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Pediatric mechanical support

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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/28433581/therapeutic-burst-suppression-coma-in-pediatric-febrile-refractory-status-epilepticus
#2
Jainn-Jim Lin, Cheng-Che Chou, Shih-Yun Lan, Hsiang-Ju Hsiao, Yu Wang, Oi-Wa Chan, Shao-Hsuan Hsia, Huei-Shyong Wang, Kuang-Lin Lin
BACKGROUND: Evidence for the beneficial effect of therapeutic burst-suppression coma in pediatric patients with febrile refractory status epilepticus is limited, and the clinical outcomes of this treatment strategy are largely unknown. Therefore, the aim of this study was to explore the outcomes of therapeutic burst-suppression coma in a series of children with febrile refractory status epilepticus. METHODS: We retrospectively reviewed consecutive pediatric patients with febrile refractory status epilepticus admitted to our pediatric intensive care unit between January 2000 and December 2013...
April 19, 2017: Brain & Development
https://www.readbyqxmd.com/read/28416331/a-novel-inflow-cannulation-strategy-for-pediatric-mechanical-circulatory-support-in-small-left-ventricles
#3
Michael Ma, Vamsi V Yarlagadda, David N Rosenthal, Katsuhide Maeda
No abstract text is available yet for this article.
March 19, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28410087/racial-and-ethnic-disparities-in-parental-refusal-of-consent-in-a-large-multisite-pediatric-critical-care-clinical-trial
#4
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
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#5
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28399119/caffeine-ameliorates-hyperoxia-induced-lung-injury-by-protecting-gch1-function-in-neonatal-rat-pups
#6
Xigang Jing, Yi-Wen Huang, Jason Jarzembowski, Yang Shi, Girija G Konduri, Ru-Jeng Teng
BACKGROUND: Bronchopulmonary dysplasia (BPD) is a major morbidity in premature infants, and impaired angiogenesis is considered a major contributor to BPD. Early caffeine treatment decreases the incidence of BPD; the mechanism remains incompletely understood. METHODS: Sprague-Dawley rat pups exposed to normoxia or hyperoxia since birth were treated daily with either 20 mg/kg caffeine or normal saline by intraperitoneal injection from day 2 of life. Lungs were obtained for studies at day 10 and 21...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28398997/scale-up-of-early-infant-hiv-diagnosis-and-improving-access-to-pediatric-hiv-care-in-global-plan-countries-past-and-future-perspectives
#7
Shaffiq Essajee, Ravikiran Bhairavabhotla, Martina Penazzato, Karusa Kiragu, Ilesh Jani, Sergio Carmona, Bharat Rewari, Charles Kiyaga, John Nkengasong, Trevor Peter
Investment to scale-up early infant diagnosis (EID) of HIV has increased substantially in the last decade. This investment includes physical infrastructure, equipment, human resources, and specimen transportation systems as well as specialized mechanisms to deliver laboratory results to clinics. The Global Plan Towards the Elimination of New HIV Infections Among Children by 2015 and Keeping Their Mothers Alive, as well as related international initiatives to prevent mother-to-child transmission of HIV and treat children living with HIV have been important drivers of this scale-up by mobilizing resources, creating advocacy, developing normative recommendations, and providing direct technical support to countries through the global community of international stakeholders...
May 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28394814/percutaneous-mechanical-circulatory-support-using-impella%C3%A2-devices-for-decompensated-cardiogenic-shock-a-pediatric-heart-center-experience
#8
Dhaval Parekh, Aamir Jeewa, Sebastian C Tume, William J Dreyer, Ricardo Pignatelli, David Horne, Henri Justino, Athar M Qureshi
Cardiogenic shock remains a significant cause of mortality and morbidity in children with heart failure. Percutaneous mechanical circulatory support may be an additional tool to augment left heart support and decompression in addition to conventional therapies. This report aims to review the clinical and hemodynamic outcomes of the Impella® device at a pediatric center. A retrospective review of all implants between October 2014 and November 2016 was conducted. Clinical outcomes, device implant techniques, complications, and hemodynamic data were collected...
