Read by QxMD icon Read

Critical care pediatrics

Beth Wieczorek, Judith Ascenzi, Yun Kim, Hallie Lenker, Caroline Potter, Nehal J Shata, Lauren Mitchell, Catherine Haut, Ivor Berkowitz, Frank Pidcock, Jeannine Hoch, Connie Malamed, Tamara Kravitz, Sapna R Kudchadkar
OBJECTIVE: To determine the safety and feasibility of an early mobilization program in a PICU. DESIGN: Observational, pre-post design. SETTING: PICU in a tertiary academic hospital in the United States. PATIENTS: Critically ill pediatric patients admitted to the PICU. INTERVENTION: This quality improvement project involved a usual-care baseline phase, followed by a quality improvement phase that implemented a multicomponent, interdisciplinary, and tiered activity plan to promote early mobilization of critically ill children...
October 10, 2016: Pediatric Critical Care Medicine
Folafoluwa O Odetola, Renee R Anspach, Yong Y Han, Sarah J Clark
PURPOSE: To investigate the decision making underlying transfer of children with respiratory failure from level II to level I pediatric intensive care unit care. METHODS: Interviews with 19 eligible level II pediatric intensive care unit physicians about a hypothetical scenario of a 2-year-old girl in respiratory failure: RESULTS: At baseline, indices critical to management were as follows: OI (53%), partial pressure of oxygen in arterial blood (Pao2)/Fio2 (32%), and inflation pressure (16%)...
October 4, 2016: Journal of Critical Care
Sandeep Gangadharan, Gunjan Tiyyagura, Marcie Gawel, Barbara M Walsh, Linda L Brown, Megan Lavoie, Khoon-Yen Tay, Marc A Auerbach
OBJECTIVE: The objective of this study was to explore pediatric emergency department (PED) and general emergency department (GED) providers' perceptions on caring for critically ill infants and children. METHODS: This study utilized qualitative methods to examine the perceptions of emergency department providers caring for critically ill infants and children. Teams of providers participated in 4 in situ simulation cases followed by facilitated debriefings. Debriefings were recorded and professionally transcribed...
October 4, 2016: Pediatric Emergency Care
Richmond Darko, Jessica L Mashburn
Zika virus (ZIKV) infection and its associated complications have become a significant public health concern. Zika virus is a Flavivirus, and is transmitted to humans by Aedes species mosquitoes. In May 2015, the World Health Organization reported the first locally acquired transmission of ZIKV in Brazil, the first case in the Western Hemisphere. There have also been reports of increased incidence of microcephaly and other neurologic complications associated with ZIKV infection, as well as a 20-fold increase in the incidence of Guillain-Barre Syndrome during ZIKV outbreaks...
October 2016: Pediatric Emergency Care
Michael T Long, Matthew P Murray
Tongue entrapments within bottles are very rare childhood mishaps. The most immediate hazard in a tongue entrapment is airway obstruction. Tongue entrapment is an airway emergency; contingency planning to maintain airway patency, oxygenation, and ventilation is critical. Here, we report the case of a 5-year-old girl presenting to a pediatric emergency department with an increasingly popular novelty soda bottle, featuring a unique and dangerous design, entrapped on her tongue. Operative removal was anticipated...
September 30, 2016: Pediatric Emergency Care
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed ( was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
September 30, 2016: Pediatric Critical Care Medicine
Mathew Clark, Esma Birisci, Jordan E Anderson, Christina M Anliker, Micheal A Bryant, Craig Downs, Abdallah Dalabih
BACKGROUND: Current guidelines adopted by the American Academy of Pediatrics calls for prolonged fasting times before performing pediatric procedural sedation and analgesia (PSA). PSA is increasingly provided to children outside of the operating theater by sedation trained pediatric providers and does not require airway manipulation. We investigated the safety of a shorter fasting time compared to a longer and guideline compliant fasting time. We tried to identify the association between fasting time and sedation-related complications...
