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Critical care pediatrics

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https://www.readbyqxmd.com/read/28938253/guidelines-for-the-diagnosis-and-management-of-critical-illness-related-corticosteroid-insufficiency-circi-in-critically-ill-patients-part-i-society-of-critical-care-medicine-sccm-and-european-society-of-intensive-care-medicine-esicm-2017
#1
Djillali Annane, Stephen M Pastores, Bram Rochwerg, Wiebke Arlt, Robert A Balk, Albertus Beishuizen, Josef Briegel, Joseph Carcillo, Mirjam Christ-Crain, Mark S Cooper, Paul E Marik, Gianfranco Umberto Meduri, Keith M Olsen, Sophia C Rodgers, James A Russell, Greet Van den Berghe
OBJECTIVE: To update the 2008 consensus statements for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in adult and pediatric patients. PARTICIPANTS: A multispecialty task force of 16 international experts in critical care medicine, endocrinology, and guideline methods, all of them members of the Society of Critical Care Medicine and/or the European Society of Intensive Care Medicine. DESIGN/METHODS: The recommendations were based on the summarized evidence from the 2008 document in addition to more recent findings from an updated systematic review of relevant studies from 2008 to 2017 and were formulated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology...
September 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28936143/assessment-of-readiness-of-academic-emergency-departments-in-the-central-region-of-saudi-arabia-to-receive-a-sick-child
#2
Fahad Saleh Alhajjaj, Abdullah Saleh Aldamigh
OBJECTIVE: We sought to assess the readiness of general emergency departments (EDs) in academic hospitals in the central region of the Kingdom of Saudi Arabia (KSA) to manage pediatric patients using an international tool: The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association guidelines, which include facilities, personnel, safety, and other components. METHODS: We assessed eligible centers during multiple visits from January 2016 to May 2016 in which we inspected the EDs and conducted interviews with their respective leadership in which we independently recorded our observations...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28935390/ask-the-question-screening-for-postpartum-mood-and-anxiety-disorders-in-pediatric-primary-care
#3
Stacy Kurtz, Jack Levine, Marcy Safyer
Postpartum mood and anxiety disorders (PMADs) are a significant source of toxic stress for young children and can disrupt developing brain architecture resulting in long-lasting deleterious effects. Thus, screening for PMADs must be considered as an essential task of a pediatric primary care provider (PCP) and the pediatric medical home. Problems in parenting capacity in mothers with PMADs can lead to disorders in attachment and a range of other emotional and developmental challenges for a young child. Therefore, all PCP office visits with mothers should include surveillance as well as formal screening at regular, pre-determined intervals...
September 18, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28930815/variability-in-usual-care-mechanical-ventilation-for-pediatric-acute-respiratory-distress-syndrome-time-for-a-decision-support-protocol
#4
Christopher J L Newth, Katherine A Sward, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Richard Holubkov, Allan Doctor, J Michael Dean, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol...
September 19, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28928043/treating-postpartum-mood-and-anxiety-disorders-in-primary-care-pediatrics
#5
Polina Umylny, Miguelina German, Alexa Lantiere
Postpartum psychiatric disorders represent a significant public health problem that has not been readily addressed, particularly in the primary care setting. As maternal mood and anxiety difficulties are associated with a number of adverse outcomes for the mother, her offspring and the family system, addressing these concerns during the perinatal period is of critical importance. Although researchers and clinicians have become increasingly aware of the problem, postpartum mood and anxiety disorders (PMADs) remain widely unrecognized and poorly understood by both patients and providers...
September 16, 2017: Current Problems in Pediatric and Adolescent Health Care
https://www.readbyqxmd.com/read/28927975/pediatric-arterial-catheters-complications-and-associated-risk-factors
#6
Ferdynand Hebal, Hayley T Sparks, Karen L Rychlik, Meredith Bone, Sifrance Tran, Katherine A Barsness
BACKGROUND/PURPOSE: Arterial catheter complications are a common problem in a pediatric critical care setting, but reported complication rates and risk factors associated with peripheral arterial catheter complications vary. We conducted a retrospective cohort study to identify risk factors in a pediatric patient population. METHODS: We performed a detailed abstraction of provider notes in the electronic medical records of inpatients ≤18years of age who underwent arterial line placement between January 1, 2008 and January 1, 2013 at a university-affiliated standalone pediatric hospital...
