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Pediatric respiratory

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https://www.readbyqxmd.com/read/28437378/risk-factors-for-pediatric-extubation-failure-the-importance-of-respiratory-muscle-strength
#1
Robinder G Khemani, Tro Sekayan, Justin Hotz, Rutger C Flink, Gerrard F Rafferty, Narayan Iyer, Christopher J L Newth
OBJECTIVE: Respiratory muscle weakness frequently develops during mechanical ventilation, although in children there are limited data about its prevalence and whether it is associated with extubation outcomes. We sought to identify risk factors for pediatric extubation failure, with specific attention to respiratory muscle strength. DESIGN: Secondary analysis of prospectively collected data. SETTING: Tertiary care PICU. PATIENTS: Four hundred nine mechanically ventilated children...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28434554/the-simulation-based-assessment-of-pediatric-rapid-response-teams
#2
James J Fehr, Mary E McBride, John R Boulet, David J Murray
OBJECTIVE: To create scenarios of simulated decompensating pediatric patients to train pediatric rapid response teams (RRTs) and to determine whether the scenario scores provide a valid assessment of RRT performance with the hypothesis that RRTs led by intensivists-in-training would be better prepared to manage the scenarios than teams led by nurse practitioners. STUDY DESIGN: A set of 10 simulated scenarios was designed for the training and assessment of pediatric RRTs...
April 20, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28433211/adverse-events-during-a-randomized-trial-of-ketamine-versus-co-administration-of-ketamine-and-propofol-for-procedural-sedation-in-a-pediatric-emergency-department
#3
Keith Weisz, Lalit Bajaj, Sara J Deakyne, Lina Brou, Alison Brent, Joseph Wathen, Genie E Roosevelt
BACKGROUND: The co-administration of ketamine and propofol (CoKP) is thought to maximize the beneficial profile of each medication, while minimizing the respective adverse effects of each medication. OBJECTIVE: Our objective was to compare adverse events between ketamine monotherapy (KM) and CoKP for procedural sedation and analgesia (PSA) in a pediatric emergency department (ED). METHODS: This was a prospective, randomized, single-blinded, controlled trial of KM vs...
April 19, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28428678/productive-cough-in-children-and-adolescents-view-from-primary-health-care-system
#4
REVIEW
Edin Begic, Zijo Begic, Amra Dobraca, Edo Hasanbegovic
Cough is one of the most common symptoms that doctor faces in working with pediatric population, and according to some characteristics of cough, doctors can often conclude localization, and sometimes even the nature of the disease that causes it. Cough is not only the physiological defense reaction, but a symptom of a disease. According to duration it can be acute, chronic and recidivist, recurrent and persistent, strong or discreet, caused by changes in body position and changes in outside temperature. Pathoanatomically it is divided into lobar, lobular, alveolar and interstitial, pathogenetically to bronchogenic and hematogenous, as well as in immuno competent and immunocompromised, and clinically on the local and inpatient (72 hours after hospital admission)...
February 2017: Medical Archives
https://www.readbyqxmd.com/read/28426447/measles-cases-in-children-requiring-hospital-access-in-an-academic-pediatric-hospital-in-italy-2008-2013
#5
Marta Ciofi Degli Atti, Antonietta Filia, Antonino Bella, Annamaria Sisto, Maria Antonietta Barbieri, Antonino Reale, Massimiliano Raponi
BACKGROUND: The Lazio Region is one of the Italian regions where sustained measles transmission continues to occur. We investigated measles cases reported by the Emergency Department (ED) of the largest pediatric hospital in Italy, located in Lazio. METHODS: We reviewed clinical records of all measles cases from 0 to 18 years of age evaluated in the ED in 2008-2013. We compared demographic and clinical characteristics of patients admitted to the inpatient setting with those of patients discharged home, to assess possible determinants of hospital admission...
