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Pediatric mechanical support

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https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#1
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28207796/post-extubation-stridor-in-respiratory-syncytial-virus-bronchiolitis-is-there-a-role-for-prophylactic-dexamethasone
#2
Esther S Veldhoen, Charlotte A Smulders, Teus H Kappen, Job C Calis, Job van Woensel, Paulien A M Raymakers-Janssen, Louis J Bont, Marije P Hennus
AIM: The purpose of this study was to determine the incidence of reintubation due to upper airway obstruction in a homogeneous group of ventilated infants with Respiratory Syncytial Virus bronchiolitis. Our secondary objective was to determine whether prophylactic administration of dexamethasone prior to extubation was associated with decreased risk of reintubation. METHODS: This retrospective observational study in two Pediatric Intensive Care Units in 2 university hospitals in The Netherlands included two hundred patients younger than 13 months admitted with respiratory insufficiency caused by Respiratory Syncytial Virus bronchiolitis, requiring invasive mechanical ventilation...
2017: PloS One
https://www.readbyqxmd.com/read/28196661/pediatric-medical-device-development-by-surgeons-via-capstone-engineering-design-programs
#3
Bryan S Sack, Rodolfo A Elizondo, Gene O Huang, Nicolette Janzen, Jimmy Espinoza, Magdalena Sanz-Cortes, Jennifer E Dietrich, Julie Hakim, Eric Richardson, Maria Oden, John Hanks, Balakrishna Haridas, James F Hury, Chester J Koh
BACKGROUND: There is a need for pediatric medical devices that accommodate the unique physiology and anatomy of pediatric patients that is increasingly receiving more attention. However, there is limited literature on the programs within children's hospitals and academia that can support pediatric device development. We describe our experience with pediatric device design utilizing collaborations between a children's hospital and two engineering schools. METHODS: Utilizing the academic year as a timeline, unmet pediatric device needs were identified by surgical faculty and matched with an engineering mentor and a team of students within the Capstone Engineering Design programs at two universities...
February 6, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28195883/long-term-pediatric-ventricular-assist-device-therapy-a-case-report-of-2100-days-of-support
#4
Neha J Purkey, Aileen Lin, Jenna M Murray, Maryalice Gowen, Paul Shuttleworth, Katsuhide Maeda, Christopher S Almond, David N Rosenthal, Sharon Chen
Ventricular assist devices (VADs) have been placed as destination therapy in adults for over twenty years but have only recently been considered an option in a subset of pediatric patients. A 2016 report from the Pediatric Interagency Registry for Mechanical Circulatory Support (PediMACS) revealed only eight pediatric patients implanted as destination therapy. We report the case of an adolescent male with Becker Muscular Dystrophy (BMD) who underwent VAD placement in 2011 as bridge to candidacy. He subsequently decided to remain as destination therapy and so far has accrued over 2100 days on VAD support, the longest duration of pediatric VAD support reported in the literature to date...
February 9, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28195411/family-centered-positive-behavior-support-interventions-in-early-childhood-to-prevent-obesity
#5
Justin D Smith, Sara M St George, Guillermo Prado
Positive behavior support (PBS) strategies in early childhood, which include proactively structuring environments to support and positively reinforce healthy dietary and physical activity behaviors, are critical for preventing pediatric obesity, particularly among low-income, ethnic minority children. Existing evidence-based family-centered preventive interventions effectively impact parents' use of PBS strategies. Enhancing these programs to more directly target the key mechanisms of change specific to promoting children's healthy lifestyle behaviors could serve as the foundation for the next generation of effective protocols for preventing pediatric obesity...
