Read by QxMD icon Read

pediatric delirium

Laura S Bonanno, Stephanie Pierce, Jennifer Badeaux, James J FitzSimons
This review aims to identify the effectiveness of preoperative intranasal dexmedetomidine compared with oral midazolam for the prevention of emergence delirium in pediatric patients undergoing general anesthesia.
August 2016: JBI Database of Systematic Reviews and Implementation Reports
Nienke J Vet, Niina Kleiber, Erwin Ista, Matthijs de Hoog, Saskia N de Wildt
This article discusses the rationale of sedation in respiratory failure, sedation goals, how to assess the need for sedation as well as effectiveness of interventions in critically ill children, with validated observational sedation scales. The drugs and non-pharmacological approaches used for optimal sedation in ventilated children are reviewed, and specifically the rationale for drug selection, including short- and long-term efficacy and safety aspects of the selected drugs. The specific pharmacokinetic and pharmacodynamic aspects of sedative drugs in the critically ill child and consequences for dosing are presented...
2016: Frontiers in Pediatrics
Yiquan Lin, Ying Chen, Jingxia Huang, Hongbin Chen, Weihua Shen, Wenjun Guo, Qianru Chen, Hongfeng Ling, Xiaoliang Gan
STUDY OBJECTIVES: This study aimed to test the hypothesis that premedication with a single dose of intranasal dexmedetomidine (DEX) could not only reduce preoperative anxiety but also minimize the emergence agitation in children undergoing cataract surgery with sevoflurane anesthesia. DESIGN: Single-blinded, randomized, placebo-controlled clinical comparison study. SETTING: Academic medical center. PATIENTS: Ninety American Society of Anesthesiologists physical status 1 and 2 children scheduled for cataract surgery...
September 2016: Journal of Clinical Anesthesia
Chani Traube, Elizabeth A Mauer, Linda M Gerber, Savneet Kaur, Christine Joyce, Abigail Kerson, Charlene Carlo, Daniel Notterman, Stefan Worgall, Gabrielle Silver, Bruce M Greenwald
OBJECTIVE: To determine the costs associated with delirium in critically ill children. DESIGN: Prospective observational study. SETTING: An urban, academic, tertiary-care PICU in New York city. PATIENTS: Four-hundred and sixty-four consecutive PICU admissions between September 2, 2014, and December 12, 2014. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All children were assessed for delirium daily throughout their PICU stay...
August 11, 2016: Critical Care Medicine
Gonzalo Garcia Guerra, Ari R Joffe, Dominic Cave, Jonathan Duff, Shannon Duncan, Cathy Sheppard, Gerda Tawfik, Lisa Hartling, Hsing Jou, Sunita Vohra
BACKGROUND: Despite the fact that almost all critically ill children experience some degree of pain or anxiety, there is a lack of high-quality evidence to inform preferred approaches to sedation, analgesia, and comfort measures in this environment. We conducted this survey to better understand current comfort and sedation practices among Canadian pediatric intensivists. METHODS: The survey was conducted after a literature review and initial focus groups. The survey was then pretested and validated...
September 2016: Pediatric Critical Care Medicine
Ira M Cheifetz
Led by the work of the Pediatric Acute Lung Injury Consensus Conference, much was published on the topic of pediatric ARDS in 2015. Although the availability of definitive data to the pediatric practitioner for the management of infants and children with pediatric ARDS continues to lag behind that for the adult clinician, 2015 augmented the available medical literature with more information than had been seen for years. This article will review key pediatric ARDS publications with a focus on the Pediatric Acute Lung Injury Consensus Conference consensus definition, sedation management, use of high-frequency oscillatory ventilation, diagnosis of delirium, noninvasive respiratory support, lung-protective ventilation, and adjunct management therapies...
July 2016: Respiratory Care
Melissa Brosset Ugas, Timothy Carroll, Lacey Kovar, Susana Chavez-Bueno
Typhoid fever is commonly characterized by fever and abdominal pain. Rare complications include intestinal hemorrhage, bowel perforation, delirium, obtundation, and septic shock. Herein we describe the case of a previously healthy 16-year-old male without history of travel, diagnosed with typhoid fever complicated by septic shock and acute respiratory distress syndrome treated with high-dose dexamethasone. This case details severe complications of typhoid fever that are uncommonly seen in developed countries, and the successful response to high-dose dexamethasone as adjunct therapy...
