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https://www.readbyqxmd.com/read/29150070/decreased-expression-of-indolamine-2-3-dioxygenase-in-childhood-allergic-asthma-and-its-inverse-correlation-with-fractional-concentration-of-exhaled-nitric-oxide
#1
Ying Hu, Zhiqiang Chen, Ling Jin, Mei Wang, Wei Liao
BACKGROUND: The tryptophan metabolic pathway mediated by indolamine 2,3-dioxygenase (IDO), a tryptophan-degrading enzyme, plays an important role in controlling the development of allergic inflammation. The fractional concentration of exhaled nitric oxide (FeNO) is closely associated with the allergic state and is extensively used for the clinical evaluation of airway allergic inflammation. Clinical trials have rarely assessed the expression of IDO in childhood allergic asthma and its correlation with FeNO...
November 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29149429/population-analysis-of-predictors-of-difficult-intubation-with-direct-laryngoscopy-in-pediatric-patients-with-and-without-thyroid-disease
#2
Aalap C Shah, William C K Ng, Sean Sinnott, Joseph P Cravero
PURPOSE: There are no data on the prevalence and predictors of difficult intubation (DI) in pediatric patients with thyroid disease. This study (1) assesses the prevalence of DI in patients with thyroid disease undergoing elective operations, (2) identifies other predictors of DI in children, and (3) evaluates the effect of DI on postoperative care and length-of-stay. METHODS: A single-center retrospective cohort analysis of procedures in patients assigned with an ICD-9 code for thyroid disease between June 2012 and February 2016...
November 17, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29148150/pressure-flow-characteristics-of-breathing-systems-and-their-components-for-pediatric-and-adult-patients
#3
Christin Wenzel, Stefan Schumann, Johannes Spaeth
BACKGROUND: Breathing circuits connect the ventilator to the patients' respiratory system. Breathing tubes, connectors, and sensors contribute to artificial airway resistance to a varying extent. We hypothesized that the flow-dependent resistance is higher in pediatric breathing systems and their components compared to respective types for adults. AIMS: We aimed to characterize the resistance of representative breathing systems and their components used in pediatric patients (including devices for adults) by their nonlinear pressure-flow relationship...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#4
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29148119/the-anatomy-of-the-pediatric-airway-has-our-knowledge-changed-in-120-years-a-review-of-historic-and-recent-investigations-of-the-anatomy-of-the-pediatric-larynx
#5
REVIEW
Josef Holzki, Karen A Brown, Robert G Carroll, Charles J Coté
BACKGROUND: There is disagreement regarding the anatomy of the pediatric airway, particularly regarding the shape of the cricoid cartilage and the location of the narrowest portion of the larynx. AIMS: The aim of this review is to clarify the origin and the science behind these differing views. METHODS: We undertook a review of published literature, University Libraries, and authoritative textbooks with key search words and phrases. RESULTS: In vivo observations suggest that the narrowest portion of the airway is more proximal than the cricoid cartilage...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29140970/clinical-impact-of-external-laryngeal-manipulation-during-laryngoscopy-on-tracheal-intubation-success-in-critically-ill-children
#6
Taiki Kojima, Elizabeth K Laverriere, Erin B Owen, Ilana Harwayne-Gidansky, Asha N Shenoi, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ronald C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Simon Li, Lee A Polikoff, Joy D Howell, Gabrielle Nuthall, Gokul K Bysani, Ana L Graciano, Guillaume Emeriaud, Osamu Saito, Alberto Orioles, Karen Walson, Philipp Jung, Awni M Al-Subu, Takanari Ikeyama, Rakshay Shetty, Kathleen M Yoder, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, the effectiveness to improve tracheal intubation attempt success rate in the nonanesthesia setting is not clear. The study objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in PICUs. DESIGN: A retrospective observational study using a multicenter emergency airway quality improvement registry...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#7
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29137881/comparison-between-chloral-hydrate-and-propofol-ketamine-as-sedation-regimens-for-pediatric-auditory-brainstem-response-testing
#8
Kamal Abulebda, Vinit J Patel, Sheikh S Ahmed, Alvaro J Tori, Riad Lutfi, Samer Abu-Sultaneh
INTRODUCTION: The use of diagnostic auditory brainstem response testing under sedation is currently the "gold standard" in infants and young children who are not developmentally capable of completing the test. OBJECTIVE: The aim of the study is to compare a propofol-ketamine regimen to an oral chloral hydrate regimen for sedating children undergoing auditory brainstem response testing. METHODS: Patients between 4 months and 6 years who required sedation for auditory brainstem response testing were included in this retrospective study...