September 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28926488/potential-acceptability-of-a-pediatric-ventilator-management-computer-protocol
#7
Katherine A Sward, Christopher J L Newth, Robinder G Khemani, Kent Page, Kathleen L Meert, Joseph A Carcillo, Thomas P Shanley, Frank W Moler, Murray M Pollack, Heidi J Dalton, David L Wessel, John T Berger, Robert A Berg, Rick E Harrison, Allan Doctor, J Michael Dean, Richard Holobkov, Tammara L Jenkins, Carol E Nicholson
OBJECTIVES: To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome. DESIGN: Survey/questionnaire. SETTING: The eight PICUs in the Collaborative Pediatric Critical Care Research Network. PARTICIPANTS: One hundred twenty-two physicians (attendings and fellows). INTERVENTIONS: None...
September 16, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28925974/if-you-build-it-they-will-come-initial-experience-with-a-multi-disciplinary-pediatric-neurocritical-care-follow-up-clinic
#8
Cydni N Williams, Aileen Kirby, Juan Piantino
Pediatric Neurocritical Care diagnoses account for a large proportion of intensive care admissions. Critical care survivors suffer high rates of long-term morbidity, including physical disability, cognitive impairment, and psychosocial dysfunction. To address these morbidities in Pediatric Neurocritical Care survivors, collaboration between Pediatric Neurology and Pediatric Critical Care created a multidisciplinary follow-up clinic providing specialized evaluations after discharge. Clinic referrals apply to all Pediatric Neurocritical Care patients regardless of admission severity of illness...
September 19, 2017: Children
https://www.readbyqxmd.com/read/28925929/canadian-guidelines-for-controlled-pediatric-donation-after-circulatory-determination-of-death-summary-report
#9
Matthew J Weiss, Laura Hornby, Bram Rochwerg, Michael van Manen, Sonny Dhanani, V Ben Sivarajan, Amber Appleby, Mary Bennett, Daniel Buchman, Catherine Farrell, Aviva Goldberg, Rebecca Greenberg, Ram Singh, Thomas A Nakagawa, William Witteman, Jill Barter, Allon Beck, Kevin Coughlin, Alf Conradi, Cynthia Cupido, Rosanne Dawson, Anne Dipchand, Darren Freed, Karen Hornby, Valerie Langlois, Cheryl Mack, Meagan Mahoney, Deepak Manhas, Christopher Tomlinson, Samara Zavalkoff, Sam D Shemie
OBJECTIVES: Create trustworthy, rigorous, national clinical practice guidelines for the practice of pediatric donation after circulatory determination of death in Canada. METHODS: We followed a process of clinical practice guideline development based on World Health Organization and Canadian Medical Association methods. This included application of Grading of Recommendations Assessment, Development, and Evaluation methodology. Questions requiring recommendations were generated based on 1) 2006 Canadian donation after circulatory determination of death guidelines (not pediatric specific), 2) a multidisciplinary symposium of national and international pediatric donation after circulatory determination of death leaders, and 3) a scoping review of the pediatric donation after circulatory determination of death literature...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28924562/assessment-of-analytical-performance-of-glucose-meter-in-pediatric-age-group-at-tertiary-care-referral-hospital
#10
Mohit Vijay Rojekar, Vandana Kumawat, Jayesh Panot, Surekha Khedkar, Arati Adhe-Rojekar
BACKGROUND: Glucometers are the excellent tools for self-monitoring of blood glucose (SMBG). They are important especially in the circumstances where continuous monitoring is mandatory and at decision making levels. Tight glycemic control protocols are important for preventing the ill effects of fluctuating glucose levels. This increases the use of glucometers in various healthcare settings. As technology advances, glucometers are getting better in terms of quality of results. But still some lacunae are there...
2017: Journal of Diabetes and Metabolic Disorders
https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#11
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922270/decision-making-in-pediatric-transport-team-dispatch-using-script-concordance-testing
#12
Prakadeshwari Rajapreyar, Karen Marcdante, Liyun Zhang, Pippa Simpson, Michael T Meyer
OBJECTIVES: Our objective was to compare decision-making in dispatching pediatric transport teams by Medical Directors of pediatric transport teams (serving as experts) to that of Pediatric Intensivists and Critical Care fellows who often serve as Medical Control physicians. Understanding decision-making around team composition and dispatch could impact clinical management, cost effectiveness, and educational needs. DESIGN: Survey was developed using Script Concordance Testing guidelines...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#13
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#14
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917160/is-magnet%C3%A2-recognition-associated-with-improved-outcomes-among-critically-ill-children-treated-at-freestanding-children-s-hospitals
#15
Mallikarjuna Rettiganti, Kavisha M Shah, Jeffrey M Gossett, Joshua A Daily, Paul M Seib, Punkaj Gupta
PURPOSE: With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS: Post hoc analysis of data from an existing administrative national database. We used inverse probability of treatment weighting and multivariate models to compare outcomes between two study groups after adjusting for confounding variables. RESULTS: A total of 823,634 pediatric patients from 41 centers were included...
