocol...
May 15, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29762231/surfactant-administration-during-pediatric-cardiac-extracorporeal-membrane-oxygenation
#7
Constantinos Chrysostomou, Timothy Maul, Filip Istvanic, Peter Wearden
We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2)...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29756534/neurostimulant-prescribing-patterns-in-children-admitted-to-the-icu-after-traumatic-brain-injury
#8
Amanda Marie Morrison, Amy Houtrow, James Zullo, Patrick M Kochanek, Carol Vetterly, Ericka L Fink
Neurostimulant medications are commonly prescribed following traumatic brain injury (TBI) in adults; little is known about their use in children with TBI. Our objective was to analyze neurostimulant prescribing practices from 2005 to 2015 in children admitted to the intensive care unit (ICU) with TBI. We hypothesized that neurostimulant prescriptions have increased over time and are associated with older age and injury severity. A retrospective cohort study of patients aged 1 month to 18 years with an ICD-9-CM discharge diagnosis code for TBI admitted to the ICU between 2005 and 2015 in 37 pediatric hospitals included in the Pediatric Health Information System was conducted...
May 14, 2018: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29754749/comparison-of-oral-and-axillary-temperatures-in-intubated-pediatric-patients
#9
Danielle Wood, Mary Heitschmidt, Louis Fogg
PURPOSE: Accurate body temperature measurement is essential in providing timely care to critically ill patients. Current practice within the Pediatric ICU (PICU) at a Midwestern academic medical center is to obtain axillary temperatures in endotracheally intubated patients. According to research, axillary temperatures have greater variance than other forms of temperature measurement. Research in adult patients show that oral temperature measurement in endotracheally intubated patients is acceptable as the heated gases from the ventilator has no significant effect on measured temperatures...
May 10, 2018: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/29745619/incidence-and-risk-factors-of-ventilator-associated-pneumonia-in-neonatal-intensive-care-unit-a-first-french-study
#10
Guillaume Geslain, Isabelle Guellec, Romain Guedj, Julia Guilbert, Sandrine Jean, Cécile Valentin, Maryne Demoulin, Yohann Soreze, Ricardo Carbajal, Pierre-Louis Leger, Jerome Rambaud
BACKGROUND: Ventilator-associated pneumonia (VAP) is a severe intensive complication and remains under estimated in neonatal intensive care unit (NICU). Center for Disease Control defined criteria for adults and pediatrics without neonatal criteria. The objective of this article was to evaluate the rate, the risks factors and the outcome of neonates suffering from ventilator-associated pneumonia in a French NICU. METHODS: We conducted a prospective observational study within a one-year period in our NICU...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744656/pediatric-pulmonary-artery-rehabilitation-a-review-of-our-experience-and-a-novel-approach-using-bronchial-blockers
#11
Peter D Winch, Dmitry Tumin, Jeffrey Moore, Samantha J Vizzini, Darren P Berman, Aymen N Naguib
Recent advances in the field of pediatric interventional cardiology have resulted in therapies for patients in need of augmented pulmonary artery (PA) flow. Catheter-based PA rehabilitation can be performed safely but not without the potential risk of pulmonary hemorrhage. When severe, this bleeding has the ability to contaminate the bronchi and trachea, and possibly occlude the endotracheal tube. This can result in a critical inability to ventilate and oxygenate these patients. Herein, we review our institutional experience with pulmonary hemorrhage associated with these procedures and the feasibility of predicting this outcome...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29743771/cervical-myelopathy-in-a-child-a-rare-cause-of-hypoventilation-syndrome-presenting-with-type-2-respiratory-failure
#12
Alolika Mondal, Prabhas Prasun Giri
Hypoventilation syndrome leading to Type 2 respiratory failure is not a rare cause of Pediatric Intensive Care Unit admission and mechanical ventilation. Common causes in pediatric population are Guillain-Barre syndrome and various central nervous system disorders such as encephalitis, traumatic brain injury, and drugs. Any injury or disease in the cervical cord can also produce respiratory paralysis causing respiratory failure. Here, we present two cases of mixed cerebral palsy with cervical myelopathy due to compression effect of fractured segments of first and second cervical vertebrae...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#13
Kailene Serena, Jefferson Pedro Piva, Cinara Andreolio, Paulo Roberto Antonacci Carvalho, Tais Sica da Rocha
Among the main causes of death in our country are car accidents, drowning and accidental burns. Strangulation is a potentially fatal injury and an important cause of homicide and suicide among adults and adolescents. In children, its occurrence is usually accidental. However, in recent years, several cases of accidental strangulation in children around the world have been reported. A 2-year-old male patient was strangled in a car window. The patient was admitted to the pediatric intensive care unit with a Glasgow Coma Scale score of 8 and presented with progressive worsening of respiratory dysfunction and torpor...