April 18, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28425226/a-review-of-pediatric-pulmonary-hypertension-with-new-guidelines
#6
Serdar Kula, Ayhan Pektaş
This study aims to review pediatric pulmonary hypertension (PH) by comparing the guidelines of the European Society of Cardiology (ESC)/European Respiratory Society (ERS), the American Heart Association (AHA)/American Thoracic Society (ATS), and the European Pediatric Pulmonary Vascular Disease Network (EPPVDN). All three sets of guidelines define PH as having a mean pulmonary artery pressure of ≥25 mmHg and accept the validity of the World Health Organization (WHO) classification system. Every child with a high index of suspicion for PH should undergo an initial work-up of chest X-rays, electrocardiography, and echocardiography...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28424289/disruption-of-mda5-mediated-innate-immune-responses-by-the-3c-proteins-of-coxsackievirus-a16-coxsackievirus-a6-and-enterovirus-d68
#7
Yajuan Rui, Jiaming Su, Hong Wang, Junliang Chang, Shaohua Wang, Wenwen Zheng, Yong Cai, Wei Wei, James T Gordy, Richard Markham, Wei Kong, Wenyan Zhang, Xiao-Fang Yu
Coxsackievirus A16 (CV-A16), A6 (CV-A6), and enterovirus D68 (EV-D68) belong to the Picornaviridae family and are major causes of hand, foot, and mouth disease (HFMD) and pediatric respiratory disease worldwide. The biological characteristics of these viruses, especially their interplay with the host innate immune system, have not been well investigated. In this study, we discovered that the 3C(pro) proteins from CV-A16, CV-A6, and EV-D68 bind MDA5 and inhibit its interaction with MAVS. Consequently, MDA5-triggered type I IFN signaling in the RLR pathway was blocked by CV-A16, CV-A6, and EV-D68 3C(pro) Furthermore, CV-A16, CV-A6, and EV-D68 3C(pro) all cleave TAK1, resulting in inhibition of NF-κB activation, a host response also critical for toll-like receptor (TLR) mediated signaling...
April 19, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28422948/beyond-the-uterine-environment-nonhuman-primate-model-to-investigate-maternal-fetal-and-neonatal-outcomes-following-chronic-intrauterine-infection
#8
Meredith A Kelleher, Zheng Liu, Xiaojie Wang, Christopher D Kroenke, Lisa A Houser, Brandy L Dozier, Lauren D Martin, Ken B Waites, Cindy McEvoy, Robert L Schelonka, Peta L Grigsby
BACKGROUND: Intrauterine infection is a significant cause of early preterm birth. We have developed a fetal-neonatal model in the rhesus macaque to determine the impact of chronic intrauterine infection with Ureaplasma parvum on early neonatal reflexes and brain development. METHODS: Time-mated, pregnant rhesus macaques were randomized to be inoculated with U. parvum (serovar 1; 10(5)cfu) or control media at ~120 dGA. Neonates were delivered by elective hysterotomy at 135-147 dGA (term=167d) stabilized and cared for in our nonhuman primate neonatal intensive care unit...
April 19, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28420262/impact-of-an-educational-intervention-to-improve-physician-adherence-to-bronchiolitis-clinical-practice-guidelines-a-pre-post-intervention-study
#9
Marquita C Genies, Julia M Kim, Kristina Pyclik, Suzanne Rossi, Natalie Spicyn, Janet R Serwint
Bronchiolitis is the leading cause of infant hospitalizations in the United States. Despite clinical practice guidelines discouraging the utilization of non-evidence-based therapies, there continues to be wide variation in care and resource utilization. A pre-post physician focused educational intervention was conducted with the aims to reduce the use of non-evidence-based medical therapies, including bronchodilators, among patients admitted for bronchiolitis. Among patients meeting inclusion criteria (pre: n = 45; post: n = 47), bronchodilator use decreased by 50% ( P < ...
