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Pediatric shock

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https://www.readbyqxmd.com/read/29914246/role-of-hepcidin-in-the-diagnosis-of-sepsis-and-septic-shock-in-children
#1
Osman Yeşilbaş, Esra Şevketoğlu, Burcu Bursal Duramaz, Hasan Serdar Kıhtır, Asuman Gedikbaşı, Mey Talip Petmezci, Canan Baydemir
Background/aim: The purpose of this study is to compare the diagnostic value of hepcidin level with the white blood cell (WBC), C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6) levels in pediatric sepsis and septic shock. Materials and methods: A cohort of 89 individuals were divided into four groups: a healthy control group (HCG, n = 28), pediatric intensive care unit control group (PICUCG, n = 17), sepsis group (SG, n = 23), and septic shock group (SSG, n = 21). WBC, CRP, PCT, IL-6, and hepcidin levels were studied in the PICUCG, SG, and SSG, while hepcidin and IL-6 levels were studied in the HCG...
June 14, 2018: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29891404/influenza-associated-neurological-complications-during-2014-2017-in-taiwan
#2
Li-Wen Chen, Chao-Ku Teng, Yi-Shan Tsai, Jieh-Neng Wang, Yi-Fang Tu, Ching-Fen Shen, Ching-Chuan Liu
INTRODUCTION: Seasonal influenza-associated neurological complications had high mortality and morbidity rates in recent studies. We reported influenza-associated encephalitis/encephalopathy in children during 2014-2017 in Taiwan, focusing on neurological presentations, neuroimaging correlations, and critical care managements. MATERIALS/SUBJECTS: During January 1st 2014 to June 30th 2017, pediatric patients reported to the Taiwan Centers for Disease Control surveillance system for severe complicated influenza infections in the hospital were retrospectively reviewed...
June 8, 2018: Brain & Development
https://www.readbyqxmd.com/read/29808278/clinical-and-laboratory-predictors-of-blood-loss-in-young-swine-a-model-for-pediatric-hemorrhage
#3
Xiaoming Shi, Mary J Edwards, Jordan Guice, Richard Strilka, Brandon Propper
BACKGROUND: The pediatric patient's response to hemorrhage as a function of young age is not well understood. As a result, there is no consensus on optimal resuscitation strategies for hemorrhagic shock in pediatric patients, or on the identification of clinical triggers to prompt implementation. The study objective was to develop a model of pediatric hemorrhage using young pigs to simulate school-aged children, and determine clinical and laboratory indicators for significant hemorrhage...
May 28, 2018: Pediatric Surgery International
https://www.readbyqxmd.com/read/29799085/venoarterial-extracorporeal-membrane-oxygenation-support-for-neonatal-and-pediatric-refractory-septic-shock-more-than-15-years-of-learning
#4
Anna Solé, Iolanda Jordan, Sara Bobillo, Julio Moreno, Monica Balaguer, Lluisa Hernández-Platero, Susana Segura, Francisco José Cambra, Elisabeth Esteban, Javier Rodríguez-Fanjul
The objective of the study was to report our institutional experience in the management of children and newborns with refractory septic shock who required venoarterial extracorporeal membrane oxygenation (VA ECMO) treatment, and to identify patient-and infection-related factors associated with mortality. This is a retrospective case series in an intensive care unit of a tertiary pediatric center. Inclusion criteria were patients ≤ 18 years old who underwent a VA ECMO due to a refractory septic shock due to circulatory collapse...
May 24, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29788811/central-ecmo-for-circulatory-failure-following-pediatric-liver-transplantation
#5
John P Scott, Johnny C Hong, Nathan E Thompson, Ronald K Woods, George M Hoffman
We describe the case of a 4-year-old male with a past medical history significant for nephrotic syndrome, short-bowel syndrome and fulminant hepatic failure status post (s/p) liver transplant (LT) who developed early post-transplant allograft dysfunction (hyperbilirubinemia, coagulopathy) and septic shock requiring central extracorporeal membrane oxygenation (ECMO). He remained on ECMO for 85 hours before he was decannulated without event and later underwent repeat LT. This case highlights the potential of central ECMO to provide the circulatory output necessary to reverse distributive shock physiology in patients with sepsis and hepatic dysfunction following LT...
