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Pediatric Cardiac icu

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https://www.readbyqxmd.com/read/29113557/correlation-of-lactic-acid-and-base-deficit-values-obtained-from-arterial-and-peripheral-venous-samples-in-a-pediatric-population-during-intraoperative-care
#1
Brianne M Bordes, Hina Walia, Roby Sebastian, David Martin, Dmitry Tumin, Joseph D Tobias
Lactic acid and base deficit (BD) values are frequently monitored in the intensive care unit and operating room setting to evaluate oxygenation, ventilation, cardiac output, and peripheral perfusion. Although generally obtained from an arterial cannula, such access may not always be available. The current study prospectively investigates the correlation of arterial and peripheral venous values of BD and lactic acid. The study cohort included 48 patients. Arterial BD values ranged from -8 to 4 mEq/L and peripheral venous BD values ranged from -8 to 4 mEq/L...
December 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29110981/distributive-shock-in-a-neonate-with-diffuse-infantile-hepatic-hemangioma
#2
James Brown, Rajan Arora, Usha Sethuraman
BACKGROUND: Hemangiomas are common cutaneous findings on healthy infants. These vascular malformations are generally benign, though in rare circumstances they can potentially be fatal. This is particularly true when the hemangiomas are large or numerous and occurring in visceral organs. Previously unrecognized visceral hemangiomas are part of the differential for any neonate presenting unexpectedly in shock. CASE REPORT: A 10-day-old neonate presented to the pediatric emergency department with difficulty breathing...
October 27, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29105103/development-of-a-pediatric-cardiac-mechanical-support-program
#3
Abhishek Kashyap, Joseph W Turek, Samantha J Wagner, Laura Felderman, Elizabeth A Jaggers, Peter J Gruber, R Erik Edens
The development of a pediatric cardiac support program is a complex, multidisciplinary project. This study describes the University of Iowa Congenital Heart Program's experience from its inception to the present. In, we examine those specific factors that have led to substantial improvements in the program, additionally identifying where further gains can be made. We retrospectively reviewed all pediatric patients who received mechanical cardiac support at the University of Iowa from the inception of the program in 1991...
November 3, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29076929/delirium-in-the-pediatric-cardiac-extracorporeal-membrane-oxygenation-patient-population-a-case-series
#4
Anita K Patel, Katherine V Biagas, Eunice C Clark, Chani Traube
OBJECTIVE: To determine the prevalence of delirium in children who require extracorporeal membrane oxygenation. DESIGN: Prospective observational longitudinal cohort study. SETTING: Urban academic cardiothoracic ICU. PATIENTS: All consecutive admissions to the cardiothoracic ICU who required venoarterial extracorporeal membrane oxygenation support. INTERVENTIONS: Daily delirium screening with the Cornell Assessment for Pediatric Delirium...
October 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29067568/anemia-at-pediatric-intensive-care-unit-discharge-prevalence-and-risk-markers
#5
Pierre Demaret, Oliver Karam, Marisa Tucci, Jacques Lacroix, Hélène Behal, Alain Duhamel, Frédéric Lebrun, André Mulder, Stéphane Leteurtre
BACKGROUND: Anemia is prevalent at pediatric intensive care unit (PICU) admission and incident during PICU stay, but little is known about anemia at PICU discharge . Anemia after critical illness is an important issue because it could impact post-PICU outcome. We aimed to estimate the prevalence of anemia at PICU discharge and to determine its risk markers. METHODS: This is an ancillary study of a prospective observational study on transfusion practices conducted in the PICU of a tertiary care children's hospital...