April 2016: Journal of Investigative Medicine High Impact Case Reports
Alawi Luetz, Dennis Gensel, Judith Müller, Bjoern Weiss, Viktoria Martiny, Andreas Heinz, Klaus-Dieter Wernecke, Claudia Spies
OBJECTIVES: To evaluate test validity of the Pediatric Confusion Assessment Method for the ICU, the Pediatric Anesthesia Emergence Delirium scale, and the newly developed severity scale for the Pediatric Confusion Assessment Method for the ICU; to prospectively assess covariates and their influence on test validity of the scores. DESIGN: Prospective observational cohort study. SETTING: PICU of a tertiary care medical center. PATIENTS: Critically ill patients 5 years old or older ventilated or nonventilated with an ICU length of stay of at least 24 hours...
June 7, 2016: Critical Care Medicine
Aleksandra Gavrilovska-Brzanov, Biljana Kuzmanovska, Andrijan Kartalov, Ljupco Donev, Albert Lleshi, Marija Jovanovski-Srceva, Tatjana Spirovska, Nikola Brzanov, Risto Simeonov
AIM: The aim of this study is to evaluate anesthesia and recovery profile in pediatric patients after inguinal hernia repair with caudal block or local wound infiltration. MATERIAL AND METHODS: In this prospective interventional clinical study, the anesthesia and recovery profile was assessed in sixty pediatric patients undergoing inguinal hernia repair. Enrolled children were randomly assigned to either Group Caudal or Group Local infiltration. For caudal blocks, Caudal Group received 1 ml/kg of 0...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Ramona O Hopkins, Karen Choong, Carleen A Zebuhr, Sapna R Kudchadkar
Children who survive a critical illness are at risk of developing significant, long-lasting morbidities that may include neuromuscular weakness, cognitive impairments, and new mental health disorders. These morbidities, collectively known as post-intensive care syndrome (PICS), may lead to functional impairments, difficulty in school and social settings, and reduced quality of life. Interventions aimed at rehabilitation such as early mobilization, sedation minimization and prevention of ICU-acquired weakness, delirium, and posttraumatic stress disorder may lead to improved clinical outcomes and functional recovery in critically ill children...
December 2015: Journal of Pediatric Intensive Care
Joseph A Giovannitti
PURPOSE OF REVIEW: Anesthesia for dentistry is commonly performed outside the operating room. The combination of a shared airway between surgeon and anesthetist, the variety of open airway techniques, and the out-of-operating room setting often results in anxiety and avoidance of dental cases among anesthesia personnel. This review attempts to demystify dental treatment and facilitate the anesthesia provider in providing effective sedation of dental procedures performed in the nonoperating room setting...
August 2016: Current Opinion in Anaesthesiology
Khyati Brahmbhatt, Emily Whitgob
Delirium in children is common but not widely understood by pediatric practitioners, often leading to underdiagnosis and lack of treatment. This presents a significant challenge in the young patients in the PICU who are most at risk for delirium and in whom the core features of delirium are difficult to assess and treat. However, because of the potential increased morbidity and mortality associated with untreated delirium in adults and children, it remains important to address it promptly. The literature for delirium in this age group is limited...
March 2016: Pediatrics
In-Kyung Song, Yong-Hee Park, Ji-Hyun Lee, Jin-Tae Kim, In Ho Choi, Hee-Soo Kim
BACKGROUND: Preemptive analgesia is an anti-nociceptive treatment that starts before surgery and prevents the establishment of central sensitization. Whether preemptive analgesia is more effective than conventional regimens for managing postoperative pain remains controversial. This study evaluated the efficacy of intravenous preemptive analgesia for acute postoperative pain control in pediatric patients. METHODS: In this prospective randomized controlled trial, 51 children aged 3-7 years, scheduled for corrective osteotomy were randomized into control (group C) or preemptive (group P) group...