May 1, 2018: Perfusion
https://www.readbyqxmd.com/read/29782390/suspecting-hyperferritinemic-sepsis-in-iron-deficient-population-do-we-need-a-lower-plasma-ferritin-threshold
#6
Swarup Ghosh, Arun K Baranwal, Prateek Bhatia, Karthi Nallasamy
OBJECTIVES: Hyperferritinemia is being suggested to identify patients with sepsis-induced macrophage activation syndrome for early intervention. However, data among iron-deficient children are scarce. This study was planned to explore the biological behavior of plasma ferritin in children from communities with a high frequency of iron deficiency with septic shock and its association with the outcome. DESIGN: Prospective observational study. SETTING: Tertiary care teaching hospital in a low-middle income economy of South Asia...
May 18, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29768296/pediatric-diabetic-ketoacidosis-with-hypotensive-shock-and-rash-an-unusual-presentation
#7
Yehonatan Pasternak, Omer Niv, Yehezkel Hezi Waisman
We describe a previously healthy adolescent boy who presented with respiratory distress, hypotensive shock, and a diffuse erythematous rash. The final diagnosis was diabetic ketoacidosis. Caregivers should be alert to this unusual combination of symptoms in the emergency department setting in order to improve the recognition and management of children with new-onset diabetes.
May 15, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29762333/hemodynamic-shock-caused-by-tension-pneumoperitoneum-in-a-5-year-old-girl
#8
Marie-Sophie Zentar, Laureline Berteloot, Naziha Khen Dunlop, Olivier Bustarret, Bénédicte Pigneur, Gérard Cheron, François Angoulvant
Tension pneumoperitoneum is a relatively rare occurrence in the pediatric population. However, tension pneumoperitoneum is associated with significant morbidity and mortality if it is not promptly diagnosed and treated. A 5-year-old girl was admitted to emergency department with abdominal pain. She was in shock, and the radiograph film of the abdomen revealed a voluminous tension pneumoperitoneum. Aggressive fluid challenges were performed in intensive care followed by urgent laparotomy. Primary abdominal compartment due to trapped gas caused a decreased venous return and visceral perfusion...
May 14, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29756704/cerebrospinal-fluid-shunt-associated-infections-in-pediatrics-analysis-of-the-epidemiology-and-mortality-risk-factors
#9
Soledad González, Mirta Carbonaro, Ana G Fedullo, María I Sormani, María Del C Ceinos, Roberto González, María T Rosanova
INTRODUCTION: Infections are the most common complications of ventricular cerebrospinal fluid shunts. The objective of this study was to describe the clinical, microbiological, and evolutionary characteristics of children with ventricular cerebrospinal fluid shunt-associated infections and analyze the risk factors for mortality. POPULATION AND METHODS: Descriptive, retrospective study carried out at Hospital "Prof. Dr. Juan P. Garrahan" in the Autonomous City of Buenos Aires...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29747317/-value-of-procalcitonin-in-predicting-the-severity-and-prognosis-of-neonates-with-septicemia
#10
J Zhang, D Qu, X X Ren, X D Cui, J Fu
Objective: To explore the value of procalcitonin(PCT) in predicting the severity and prognosis of neonates with septicemia. Methods: The clinical data of the hospitalized neonates over the age of 72 hours with double positive blood cultures from December 1st, 2011 to September 30, 2017 at the neonatal intensive care unit of Children's Hospital Affiliated to Capital Institute of Pediatrics was analyzed retrospectively. Results: A total of 75 neonates were included in the study. There was a significant negative correlation between PCT and neonatal critical illness score ( r =-0...
April 24, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29742212/accidental-strangulation-in-children-by-the-automatic-closing-of-a-car-window
#11
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/29740571/hands-on-defibrillation-skills-of-pediatric-acute-care-providers-during-a-simulated-ventricular-fibrillation-cardiac-arrest-scenario
#12
Utpal S Bhalala, Niveditha Balakumar, Maria Zamora, Elumalai Appachi
Introduction: Timely defibrillation in ventricular fibrillation cardiac arrest (VFCA) is associated with good outcome. While defibrillation skills of pediatric providers have been reported to be poor, the factors related to poor hands-on defibrillation skills of pediatric providers are largely unknown. The aim of our study was to evaluate delay in individual steps of the defibrillation and human and non-human factors associated with poor hands-on defibrillation skills among pediatric acute care providers during a simulated VFCA scenario...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29736378/confidence-level-of-pediatric-trainees-in-management-of-shock-states
#13
Kavita Morparia, Julie Berg, Sonali Basu
AIM: To assess overall confidence level of trainees in assessing and treating shock, we sought to improve awareness of recurrent biases in clinical decision-making to help address appropriate educational interventions. METHODS: Pediatric trainees on a national listserv were offered the opportunity to complete an electronic survey anonymously. Four commonly occurring clinical scenarios were presented, and respondents were asked to choose whether or not they would give fluid, rank factors utilized in decision-making, and comment on confidence level in their decision...