October 24, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29066147/heart-type-fatty-acid-binding-protein-and-high-dose-methylprednisolone-in-pediatric-cardiac-surgery
#6
Eero Pesonen, Juho Keski-Nisula, Arie Passov, Raisa Vähätalo, Juha Puntila, Sture Andersson, Pertti K Suominen
OBJECTIVES: Corticosteroids possess cardioprotection in experimental cardiac ischemia/reperfusion. The authors hypothesized that if cardioprotection of corticosteroids occured during pediatric cardiac surgery, then methylprednisolone used in cardiopulmonary bypass prime would reduce postoperative concentrations of heart-type fatty-acid-binding protein, a cardiac biomarker. DESIGN: A double-blind, placebo-controlled, randomized clinical trial. SETTING: Operating room and pediatric intensive care unit of a university hospital...
May 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29063727/nurse-driven-analgesia-and-sedation-in-pediatric-patients-with-univentricular-hearts-requiring-extracorporeal-life-support-after-first-stage-palliation-surgery-a-pilot-study
#7
Jörg Michel, Michael Hofbeck, Ines Gerbig, Vanya Icheva, Ellen Heimberg, Walter Jost, Christian Schlensak, Matthias Kumpf, Gunnar Blumenstock, Felix Neunhoeffer
BACKGROUND: Few data are available regarding requirements of sedation and analgesia in children during extracorporeal life support. AIMS: The aim of this study was to evaluate if children with functionally univentricular hearts on extracorporeal life support after first-stage palliation surgery have higher requirement of analgesics and sedatives compared with children without extracorporeal life support using a goal-directed nurse-driven analgesia and sedation protocol...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29058296/research-and-application-of-transnasal-transesophageal-echocardiography-probe
#8
Lei Wang, Jing Zhang, Shao-Ping Zheng, Lin He, Jing Wang, Xin-Fang Wang, Ming-Xing Xie
The intubation of conventional transesophageal echocardiography (TEE) probes into patients causes serious esophagus irritation, and thus the use of TEE probes in pediatric practice is limited. In this study, we aimed at the development of a special probe which could be inserted through the nasopharyngeal cavity into the esophagus to obtain the same high-quality echocardiography images as those obtained by conventional TEE and improve patients' experience. During the examination, the patients felt relaxed for a longer time and cooperated with the sonographers in the process of cardiac catheterization conducted in the surgery room or the intensive care unit (ICU), resulting in improved accuracy of the diagnosis and timely administration of appropriate treatment...
October 2017: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/29058248/ventilation-during-cardiopulmonary-resuscitation-in-children-a-survey-on-clinical-practice
#9
Rafael González, Lázaro Pascual, Alexandra Sava, Sara Tolón, Javier Urbano, Jesus López-Herce
BACKGROUND: This study aimed to investigate the ventilation practice during cardiopulmonary resuscitation (CPR) and after return of spontaneous circulation (ROSC) in children. METHODS: An online survey of CPR practices was designed and sent to healthcare professionals treating children. RESULTS: A total of 477 healthcare professionals from 46 countries responded to this survey; 92.7% were physicians and 64.2% worked in pediatric intensive care units...
December 2017: World Journal of Pediatrics: WJP
https://www.readbyqxmd.com/read/29055711/comparison-of-del-nido-and-st-thomas-cardioplegia-solutions-in-pediatric-patients-a-prospective-randomized-clinical-trial
#10
Sachin Talwar, Amolkumar Bhoje, Vishnubhatla Sreenivas, Neeti Makhija, Sudheer Aarav, Shiv Kumar Choudhary, Balram Airan
We conducted a prospective randomized trial to compare del Nido (DN) cardioplegia with conventional cold blood cardioplegia (St Thomas [STH]) in pediatric patients. We randomized 100 pediatric patients aged ≤12 years undergoing elective repair of ventricular septal defects and tetralogy of Fallot to the DN and the STH groups. In the DN group, a 20 mL/kg single dose was administered. In the STH group, a 30 mL/kg dose was administered, followed by repeated doses at 25- to 30-minute intervals. The primary outcome was cardiac index that was measured 4 times intra- and postoperatively...