September 2016: Anesthesia, Essays and Researches
Rohan A Ramasubbu, Benjamin M Ramasubbu
BACKGROUND: Management of open tibial fractures is well documented in adults, with existing protocols outlining detailed treatment strategies. No clear guidelines exist for children. Surgical stabilization of tibial fractures in the pediatric population requires implants that do not disrupt the open epiphyses (growth plate). Both elastic stable intramedullary nails and external fixation can be used. The objective of this study was to identify the optimal method of surgical stabilization in the treatment of open tibial fractures in children...
September 2016: Indian Journal of Orthopaedics
Camilla S Hanson, Jonathan C Craig, Allison Tong
Patient- and family-centered care is hailed as a hallmark of high-quality pediatric care. This partnership between patients, families and their healthcare providers is central to caring for children with chronic kidney disease (CKD), given the long-term and profound impact of the disease and its treatment on the development and quality of life of these children. This paradigm hinges on a comprehensive and detailed understanding of the needs, beliefs and values of children with CKD and their families. However, their perspectives may remain undisclosed during time-limited clinical consultations and because of beliefs that if they did disclose their concerns, their care would be jeopardized...
October 15, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
Laurence Ducharme-Crevier, Michele G Mills, Priya M Mehta, Craig M Smith, Mark S Wainwright
BACKGROUND: The primary objective of this study was to characterize changes in cerebral blood flow measured using transcranial Doppler in children with central nervous system infections. We hypothesized that children with central nervous system infections have abnormal cerebral blood flow, associated with a greater frequency of complications and poor neurological outcome. METHODS: We conducted a single-center, retrospective study of children admitted to the neonatal or pediatric intensive care unit with central nervous system infection and undergoing transcranial Doppler as part of routine care between March 2011 and July 2015...
September 4, 2016: Pediatric Neurology
Riad Lutfi, Kamal Abulebda, Mara E Nitu, Jean P Molleston, Molly A Bozic, Girish Subbarao
Pediatric acute liver failure is rare but life-threatening illness that occurs in children without preexisting liver disease. The rarity of the disease, along with its severity and heterogeneity, presents unique clinical challenges to the physicians providing care for pediatric patients with acute liver failure. In this review, practical clinical approaches to the care of critically ill children with acute liver failure are discussed with an organ system specific approach. The underlying pathophysiological processes, major areas of uncertainty, and approaches to the critical care management of pediatric acute liver failure are also reviewed...
October 12, 2016: Journal of Pediatric Gastroenterology and Nutrition
Henrika Wickström, Johan O Nyman, Mathias Indola, Heidi Sundelin, Leif Kronberg, Maren Preis, Jukka Rantanen, Niklas Sandler
Printing technologies were recently introduced to the pharmaceutical field for manufacturing of drug delivery systems. Printing allows on demand manufacturing of flexible pharmaceutical doses in a personalized manner, which is critical for a successful and safe treatment of patient populations with specific needs, such as children and the elderly, and patients facing multimorbidity. Printing of pharmaceuticals as technique generates new demands on the quality control procedures. For example, rapid quality control is needed as the printing can be done on demand and at the point of care...
October 13, 2016: AAPS PharmSciTech
Ramachandran Rameshkumar, Sriram Krishnamurthy, Rajesh Nachiappa Ganesh, Subramanian Mahadevan, Parameswaran Narayanan, Ponnarmeni Satheesh, Puneet Jain
BACKGROUND: Septic acute kidney injury (AKI) accounts for more than half of all cases of AKI in critically ill children. The renal histology was found to alter the management in more than two-third of cases of adult acute renal failure. Better insight into the pathogenesis of pediatric septic AKI could be based on developing a clearer appreciation of the histopathological changes. No comprehensive study of the histopathological features of septic AKI in critically ill children has yet been performed...
October 13, 2016: Clinical and Experimental Nephrology
Seher Erdoğan, Arzu Oto, Mehmet Boşnak
Mean platelet volume (MPV) is a simple and economical test that is easy to interpret and is routinely measured with automatic cell counters. It indicates platelet volume and platelet function and activation. Variations in platelet volume may occur more as a result of varying differentiation of megakaryocytes in association with production agents in bone marrow rather than of ageing of platelets in circulation. The purpose of this study was to evaluate the relation between mortality and changes in MPV values in patients hospitalized in the pediatric intensive care unit...