April 2016: Paediatric Anaesthesia
Chandima Divithotawela, Peter Garrett, Glen Westall, Balu Bhaskar, Maneesha Tol, Daniel C Chambers
Hemophagocytic lymphohistiocytosis (HLH) is a rare, frequently under-recognized condition associated with multi-organ failure and very high mortality. A 44-year-old woman was admitted with a 4-day history of fever, headache, delirium, and dyspnea. She progressed rapidly to type 1 respiratory failure and required intubation and mechanical ventilation. Laboratory tests showed pancytopenia, abnormal liver enzyme levels, elevated triglyceride level, and elevated ferritin level. Bone marrow biopsy showed features of HLH...
March 2016: Respirology Case Reports
Keith K Abe, Roshni L Koli, Loren G Yamamoto
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is an acute autoimmune neurological disorder that presents with acute to subacute psychiatric and/or neurological complaints including new onset behavioral changes that may evolve to psychosis and catatonia, cognitive decline, new onset seizures, progressive encephalopathy, and/or movement disorders. Female teens and adults often have an associated ovarian teratoma as an underlying etiology, but most pediatric patients do not have an identifiable associated neoplasm...
February 2016: Pediatric Emergency Care
Mary Saliski, Sapna R Kudchadkar
Achieving successful early mobilization for the intubated, critically ill child is dependent on optimizing sedation and analgesia. Finding the fine balance between oversedation and undersedation can be challenging. The ideal is for a child to be lucid and interactive during the daytime and demonstrate normal circadian rhythm for sleep with rest at night. Being alert during the day facilitates active participation in therapy including potential ambulation, while decreasing the risk of delirium during mechanical ventilation...
2015: Journal of Pediatric Intensive Care
Jan N M Schieveld, Jurjen J van Zwieten
OBJECTIVE: We aim to provide evidence for our view that a single, standardized (and preferably observational) screening tool for delirium should be used in patients of all ages (children, adults, and the elderly). DATA SOURCES: To support our viewpoint, we searched, in the period February 25, 2015, to August 5, 2015, Pubmed and all the major textbooks. STUDY SELECTION: We searched PubMed using the following terms: "delirium," "screening tool," "pediatric," "adult," "elderly," "unifying," "observational," "CAPD," and "DOS...
September 2016: Critical Care Medicine
Yang Liu, Dao-Lin Kang, He-Yi Na, Bi-Lian Li, Ying-Yi Xu, Jin Ni, Jun-Zheng Wu
Children with cerebral palsy can demonstrate irritability following emergence from general anaesthesia. As well, an elevated rate of emergence delirium (ED) in children has been associated with the application of sevoflurane. The current study's intent is to administer dexmedetomidine, in a single dosage administration, at the initial phase of sevoflurane based anesthesia with regard to the occurrence and severity of ED in children afflicted with cerebral palsy. Participating in the study (American Society of Anesthesiologists I-II) are eighty children ranging in ages two through twelve years...
2015: International Journal of Clinical and Experimental Medicine
Wanying Pan, Yueting Wang, Lin Lin, Ge Zhou, Xiaoxiao Hua, Liqiu Mo
BACKGROUND: Dexmedetomidine decreases cardiac complications in adults undergoing cardiovascular surgery. This systematic review assessed whether perioperative dexmedetomidine improves congenital heart disease (CHD) surgery outcomes in children. METHODS: The PubMed, Embase, and Cochrane Library databases were searched for randomized controlled trials (RCTs) or observational studies that were published until 16 April 2015 and compared dexmedetomidine with placebo or an alternative anesthetic agent during pediatric CHD surgery...
March 2016: Paediatric Anaesthesia
Nobuko Ohashi, Sadahei Denda, Kenta Furutani, Takayuki Yoshida, Yoshinori Kamiya, Reiko Komura, Hironobu Nishimaki, Yasushi Iinuma, Yutaka Hirayama, Shinichi Naitou, Koju Nitta, Hiroshi Baba
PURPOSE: Emergence delirium (ED) is a common postoperative complication of ambulatory pediatric surgery done under general anesthesia with sevoflurane. However, perioperative analgesic techniques have been shown to reduce sevoflurane-induced ED. The primary objective of this investigation was to examine whether an ultrasound-guided ilioinguinal/iliohypogastric (II/IH) nerve block for ambulatory pediatric inguinal hernia repair could reduce the incidence of sevoflurane-induced ED. METHODS: The subjects of this prospective randomized double-blind study were 40 boys ranging in age from 1 to 6 years, who were scheduled to undergo ambulatory inguinal hernia repair...
August 2016: Surgery Today
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"