October 28, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#9
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29124401/bronchoscopic-assessments-and-clinical-outcomes-in-pediatric-patients-with-tracheomalacia-and-bronchomalacia
#10
Yuichi Okata, Tomomi Hasegawa, Yuko Bitoh, Kosaku Maeda
BACKGROUND: Tracheomalacia and bronchomalacia (TM/BM) are one of the serious causes of airway obstruction in infants and children. This study reviewed our bronchoscopic assessments and clinical outcomes in pediatric patients with TM/BM, and investigated risk factors of surgical intervention for TM/BM. METHODS: Fifty-seven consecutive patients who were diagnosed as TM/BM by bronchoscopy between 2009 and 2013 were reviewed retrospectively. They were divided into two groups according to the presence (group E, n = 26) or absence (group N, n = 31) of acute life-threatening events and extubation failure (ALTE/EF)...
November 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29123910/management-of-pediatric-cannot-intubate-cannot-oxygenate
#11
Yohei Okada, Wataru Ishii, Norio Sato, Hirokazu Kotani, Ryoji Iiduka
Case: "Cannot intubate, cannot oxygenate" (CICO) is a rare, life-threatening situation. We describe a pediatric case of CICO and highlight some educational points.A 3-year-old boy who collapsed in the bathtub came to our emergency department. On admission, he went into cardiac arrest probably because of an airway obstruction. We judged his condition as CICO and carried out an emergent tracheostomy after several attempts to perform a cricothyroidotomy failed. We continued resuscitation; however, circulation did not return spontaneously...
October 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29116124/monocytes-from-patients-with-primary-ciliary-dyskinesia-show-enhanced-inflammatory-properties-and-produce-higher-levels-of-pro-inflammatory-cytokines
#12
M Cockx, M Gouwy, P Ruytinx, I Lodewijckx, A Van Hout, S Knoops, N Pörtner, I Ronsse, L Vanbrabant, V Godding, K De Boeck, J Van Damme, M Boon, S Struyf
Patients with Primary Ciliary Dyskinesia (PCD) suffer from recurrent upper and lower airway infections due to defects in the cilia present on the respiratory epithelium. Since chronic inflammatory conditions can cause changes in innate immune responses, we investigated whether monocytes isolated from the peripheral blood of pediatric PCD patients respond differently to inflammatory stimuli, compared to monocytes from healthy children and adults. The receptor for C5a (C5aR) was upregulated in PCD, whereas expression levels of the leukocyte chemoattractant receptors CCR1, CCR2, CCR5, BLT1 and FPR1 on PCD monocytes were similar to those on monocytes from healthy individuals...
November 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29114060/ethics-rounds-death-after-pediatric-dental-anesthesia-an-avoidable-tragedy
#13
Helen Lee, Peter Milgrom, Colleen E Huebner, Philip Weinstein, Wylie Burke, Erika Blacksher, John D Lantos
Early childhood caries (ECC) is the single most common chronic childhood disease. In the treatment of ECC, children are often given moderate sedation or general anesthesia. An estimated 100 000 to 250 000 pediatric dental sedations are performed annually in the United States. The most common medications are benzodiazepines, opioids, local anesthetics, and nitrous oxide. All are associated with serious adverse events, including hypoxemia, respiratory depression, airway obstruction, and death. There is no mandated reporting of adverse events or deaths, so we don't know how often these occur...