November 2015: Turkish Journal of Pediatrics
Madhuradhar Chegondi, Jun Sasaki, André Raszynski, Balagangadhar R Totapally
OBJECTIVE: To evaluate the hemoglobin threshold for red cell transfusion in children admitted to a pediatric intensive care unit (PICU). METHODS: Retrospective chart review study. Tertiary care PICU. Critically ill pediatric patients requiring blood transfusion. No intervention. RESULTS: We analyzed the charts of all children between 1 month and 21 years of age who received packed red blood cell (PRBC) transfusions during a 2-year period. The target patients were identified from our blood bank database...
July 2016: Transfusion Medicine and Hemotherapy
Beata Rybojad, Mariusz Goniewicz, Daniel Sieniawski
Pain management in emergency medical care remains underestimated, especially in pediatric patients. This is due to neglecting the issue, lack of knowledge in the appropriate use of analgesics and finally- the fear of being criticized by physicians in hospital departments. Moreover, it is difficult to objectively assess a child with acute pain. Even experienced "adult" anesthesiologists wonder how to recognize if a child suffers strong pain or is just anxious. Many different pain scales are available and some of them may be used in emergency medical care...
2016: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Oliver Karam, Pierre Demaret, Alain Duhamel, Alison Shefler, Philip C Spinella, Simon J Stanworth, Marisa Tucci, Stéphane Leteurtre
BACKGROUND: Organ dysfunction scores, based on physiological parameters, have been created to describe organ failure. In a general pediatric intensive care unit (PICU) population, the PEdiatric Logistic Organ Dysfunction-2 score (PELOD-2) score had both a good discrimination and calibration, allowing to describe the clinical outcome of critically ill children throughout their stay. This score is increasingly used in clinical trials in specific subpopulation. Our objective was to assess the performance of the PELOD-2 score in a subpopulation of critically ill children requiring plasma transfusions...
December 2016: Annals of Intensive Care
Paul A Checchia
The growth of Pediatric Cardiovascular Intensive Care as a subspecialty has been incredible. Outcomes have improved, care delivery has matured, and research has made advances. Within this review, we take the opportunity to examine the subspecialty's past accomplishments with pride, take stock in its current state, and look forward with excitement to its future. While outcomes in general have improved dramatically, we must always be aware of the outcomes that matter to families and patients. Additionally, we must constantly ask ourselves to improve...
July 2016: Translational pediatrics
Christine Dennis, Pamela Baxter, Jenny Ploeg, Susan Blatz
AIMS: A discussion of partnership in the context of family centered care in the acute paediatric setting, through a critical analysis of partnership models. BACKGROUND: Paediatric healthcare practitioners understand the importance of family centered care, but struggle with how to translate the core tenets into action and are confused by several rival terms. Partnering relationships are included in definitions of family centered care, yet less is known about strategies to fully engage or support parents in these partnerships...
October 5, 2016: Journal of Advanced Nursing
Jennifer A Muszynski, Philip C Spinella, Jill M Cholette, Jason P Acker, Mark W Hall, Nicole P Juffermans, Daniel P Kelly, Neil Blumberg, Kathleen Nicol, Jennifer Liedel, Allan Doctor, Kenneth E Remy, Marisa Tucci, Jacques Lacroix, Philip J Norris
Transfusion-related immunomodulation (TRIM) in the intensive care unit (ICU) is difficult to define and likely represents a complicated set of physiologic responses to transfusion, including both proinflammatory and immunosuppressive effects. Similarly, the immunologic response to critical illness in both adults and children is highly complex and is characterized by both acute inflammation and acquired immune suppression. How transfusion may contribute to or perpetuate these phenotypes in the ICU is poorly understood, despite the fact that transfusion is common in critically ill patients...
October 2, 2016: Transfusion
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"