February 13, 2017: Child Development
https://www.readbyqxmd.com/read/28184368/prevention-of-hospital-acquired-venous-thromboembolism-in-children-a-review-of-published-guidelines
#6
REVIEW
E Vincent S Faustino, Leslie J Raffini
Venous thromboembolism, which includes deep venous thrombosis and pulmonary embolism, is a potentially preventable condition in children. In adults, pharmacologic prophylaxis has been shown to significantly reduce the incidence of venous thromboembolism in distinct patient cohorts. However, pediatric randomized controlled trials have failed to demonstrate the efficacy of pharmacologic prophylaxis against thrombosis associated with central venous catheters, the most important risk factor for venous thromboembolism in children...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#7
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28152280/surfactant-administration-via-a-thin-endotracheal-catheter-during-spontaneous-breathing-in-preterm-infants
#8
REVIEW
Wanliang Wu, Yan Shi, Fengxia Li, Zhuoyu Wen, Hongli Liu
To systematically review the clinical outcomes of surfactant administration via a thin endotracheal catheter during spontaneous breathing compared with conventional administration involving tracheal intubation, mechanical ventilation (MV), and tracheal extubation, in preterm infants. PubMed, EMBASE, and the Cochrane Library were searched to identify relevant clinical trials. Data were analyzed using the Cochrane Collaboration methods. Primary outcome measures included the incidence of MV and bronchopulmonary dysplasia (BPD)...
February 2, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28144610/pediatric-hepatocellular-carcinoma-challenges-and-solutions
#9
REVIEW
Irene Schmid, Dietrich von Schweinitz
Hepatocellular carcinoma (HCC) is a very rare entity in children, making it nearly impossible to orchestrate Phase II/III studies even as multinational cooperative trials. In contrast to adults, nearly 50% of the children have a response (α-fetoprotein decline and/or tumor shrinkage) to chemotherapeutic agents such as cisplatin and doxorubicin (PLADO), demonstrating that HCC in childhood can be chemotherapy sensitive. As a result, the main treatment options in pediatric HCC focus on systemic drug therapies and resection as the central therapy...
2017: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/28141793/sex-specific-associations-between-cerebrovascular-blood-pressure-autoregulation-and-cardiopulmonary-injury-in-neonatal-encephalopathy-and-therapeutic-hypothermia
#10
Raul Chavez-Valdez, Matthew O'Connor, Jamie Perin, Michael Reyes, Jillian Armstrong, Charlamaine Parkinson, Maureen Gilmore, Jacky Jennings, Frances J Northington, Jennifer K Lee
BACKGROUND: Cardiopulmonary injury is common in neonatal encephalopathy, but the link with cerebrovascular dysfunction is unknown. We hypothesized that cerebral autoregulation is associated with cardiopulmonary injury in neonates treated with therapeutic hypothermia (TH) for neonatal encephalopathy. METHODS: The cerebral hemoglobin volume index (HVx) from near-infrared spectroscopy was used to identify the mean arterial blood pressure (MAP) with optimal autoregulatory vasoreactivity (MAPOPT)...
January 31, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28129857/discovering-novel-oncogenic-pathways-and-new-therapies-using-zebrafish-models-of-sarcoma
#11
M N Hayes, D M Langenau
Sarcoma is a type of cancer affecting connective, supportive, or soft tissue of mesenchymal origin. Despite rare incidence in adults (<1%), over 15% of pediatric cancers are sarcoma. Sadly, both adults and children with relapsed or metastatic disease have devastatingly high rates of mortality. Current treatment options for sarcoma include surgery, radiation, and/or chemotherapy; however, significant limitations exist with respect to the efficacy of these strategies. Strong impetus has been placed on the development of novel therapies and preclinical models for uncovering mechanisms involved in the development, progression, and therapy resistance of sarcoma...
2017: Methods in Cell Biology
https://www.readbyqxmd.com/read/28109452/erratum-to-adverse-events-in-children-implanted-with-ventricular-assist-devices-in-the-us-data-from-the-pediatric-interagency-registry-for-mechanical-circulatory-support-pedimacs
#12
David N Rosenthal
No abstract text is available yet for this article.
January 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28108423/isolated-transverse-process-fractures-a-systematic-analysis
#13
REVIEW
Daniel T Nagasawa, Timothy T Bui, Carlito Lagman, Seung J Lee, Lawrance K Chung, Tianyi Niu, Alexander Tucker, Bilwaj Gaonkar, Isaac Yang, Luke Macyszyn
OBJECTIVE: To review the literature on isolated transverse process fractures (ITPFs) and provide evidence for and validate the current practice of conservative management. METHODS: The PubMed database was searched for published literature related to ITPFs. Baseline patient (age, sex, presentation, mechanism of injury) and fracture (number of fractures, level, single or multi-segmental) characteristics were extracted. Management, and outcomes were also recorded. Statistical comparisons were ascertained through N-1 Pearson Chi-squared tests...