May 4, 2018: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29732457/a-computable-definition-of-sepsis-facilitates-screening-and-performance-improvement-tracking
#14
Lauren J Alessi, Holly R Warmus, Erin K Schaffner, Sajel Kantawala, Joseph Carcillo, Johanna Rosen, Christopher M Horvat
Background: Sepsis kills almost 5,000 children annually, accounting for 16% of pediatric health care spending in the United States. Objectives: We sought to identify sepsis within the Electronic Health Record (EHR) of a quaternary children's hospital to characterize disease incidence, improve recognition and response, and track performance metrics. Methods: Methods are organized in a plan-do-study-act cycle. During the "plan" phase, electronic definitions of sepsis (blood culture and antibiotic within 24 hours) and septic shock (sepsis plus vasoactive medication) were created to establish benchmark data and track progress with statistical process control...
March 2018: Pediatric Quality & Safety
https://www.readbyqxmd.com/read/29726824/advances-in-the-management-of-pediatric-septic-shock-old-questions-new-answers
#15
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/29720802/a-viral-polymyositis-masquerade-life-threatening-case-of-juvenile-dermatomyositis-complicated-by-systemic-capillary-leak-syndrome
#16
Bhaskara P Shelley, Shrijeet Chakraborti
This is a case report of an 8-year-old boy who developed an atypical, rare subphenotype of autoimmune inflammatory acute juvenile dermatomyositis (JDM), initially masquerading as viral polymyositis (PM)-like presentation, that was complicated by a hitherto unreported fulminant, life-threatening pediatric systemic capillary leak syndrome (SCLS). We highlight the close differential between viral PM and JDM, the baffling clinical syndromic constellation of hypotension with hemoconcentration - a "shock"-like syndrome, hypoalbuminemia without albuminuria, and generalized edema with the atypical JDM presentation, and stress crucial need to implement early aggressive, multipronged immunomodulatory treatment along with intensive fluid resuscitation which saved the life, this patient from a stormy, and turbulent 4-week clinical illness...
January 2018: Annals of Indian Academy of Neurology
https://www.readbyqxmd.com/read/29699503/comparison-of-the-incidence-clinical-features-and-outcomes-of-invasive-candidiasis-in-children-and-neonates
#17
Jen-Fu Hsu, Mei-Yin Lai, Chiang-Wen Lee, Shih-Ming Chu, I-Hsyuan Wu, Hsuan-Rong Huang, I-Ta Lee, Ming-Chou Chiang, Ren-Huei Fu, Ming-Horng Tsai
BACKGROUND: Invasive candidiasis differs greatly between children and neonates. We aimed to investigate the different therapeutic approaches and their effects on treatment outcomes of these two groups. METHODS: Episodes of neonatal invasive candidiasis were compared with non-neonatal pediatric episodes during a 12-year cohort study. Clinical isolates were documented by matrix-assisted laser desorption/ionization-time of flight mass spectrometry and DNA sequencing, and antifungal susceptibility testing was performed...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29685473/acute-pediatric-colchicine-toxicity-is-associated-with-marked-bradydysrhythmias
#18
Lamya Mubayed, Brie-Ann A Muller, Jessica L Jacobson, Howard A Hast, Hoang H Nguyen
BACKGROUND: Colchicine ingestion is rare but highly lethal. Patients usually die of multiorgan failure and cardiogenic shock. Colchicine is not only associated with depressed myocardial function but also with fatal heart rhythm disturbances, such as complete heart block, ventricular tachycardia, and asystole. While histologic changes of myocytes are well known, the mechanism by which colchicine affects cardiac impulse generation and conduction is not fully understood. CASE REPORT: We present a case of colchicine ingestion with sinus bradycardia, marked sinus arrhythmia, and first- and second-degree heart block...
April 20, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#19
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
July 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#20
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
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