April 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/28419085/neonatal-outcomes-of-moderatelyly-preterm-infants-compared-to-extremely-preterm-infants
#10
Michele C Walsh, Edward F Bell, Sarah Kandefer, Shampa Saha, Waldemar A Carlo, Carl T D'Angio, Abbot R Laptook, Pablo J Sanchez, Barbara J Stoll, Seetha Shankaran, Krisa P Van Meurs, Noah Cook, Rosemary D Higgins, Abhik Das, Nancy S Newman, Kurt Schibler, Barbara Schmidt, C Michael Cotten, Brenda B Poindexter, Kristi L Watterberg, William E Truog
BACKGROUND: Extremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the U.S., yet these infants are focus of most published research. Moderately preterm neonates (MPT, 29-33(6/7) weeks), are an understudied group of high-risk infants. METHODS: Objective: To determine the neonatal outcomes of MPT across the gestational age spectrum, and to compare these to EPT. A prospective observational cohort was formed in 18 Level 3-4 NICUs in the Eunice Kennedy Shriver NICHD Neonatal Research Network...
April 18, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28419061/functional-status-of-neonatal-and-pediatric-patients-after-extracorporeal-membrane-oxygenation
#11
Katherine Cashen, Ron Reeder, Heidi J Dalton, Robert A Berg, Thomas P Shanley, Christopher J L Newth, Murray M Pollack, David Wessel, Joseph Carcillo, Rick Harrison, J Michael Dean, Tammara Jenkins, Kathleen L Meert
OBJECTIVES: To describe functional status at hospital discharge for neonatal and pediatric patients treated with extracorporeal membrane oxygenation, and identify factors associated with functional status and mortality. DESIGN: Secondary analysis of observational data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. SETTING: Eight hospitals affiliated with the Collaborative Pediatric Critical Care Research Network...
April 17, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28418347/difficult-cases-of-odontogenic-deep-neck-infections-a-report-of-three-patients
#12
Onur İsmi, Mesut Yeşilova, Cengiz Özcan, Yusuf Vayisoğlu, Kemal Görür
BACKGROUND: Deep neck infections are important otolaryngologic emergencies due to serious complications and the risk of airway compromise, which can lead to mortality. Although the most common causes among pediatric patients are tonsillitis and pharyngeal infections, odontogenic infections are an important cause in adults. CASE REPORT: We present three patients with multiple deep neck space abscess formation due to odontogenic infection. Two of them required tracheotomy due to airway compromise, and one had mediastinitis...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28416430/-extracorporeal-membrane-oxygenation-in-critically-ill-neonates-and-children
#13
J Rambaud, J Guilbert, I Guellec, S Jean, A Durandy, M Demoulin, A Amblard, R Carbajal, P-L Leger
Extracorporeal membrane oxygenation is used as a last resort during neonatal and pediatric resuscitation in case of refractory circulatory or respiratory failure under maximum conventional therapies. Different types of ECMO can be used depending on the initial failure. The main indications for ECMO are refractory respiratory failure (acute respiratory distress syndrome, status asthmaticus, severe pneumonia, meconium aspiration syndrome, pulmonary hypertension) and refractory circulatory failure (cardiogenic shock, septic shock, refractory cardiac arrest)...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#14
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28413621/recent-advances-in-pediatric-ventilatory-assistance
#15
REVIEW
Nicolas Nardi, Guillaume Mortamet, Laurence Ducharme-Crevier, Guillaume Emeriaud, Philippe Jouvet
In this review on respiratory assistance, we aim to discuss the following recent advances: the optimization and customization of mechanical ventilation, the use of high-frequency oscillatory ventilation, and the role of noninvasive ventilation. The prevention of ventilator-induced lung injury and diaphragmatic dysfunction is now a key aspect in the management of mechanical ventilation, since these complications may lead to higher mortality and prolonged length of stay in intensive care units. Different physiological measurements, such as esophageal pressure, electrical activity of the diaphragm, and volumetric capnography, may be useful objective tools to help guide ventilator assistance...