April 6, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28376077/maternal-nutrient-restriction-in-guinea-pigs-leads-to-fetal-growth-restriction-with-evidence-for-chronic-hypoxia
#9
Alexander A Elias, Yohei Maki, Brad Matushewski, Karen Nygard, Timothy R H Regnault, Bryan S Richardson
BACKGROUND: We determined if maternal nutrient restriction (MNR) in guinea pigs leading to fetal growth restriction (FGR), impacts markers for tissue hypoxia implicating a mechanistic role for chronic hypoxia. METHODS: Guinea pigs were fed ad libitum (Control) or 70% of the control diet pre-pregnant switching to 90% at mid-pregnancy (MNR). Near term, Hypoxyprobe-1 (HP-1), a marker of tissue hypoxia, was injected into pregnant sows. Fetuses were then necropsied and liver, kidney and placental tissues were processed for erythropoietin (EPO), EPO-receptor (EPOR), and VEGF protein levels, and for HP-1 immunoreactivity (IR)...
April 4, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28366356/comparison-of-effort-of-breathing-for-infants-on-nasal-modes-of-respiratory-support
#10
Asavari Kamerkar, Justin Hotz, Rica Morzov, Christopher J L Newth, Patrick A Ross, Robinder G Khemani
OBJECTIVE: To directly compare effort of breathing between high flow nasal cannula (HFNC), nasal intermittent mechanical ventilation (NIMV), and nasal continuous positive airway pressure (NCPAP). STUDY DESIGN: This was a single center prospective cross-over study for patients <6 months in the cardiothoracic or pediatric intensive care unit receiving nasal noninvasive respiratory support after extubation. We measured effort of breathing using esophageal manometry with pressure-rate product (PRP) on all 3 modes...
March 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28357450/an-alternative-strategy-for-bridge-to-transplant-recovery-in-small-children-with-dilated-cardiomyopathy
#11
REVIEW
Gilles Mets, Joseph Panzer, Daniël De Wolf, Thierry Bové
Dilated cardiomyopathy in children still has a poor prognosis with high rates of mortality and cardiac transplantation (resp. around 20 and 25%). Awaiting transplantation or possible recovery, these pediatric patients are mechanically supported with extracorporeal membrane oxygenation or a paracorporeal ventricular assist device, both resulting in higher survival rates but also entailing considerable risks of infection, thrombosis, or bleeding. A new indication for an old technique, i.e., pulmonary artery banding, presents itself as an interesting alternative to mechanical circulatory support in selected infants and small children with dilated LV cardiomyopathy and preserved RV function...
March 29, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28353318/high-flow-nasal-cannula-therapies-for-respiratory-management-in-pediatric-patients
#12
Gang Liu, Conghai Fan, Hongwei Wu
High flow nasal cannula (HFNC) oxygen therapy is a non-invasive form of respiratory support that is rapidly being taken up in paediatric intensive care units (PICU). For infants with bronchiolitis - who are the largest non-elective source of admissions to a PICU - there is some evidence that using HFNC therapy reduces the need for intubation and mechanical ventilation. The aim of this review article is is to explore, describe, critique and add to the evidence surrounding the use of HFNC therapy in the pediatric population for the management of respiratory distress...
March 27, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28341498/natural-history-of-iatrogenic-pediatric-femoral-artery-injury
#13
Elizabeth A Andraska, Tatum Jackson, Huiting Chen, Katherine A Gallagher, Jonathan L Eliason, Dawn M Coleman
INTRODUCTION: Iatrogenic femoral artery trauma complicates the course of critically-ill neonates and children. Complications from persistent arterial occlusion include claudication and limb length discrepancies. Data supporting risk factors for such and need for revascularization are lacking. METHODS: Review of a prospectively maintained database at a tertiary institution of iatrogenic pediatric femoral artery injuries incurred between 2013-2014 was performed. Additional injuries were identified by review of pediatric arterial duplex performed between 2008-2013...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28339407/upper-extremity-muscle-activation-in-children-with-unilateral-cerebral-palsy-during-an-auditory-cued-repetitive-task-effects-on-bimanual-coordination
#14
Jeanne Charles
PURPOSE: The aim of this exploratory study was to investigate mirror muscle activation in the upper limbs of children with unilateral cerebral palsy during an auditory-cued repetitive squeezing task and to compare upper limb muscle activation patterns to typically developing peers engaged in the same task. METHODS: A convenience sample of six children with unilateral cerebral palsy and six typically developing peers (7-17 y) participated in the study. Muscle activity was measured using a 16 channel Zerowire EMG system (Noraxon, USA Inc...