September 1, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29026677/bedside-ultrasound-in-the-diagnosis-and-treatment-of-children-with-respiratory-difficulty-following-cardiac-surgery
#11
REVIEW
Hussam Kanaan Hamadah, Mohamed Salim Kabbani
Many children frequently fail extubation or require a prolonged period of positive pressure ventilation support after cardiac surgery. Pediatric cardiac Intensive Care Unit (PCICU) ultrasound (US) stands as a simple, basic bedside tool that can be performed by trained intensivists for the diagnosis with immediate implication on therapeutic decisions in multiple scenarios that physicians may face in PCICU. Bedside US is widely available, convenient, and inexpensive. This educational article based mainly on our own experience is highlighting the role of US in detecting the most common causes of respiratory weaning difficulties and extubation failure in postoperative cardiac children through proposed illustration and algorithm...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28991830/development-and-validation-of-an-empiric-tool-to-predict-favorable-neurologic-outcomes-among-picu-patients
#12
Punkaj Gupta, Mallikarjuna Rettiganti, Jeffrey M Gossett, Jennifer Daufeldt, Tom B Rice, Randall C Wetzel
OBJECTIVES: To create a novel tool to predict favorable neurologic outcomes during ICU stay among children with critical illness. DESIGN: Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with favorable neurologic outcomes. A mixed effects logistic regression model was used to create the final prediction model including all predictors selected from the lasso model. Model validation was performed using a 10-fold internal cross-validation approach...
October 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28990967/the-pediatric-cardiac-intensive-care-unit-parental-stress-model-refinement-using-directed-content-analysis
#13
Amy Jo Lisanti, Nadya Golfenshtein, Barbara Medoff-Cooper
This descriptive, qualitative study used directed content analysis to explore and clarify specific foci of parental stress for mothers of infants with complex congenital heart disease in the pediatric cardiac intensive care unit (PCICU). The PCICU Parental Stress Model was used as the guiding theoretical framework. Three focus groups were conducted with 14 mothers of infants who were being cared for in a PCICU at a large mid-Atlantic children's hospital. Data provided themes to support and refine the PCICU Parental Stress Model that can be used to guide practice, education, and future research in this unique population and setting...
October 2017: ANS. Advances in Nursing Science
https://www.readbyqxmd.com/read/28987397/duration-of-postoperative-mechanical-ventilation-as-a-quality-metric-for-pediatric-cardiac-surgical-programs
#14
Michael Gaies, David K Werho, Wenying Zhang, Janet E Donohue, Sarah Tabbutt, Nancy S Ghanayem, Mark A Scheurer, John M Costello, J William Gaynor, Sara K Pasquali, Justin B Dimick, Mousumi Banerjee, Steven M Schwartz
BACKGROUND: Few metrics exist to assess quality of care at pediatric cardiac surgical programs, limiting opportunities for benchmarking and quality improvement. Postoperative duration of mechanical ventilation (POMV) may be an important quality metric because of its association with complications and resource utilization. In this study we modelled case-mix-adjusted POMV duration and explored hospital performance across POMV metrics. METHODS: This study used the Pediatric Cardiac Critical Care Consortium clinical registry to analyze 4,739 hospitalizations from 15 hospitals (October 2013 to August 2015)...
October 4, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28980410/the-pediatric-echocardiography-boot-camp-four-year-experience-and-impact-on-clinical-performance
#15
Shiraz A Maskatia, Antonio G Cabrera, Shaine A Morris, Carolyn A Altman
BACKGROUND: We previously reported on the short-term impact of an echocardiography "Boot Camp" on a single class of cardiology fellows (CF). The impact of the Boot Camp on performance throughout fellowship is unknown. METHODS: We enrolled four classes of CFs and two classes of cardiac ICU fellows (CVs) prospectively into the Boot Camp and compared CFs to a historical cohort. Experience with echocardiography was surveyed. Outcome measures included written pre- and post-Camp exams, a performance based test (PBT), self-efficacy assessments, numbers of echocardiograms performed, and echocardiogram quality during the last 3 months of fellowship...