March 2018: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29732652/tracheobronchial-angles-in-children-three-dimensional-computed-tomography-based-measurements
#14
Tariq M Wani, Basharat Buchh, Faris Saeed AlGhamdi, Ravees Jan, Dmitry Tumin, Joseph D Tobias
BACKGROUND: Studies have shown significant variation in the tracheobronchial angles in pediatric-aged patients. The current study revisits tracheobronchial angle measurements in children using accurate computed tomography-based 3-dimensional images to add clarity to the understanding of tracheobronchial angles. The primary objective of the current study was to measure the right and left bronchial angle take off from the trachea using 3-dimensional computed tomography-based images of the air column in the tracheobronchial tree...
May 6, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29732502/retention-of-knowledge-and-skills-in-pediatric-basic-life-support-amongst-pediatricians
#15
Mathijs Binkhorst, Michelle Coopmans, Jos M T Draaisma, Petra Bot, Marije Hogeveen
Retention of resuscitation skills is usually assessed at a predefined moment, which enables participants to prepare themselves, possibly introducing bias. In this multicenter study, we evaluated the retention of knowledge and skills in pediatric basic life support (PBLS) amongst 58 pediatricians and pediatric residents with an unannounced examination. Practical PBLS skills were assessed with a validated scoring instrument, theoretical knowledge with a 10-item multiple-choice test (MCQ). Participants self-assessed their PBLS capabilities using five-point Likert scales...
May 7, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29729659/improving-health-care-for-critically-ill-patients-using-an-evidence-based-collaborative-approach-to-abcdef-bundle-dissemination-and-implementation
#16
Mary Ann Barnes-Daly, Brenda T Pun, Lori A Harmon, Diane G Byrum, Vishakha K Kumar, John W Devlin, Joanna L Stollings, Kathleen A Puntillo, Heidi J Engel, Patricia J Posa, Juliana Barr, William D Schweickert, Cheryl L Esbrook, Ken D Hargett, Shannon S Carson, J Matthew Aldrich, E Wesley Ely, Michele C Balas
BACKGROUND: Patients admitted to intensive care units (ICUs) often experience pain, oversedation, prolonged mechanical ventilation, delirium, and weakness. These conditions are important in that they often lead to protracted physical, neurocognitive, and mental health sequelae now termed postintensive care syndrome. Changing current ICU practice will not only require the adoption of evidence-based interventions but the development of effective and reliable teams to support these new practices...
May 5, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29727363/benzodiazepines-and-development-of-delirium-in-critically-ill-children-estimating-the-causal-effect
#17
Kalgi Mody, Savneet Kaur, Elizabeth A Mauer, Linda M Gerber, Bruce M Greenwald, Gabrielle Silver, Chani Traube
OBJECTIVES: Benzodiazepine use may be associated with delirium in critically ill children. However, benzodiazepines remain the first-line sedative choice in PICUs. Objectives were to determine the temporal relationship between administration of benzodiazepines and delirium development, control for time-varying covariates such as mechanical ventilation and opiates, and evaluate the association between dosage of benzodiazepines and subsequent delirium. DESIGN: Retrospective observational study...
May 4, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29727354/applying-machine-learning-to-pediatric-critical-care-data
#18
Jon B Williams, Debjit Ghosh, Randall C Wetzel
OBJECTIVES: To explore whether machine learning applied to pediatric critical care data could discover medically pertinent information, we analyzed clinically collected electronic medical record data, after data extraction and preparation, using k-means clustering. DESIGN: Retrospective analysis of electronic medical record ICU data. SETTING: Tertiary Children's Hospital PICU. PATIENTS: Anonymized electronic medical record data from PICU admissions over 10 years...
April 30, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#19
Javed Ismail, M Jayashree
Septic shock in children is associated with high mortality, especially in developing countries. Management includes early recognition, timely antibiotics, aggressive fluid resuscitation, and appropriate vasoactive therapy, to achieve the therapeutic end points. The evidence at each step in management has evolved over the past decade with a paradigm shift in emphasis from a 'protocolized care' to an 'individualized physiology-based care'. This shift mirrors the general trend one observes in critical care with respect to various treatment modalities i...
April 15, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29725174/clinico-radiologic-profile-of-pediatric-traumatic-brain-injury-in-western-rajasthan
#20
Pawan Kumar Dara, Manish Parakh, Shyama Choudhary, Hemant Jangid, Priyanka Kumari, Satyendra Khichar
Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI...
April 2018: Journal of Neurosciences in Rural Practice
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