2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/28333694/high-flow-nasal-cannula-therapy-beyond-the-perinatal-period
#15
Michael Lee, Joshua Nagler
PURPOSE OF REVIEW: High-flow nasal cannula (HFNC) is emerging as a means of oxygen delivery and respiratory support for a range of conditions outside the perinatal period. We aim to review the mechanisms of action and advantages of HFNC and to summarize current findings regarding clinical benefit in specific pediatric disease processes and in patients with significant respiratory distress. RECENT FINDINGS: Currently published studies outside the neonatal population demonstrate both safety and efficacy of this mode of respiratory support...
March 22, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28325298/relevance-of-fusion-genes-in-pediatric-cancers-toward-precision-medicine
#16
REVIEW
Célia Dupain, Anne Catherine Harttrampf, Giorgia Urbinati, Birgit Geoerger, Liliane Massaad-Massade
Pediatric cancers differ from adult tumors, especially by their very low mutational rate. Therefore, their etiology could be explained in part by other oncogenic mechanisms such as chromosomal rearrangements, supporting the possible implication of fusion genes in the development of pediatric cancers. Fusion genes result from chromosomal rearrangements leading to the juxtaposition of two genes. Consequently, an abnormal activation of one or both genes is observed. The detection of fusion genes has generated great interest in basic cancer research and in the clinical setting, since these genes can lead to better comprehension of the biological mechanisms of tumorigenesis and they can also be used as therapeutic targets and diagnostic or prognostic biomarkers...
March 17, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#17
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28318514/incorporating-comorbidity-within-risk-adjustment-for-uk-pediatric-cardiac-surgery
#18
Katherine L Brown, Libby Rogers, David J Barron, Victor Tsang, David Anderson, Shane Tibby, Thomas Witter, John Stickley, Sonya Crowe, Kate English, Rodney C Franklin, Christina Pagel
BACKGROUND: When considering early survival rates after pediatric cardiac surgery it is essential to adjust for risk linked to case complexity. An important but previously less well understood component of case mix complexity is comorbidity. METHODS: The National Congenital Heart Disease Audit data representing all pediatric cardiac surgery procedures undertaken in the United Kingdom and Ireland between 2009 and 2014 was used to develop and test groupings for comorbidity and additional non-procedure-based risk factors within a risk adjustment model for 30-day mortality...
March 15, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28318175/psychosocial-care-in-the-department-of-pediatric-hematology-and-oncology-of-public-hospitals-in-argentina
#19
Débora Farberman, Teresa Méndez, Leticia García, Lucía Salvia, Silvia Otarolac
BACKGROUND: Blood diseases and cancer are part of a group of rare conditions in pediatrics. In general, cancer treatments are prolonged (months or years), so psychosocial support has been introduced to provide comprehensive care to these patients. OBJECTIVE: To explore psychosocial care provided at the public hospitals of Argentina to children and adolescents with cancer. Population and Methods. An electronic questionnaire was sent to the heads of the Departments of Hematology and Oncology, Mental Health, and Social Services of 27 public hospitals providing care to pediatric patients with cancer...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28302031/hif1a-is-overexpressed-in-medulloblastoma-and-its-inhibition-reduces-proliferation-and-increases-epas1-and-atg16l1-methylation
#20
Gustavo Alencastro Veiga Cruzeiro, Maristella Bergamo Dos Reis, Vanessa Silva Silveira, Régia Caroline Peixoto Lira, Carlos Gilberto Carlotti, Luciano Neder, Ricardo Santos Oliveira, José Andres Yunes, Silvia Regina Brandalise, Simone Aguiar, Agda Karina Eterovic, Luiz Gonzaga Tone, Carlos Alberto Scrideli, Elvis Terci Valera
BACKGROUND: Genetic and epigenetic modifications are closely related to tumor initiation and progression and can provide guidance for understanding tumor functioning, potentially leading to the discovery of new therapies. Studies have associated hypoxia-related genes to tumor progression and chemo/radioresistance in brain tumors. Information on the expression profile of hypoxia-related genes in pediatric medulloblastoma, although scarce, may reveal relevant information that could support treatment decisions...
March 15, 2017: Current Cancer Drug Targets
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