November 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#14
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29108843/outcomes-following-elective-resection-of-congenital-pulmonary-airway-malformations-are-equivalent-after-3-months-of-age-and-a-weight-of-5-kg
#15
Brian C Gulack, Harold J Leraas, Brian Ezekian, Jina Kim, Christopher Reed, Obinna O Adibe, Henry E Rice, Elisabeth T Tracy
PURPOSE: Resection of congenital pulmonary airway malformations (CPAMs) is often performed to reduce the risk of recurrent infection and malignant transformation. However, there is substantial variation in the timing of resection. This study was performed to determine the association of age and weight on outcomes following elective resection of CPAMs. METHODS: The American College of Surgeons National Surgical Quality Improvement Program-Pediatric database from 2012 to 2014 was queried for infants undergoing elective resection of a CPAM...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103943/from-oral-facial-dysfunction-to-dysmorphism-and-the-onset-of-pediatric-osa
#16
REVIEW
Christian Guilleminault, Yu-Shu Huang
The upper airway is a collapsible tube, and its collapsibility increases during sleep. Extrinsic factors such as atypical craniofacial features may increase the risks of airway collapse. We review early development of oral-facial structures and the anatomical variants that may be present at birth and can impact nasal breathing. After birth, there is a continuous interaction between orofacial functions and growth of anatomic features. We review the dysfunctions identified to date that may impact orofacial development leading to sleep-disordered-breathing through changes in the orofacial growth...
July 6, 2017: Sleep Medicine Reviews
https://www.readbyqxmd.com/read/29103789/an-in-situ-simulation-based-educational-outreach-project-for-pediatric-trauma-care-in-a-rural-trauma-system
#17
Lilly Bayouth, Sarah Ashley, Jackie Brady, Bryan Lake, Morgan Keeter, David Schiller, Walter C Robey, Stephen Charles, Kari M Beasley, Eric A Toschlog, Shannon W Longshore
BACKGROUND: Outcome disparities between urban and rural pediatric trauma patients persist, despite regionalization of trauma systems. Rural patients are initially transported to the nearest emergency department (ED), where pediatric care is infrequent. We aim to identify educational intervention targets and increase provider experience via pediatric trauma simulation. METHODS: Prospective study of simulation-based pediatric trauma resuscitation was performed at three community EDs...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29099872/a-pilot-randomized-controlled-trial-of-ekg-for-neonatal-resuscitation
#18
Anup Katheria, Kathy Arnell, Melissa Brown, Kasim Hassen, Mauricio Maldonado, Wade Rich, Neil Finer
BACKGROUND: The seventh edition of the American Academy of Pediatrics Neonatal Resuscitation Program recommends the use of a cardiac monitor in infants that need resuscitation. Previous trials have shown that EKG heart rate is available before pulse rate from a pulse oximeter. To date no trial has looked at how the availability of electrocardiogram (EKG) affects clinical interventions in the delivery room. OBJECTIVE: To determine whether the availability of an EKG heart rate value and tracing to the clinical team has an effect on physiologic measures and related interventions during the stabilization of preterm infants...
2017: PloS One
https://www.readbyqxmd.com/read/29098994/correlation-of-cutaneous-sensitivity-and-cytokine-response-in-children-with-asthma
#19
Meenu Singh, Amit Agarwal, Bishnupada Chatterjee, Anil Chauhan, Rashmi Ranjan Das, Nandini Paul
BACKGROUND: Food allergy occurs in a significant portion of pediatric asthma. Various cells and their mediators/cytokines play a pivotal role in orchestrating the airway inflammatory response in asthma. OBJECTIVE: To study the cutaneous hypersensitivity, Th1, Th2, and Th17 response of pediatric population with asthma and genetic predisposition to atopy, by determining total immunoglobulin E (IgE) level in response to various food allergens. MATERIALS AND METHODS: Fifty asthmatic children with a history of worsening symptoms by various food allergens (study group) and twenty healthy children (control group) were included...
November 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/29096887/definitive-airway-management-after-prehospital-supraglottic-rescue-airway-in-pediatric-trauma
#20
Matthew C Hernandez, Ryan M Antiel, Karthik Balakrishnan, Martin D Zielinski, Denise B Klinkner
INTRODUCTION: Supraglottic airway (SGA) use and outcomes in pediatric trauma are poorly understood. We compared outcomes between patients receiving prehospital SGA versus bag mask ventilation (BVM). METHODS: We reviewed pediatric multisystem trauma patients (2005-2016), comparing SGA and BVM. Primary outcome was adequacy of oxygenation and ventilation. Additional measures included tracheostomy, mortality and abbreviated injury scores (AIS). RESULTS: Ninety patients were included (SGA, n=17 and BVM, n=73)...
October 6, 2017: Journal of Pediatric Surgery
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