October 2017: Echocardiography
https://www.readbyqxmd.com/read/28977299/saccharomyces-cerevisiae-fungemia-in-a-pediatric-patient-after-treatment-with-probiotics
#16
Mariá Ribas Romanio, Ligia Augusto Coraine, Vinicius Pignoti Maielo, Marcelo Luiz Abramczyc, Renato Lopes de Souza, Nilton Ferraro Oliveira
OBJECTIVE: To report the case of a one-year-old patient with a bloodstream infection associated with probiotics, and to discuss the indications and precautions concerning the therapeutic use of probiotics. CASE DESCRIPTION: A one-year-old male patient with Down syndrome in a late postoperative period of congenital cardiac disease correction. The patient was severely malnourished and had been hospitalized since he was two months old in the Pediatric Intensive Care Unit...
July 2017: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
https://www.readbyqxmd.com/read/28977099/fluid-overload-in-children-undergoing-mechanical-ventilation
#17
Clarice Laroque Sinott Lopes, Jefferson Pedro Piva
Patients admitted to an intensive care unit are prone to cumulated fluid overload and receive intravenous volumes through the aggressive resuscitation recommended for septic shock treatment, as well as other fluid sources related to medications and nutritional support. The liberal liquid supply strategy has been associated with higher morbidity and mortality. Although there are few prospective pediatric studies, new strategies are being proposed. This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28971158/scorpion-related-cardiomyopathy-and-acute-pulmonary-edema-in-a-child-who-is-stung-by-leiurus-abdullahbayrami
#18
Mehmet Dokur, Mustafa Dogan, Ersen Aydin Yagmur
Venom of Leiurus abdullahbayrami (Scorpiones: Buthidae) is an extremely toxic one and it stimulates voltage-gated sodium and potassium channels. In case of a stung by this scorpion; excessive catecholamine release occur and it impairs left ventricle contractility and consequently a heart failure occurs (scorpion sting-related cardiomyopathy). In addition to this cardiac-induced acute pulmonary, edema may occur in severe cases too. An 11-year-old male child who was stung by a scorpion (species: Leiurus abdullahbayrami) consulted to the Emergency Room...
September 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28948337/blood-versus-crystalloid-cardioplegia-in-pediatric-cardiac-surgery-a-systematic-review-and-meta-analysis
#19
REVIEW
Konstantinos S Mylonas, Aspasia Tzani, Panagiotis Metaxas, Dimitrios Schizas, Vasileios Boikou, Konstantinos P Economopoulos
The benefit of blood cardioplegia (BCP) compared to crystalloid cardioplegia (CCP) is still debatable. Our aim was to systematically review and synthesize all available evidence on the use of BCP and CCP to assess if any modality provides superior outcomes in pediatric cardiac surgery. A systematic literature search of the PubMed and Cochrane databases was performed with respect to the PRISMA statement (end-of-search date: January 30th, 2017). We extracted data on study design, demographics, cardioplegia regimens, and perioperative outcomes as well as relevant biochemical markers, namely cardiac troponin I (cTnI), lactate, and ATP levels at baseline, after reperfusion and postoperatively at 1, 4, 12, and 24 h as applicable...
December 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28941543/cardiopulmonary-resuscitation-in-pediatric-and-cardiac-intensive-care-units
#20
REVIEW
Robert M Sutton, Ryan W Morgan, Todd J Kilbaugh, Vinay M Nadkarni, Robert A Berg
Approximately 5000 to 10,000 children suffer an in-hospital cardiac arrest requiring cardiopulmonary resuscitation (CPR) each year in the United States. Importantly, 2% to 6% of all children admitted to pediatric intensive care units (ICUs) receive CPR, as do 4% to 6% of children admitted to pediatric cardiac ICUs. Survival from pediatric ICU cardiac arrest has improved substantially during the past 20 years presumably due to improved training methods, CPR quality, and post-resuscitation care. Extracorporeal life support CPR remains an important treatment option for both cardiac and noncardiac ICU patients...
October 2017: Pediatric Clinics of North America
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