2017: F1000Research
https://www.readbyqxmd.com/read/28413125/transient-dysautonomia-in-an-acute-phase-of-encephalopathy-with-biphasic-seizures-and-late-reduced-diffusion
#16
Yuko Ichimiya, Noriyuki Kaku, Yasunari Sakai, Fumiya Yamashita, Wakato Matsuoka, Mamoru Muraoka, Satoshi Akamine, Soichi Mizuguchi, Michiko Torio, Yoshitomo Motomura, Yuichiro Hirata, Yoshito Ishizaki, Masafumi Sanefuji, Hiroyuki Torisu, Hidetoshi Takada, Yoshihiko Maehara, Shouichi Ohga
Paroxysmal sympathetic hyperactivity (PSH) is a dysautonomic condition that is associated with various types of acquired brain injuries. Traumatic brain lesions have been documented as the leading cause of PSH. However, detailed clinical features of pediatric PSH caused by intrinsic brain lesions remain to be elusive. We present a 3-year-old boy, who had been diagnosed as having cerebral palsy, developmental delay and epilepsy after perinatal hypoxia-induced brain injury. He developed status epilepticus with fever on the third day of respiratory infection...
April 13, 2017: Brain & Development
https://www.readbyqxmd.com/read/28412073/pediatric-acute-flaccid-paralysis-enterovirus-d68-associated-anterior-myelitis
#17
James A Yoder, Michael Lloyd, Luke Zabrocki, Jonathan Auten
BACKGROUND: Enteroviral infections can cause acute flaccid paralysis secondary to anterior myelitis. Magnetic resonance imaging (MRI) is important in the diagnosis of this potentially devastating pediatric disease. Before the 2014 outbreak of Enterovirus D68 (EV-D68), the virus was considered a relatively benign disease. CASE REPORT: A fully immunized 8-year-old boy was brought to the emergency department complaining of a cough, headache, neck pain, and right arm pain and weakness...
April 12, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28410811/long-term-non-invasive-ventilation-therapies-in-children-a-scoping-review
#18
REVIEW
Maria L Castro-Codesal, Kristie Dehaan, Robin Featherstone, Prabhjot K Bedi, Carmen Martinez Carrasco, Sherri L Katz, Elaine Y Chan, Glenda N Bendiak, Fernanda R Almeida, Deborah L Olmstead, Rochelle Young, Vicki Woolf, Karen A Waters, Colin Sullivan, Lisa Hartling, Joanna E MacLean
Long-term non-invasive ventilation (NIV) is a common modality of breathing support used for a range of sleep and respiratory disorders. The aim of this scoping review was to provide a summary of the literature relevant to long-term NIV use in children. We used systematic methodology to identify 11,581 studies with final inclusion of 289. We identified 76 terms referring to NIV; the most common term was NIV (22%). Study design characteristics were most often single center (84%), observational (63%), and retrospective (54%)...
March 2, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/28410274/three-hypothetical-inflammation-pathobiology-phenotypes-and-pediatric-sepsis-induced-multiple-organ-failure-outcome
#19
Joseph A Carcillo, E Scott Halstead, Mark W Hall, Trung C Nguyen, Ron Reeder, Rajesh Aneja, Bita Shakoory, Dennis Simon
OBJECTIVES: We hypothesize that three inflammation pathobiology phenotypes are associated with increased inflammation, proclivity to develop features of macrophage activation syndrome, and multiple organ failure-related death in pediatric severe sepsis. DESIGN: Prospective cohort study comparing children with severe sepsis and any of three phenotypes: 1) immunoparalysis-associated multiple organ failure (whole blood ex vivo tumor necrosis factor response to endotoxin < 200 pg/mL), 2) thrombocytopenia-associated multiple organ failure (new onset thrombocytopenia with acute kidney injury and a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13 activity < 57%), and/or 3) sequential multiple organ failure with hepatobiliary dysfunction (respiratory distress followed by liver dysfunction with soluble Fas ligand > 200 pg/mL), to those without any of these phenotypes...
April 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28410087/racial-and-ethnic-disparities-in-parental-refusal-of-consent-in-a-large-multisite-pediatric-critical-care-clinical-trial
#20
Joanne E Natale, Ruth Lebet, Jill G Joseph, Christine Ulysse, Judith Ascenzi, David Wypij, Martha A Q Curley
OBJECTIVE: To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. STUDY DESIGN: We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation...
May 2017: Journal of Pediatrics
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