January 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28095378/advanced-neuroimaging-techniques-in-pediatric-hydrocephalus
#14
Smruti K Patel, Weihong Yuan, Francesco T Mangano
From the early days of pneumoencephalography and ventriculography to the emerging technology of magnetic resonance diffusion tensor imaging (DTI) of the present day, neuroimaging has always been a critical tool in the diagnosis and treatment of pediatric hydrocephalus. There is accumulating evidence from both human and animal research suggesting that one of the major pathophysiological mechanisms underlying poor outcomes in these children is damage to vulnerable white matter (WM) structures in the brain as a result of ventricular enlargement and increased intracranial pressure...
January 18, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28093806/outcomes-of-the-twelfth-international-conference-on-pediatric-mechanical-circulatory-support-systems-and-pediatric-cardiopulmonary-perfusion
#15
EDITORIAL
Emile A Bacha, Paul Chai, Akif Ündar
No abstract text is available yet for this article.
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28092566/wake-up-exoskeleton-to-assist-children-with-cerebral-palsy-design-and-preliminary-evaluation-in-level-walking
#16
Fabrizio Patane, Stefano Rossi, Fausto Del Sette, Juri Taborri, Paolo Cappa
This paper presents the modular design and control of a novel compliant lower limb multi-joint exoskeleton for the rehabilitation of ankle knee mobility and locomotion of pediatric patients with neurological diseases, such as Cerebral Palsy (CP). The device consists of an untethered powered knee-ankle-foot orthosis (KAFO), addressed as WAKE-up (Wearable Ankle Knee Exoskeleton), characterized by a position control and capable of operating synchronously and synergistically with the human musculoskeletal system...
January 11, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#17
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28079914/intravenous-immunoglobulin-in-pediatric-rheumatology-when-to-use-it-and-what-is-the-evidence
#18
Martha M Rodriguez, Linda Wagner-Weiner
Intravenous immunoglobulin (IVIG) is given to children with a variety of rheumatologic illnesses. The mechanism of action by which it exerts therapeutic effects is not well understood and likely differs in the medical conditions for which it is given. IVIG is approved by the US Food and Drug Administration and is the standard of care for Kawasaki disease, but most IVIG use in pediatric rheumatology is "off-label. " The literature supports the use of IVIG for juvenile dermatomyositis, although it is unclear whether its use should be limited to those children with more severe or refractory disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28063864/the-end-of-life-experience-of-pediatric-heart-transplant-recipients
#19
Seth A Hollander, John Dykes, Sharon Chen, Lynsey Barkoff, Barbara Sourkes, Harvey Cohen, David N Rosenthal, Daniel Bernstein, Beth D Kaufman
CONTEXT: Despite advances in therapies, many pediatric heart transplant (Htx) recipients will die prematurely. We characterized the circumstances surrounding death in this cohort, including location of death and interventions performed in the final 24 hours. METHODS: We reviewed all patients who underwent Htx at Lucile Packard Children's Hospital, Stanford, survived hospital discharge, and subsequently died between 7/19/2007-9/13/2015. The primary outcome studied was location of death, characterized as inpatient, outpatient, or emergency department (ED)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28060793/preterm-birth-and-ventilation-decrease-surface-density-of-glomerular-capillaries-in-lambs-regardless-of-postnatal-respiratory-support-mode
#20
Eveline Staub, Mar Janna Dahl, Calan Yost, Sydney Bowen, Toshio Aoki, Adam Blair, Zhengming Wang, Donald M Null, Bradley A Yoder, Kurt H Albertine
BACKGROUND: Prematurity is often complicated by respiratory support, including invasive mechanical ventilation (IMV) and non-invasive support (NIS). Compared to IMV, NIS reduces injury to the lung and brain. Prematurity may also disrupt glomerular architecture. Whether NIS differentially affects glomerular architecture is incompletely understood. We hypothesized that IMV would lead to greater disruption of glomerular architecture than NIS. METHODS: This is a secondary analysis of kidneys from moderately preterm lambs delivered at ~131d gestation (term ~150d) that had antenatal steroid exposure and surfactant treatment before resuscitation by IMV...
January 6, 2017: Pediatric Research
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