September 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917005/outcome-of-pediatric-acute-kidney-injury-a-multicenter-prospective-cohort-study
#16
Jameela A Kari, Khalid A Alhasan, Mohamed A Shalaby, Norah Khathlan, Osama Y Safdar, Suleman A Al Rezgan, Sherif El Desoky, Amr S Albanna
BACKGROUND: Acute kidney injury (AKI) is a common problem encountered in critically ill children with an increasing incidence and evolving epidemiology. AKI carries a serious morbidity and mortality in patients requiring admission to a pediatric intensive care unit (PICU). METHODS: We undertook a prospective cohort study of PICU admissions at three tertiary care hospitals in the Kingdom of Saudi Arabia over 2 years. The Kidney Disease Improving Global Outcomes (KDIGO) definition was used to diagnose AKI...
September 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28916016/comparing-two-models-of-integrated-behavioral-health-programs-in-pediatric-primary-care
#17
REVIEW
Miguelina Germán, Michael L Rinke, Brittany A Gurney, Rachel S Gross, Diane E Bloomfield, Lauren A Haliczer, Silvie Colman, Andrew D Racine, Rahil D Briggs
This study examined how to design, staff, and evaluate the feasibility of 2 different models of integrated behavioral health programs in pediatric primary care across primary care sites in the Bronx, NY. Results suggest that the Behavioral Health Integration Program model of pediatric integrated care is feasible and that hiring behavioral health staff with specific training in pediatric, evidence-informed behavioral health treatments may be a critical variable in increasing outcomes such as referral rates, self-reported competency, and satisfaction...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28916012/preliminary-outcomes-from-an-integrated-pediatric-mental-health-outpatient-clinic
#18
REVIEW
Gary R Maslow, Adrienne Banny, McLean Pollock, Kristen Stefureac, Kendra Rosa, Barbara Keith Walter, Katherine Hobbs Knutson, Joseph Lucas, Nicole Heilbron
An estimated 1 in 5 children in the United States meet criteria for a diagnosable mental disorder, yet fewer than 20% receive mental health services. Unmet need for psychiatric treatment may contribute to patterns of increasing use of the emergency department. This article describes an integrated pediatric evaluation center designed to prevent the need for treatment in emergency settings by increasing access to timely and appropriate care for emergent and critical mental health needs. Preliminary results showed that the center provided rapid access to assessment and treatment services for children and adolescents presenting with a wide range of psychiatric concerns...
October 2017: Child and Adolescent Psychiatric Clinics of North America
https://www.readbyqxmd.com/read/28911938/-families-experiences-and-satisfaction-with-a-pediatric-emergency-service
#19
S Perret, M Gehri, J Pluies, I Rossi, C Akre
OBJECTIVE: Today, pediatric emergency services receive a rising number of "non-urgent" cases, which are due to parental anxiety or a miscomprehension of medical explanations. The aim of this study was therefore to understand what those families experience and need when they consult in such cases, in order to respond with adapted solutions. METHODS: Semi-structured interviews and questionnaires with parents, after the consultation or in the waiting room. RESULTS: Based on the families' narratives, we present the results in six steps, which correspond to the steps they experience from the decision to go to the hospital to the consultation...
September 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28906423/empowering-parents-of-australian-infants-and-children-in-hospital-translation-cultural-adaptation-and-validation-of-the-empowerment-of-parents-in-the-intensive-care-30-aus-questionnaire
#20
Fenella J Gill, Sally Wilson, Laurene Aydon, Gavin D Leslie, Jos M Latour
OBJECTIVES: To translate, culturally adapt, and psychometrically test the EMpowerment of PArents in The Intensive Care-30 questionnaire in Australian pediatric critical care, neonatal, and pediatric ward settings. DESIGN: Cross-sectional, descriptive, multicenter study conducted in two phases; 1) translation and cultural adaptation and 2) validation of the EMpowerment of PArents in The Intensive Care-30 questionnaire. SETTINGS: Two Western Australian sites, the PICU and two pediatric wards of a children's hospital and the neonatal unit of a women's and newborn hospital...
September 12, 2017: Pediatric Critical Care Medicine
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