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pediatrics and neonate

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https://www.readbyqxmd.com/read/27933652/nonobstructive-diffuse-dilated-bowel-loops-prenatal-diagnosis-fetal-characteristics-and-neonatal-outcomes
#1
Guy Katz, Ben Pode-Shakked, Michal Berkenstadt, Ron Bilik, Sylvie Polak Charcon, Iris Barshack, Reuven Achiron, Yinon Gilboa
OBJECTIVES: The purpose of this study was to describe the characteristics and outcomes of fetuses with a diagnosis of nonobstructive diffuse dilated bowel loops. METHODS: We conducted a retrospective study of all pregnancies with fetal diagnosis of nonobstructive diffuse dilated bowel loops over 14 years in a large tertiary referral center. Fetomaternal and neonatal characteristics and outcomes were assessed. RESULTS: Seven fetuses had sonograms showing diffuse dilated bowel loops; none of them had intestinal obstruction after labor...
December 8, 2016: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27931653/hemodynamic-coherence-in-critically-ill-pediatric-patients
#2
REVIEW
Ö Erdem, J W Kuiper, D Tibboel
Differences in physiology and pathophysiology make the treatment of developing, critically ill children particularly challenging as compared to that of adults. Significant differences in the cardiovascular system of neonates and children in size, weight, body proportions, and metabolism should be considered. Hemodynamic monitoring is crucial for early warning of pending deterioration and to guide therapy. Current monitoring is limited to the macrocirculation, but an adequately functioning macrocirculation does not guarantee a well-functioning microcirculation...
December 2016: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/27931209/prevalence-and-risk-factors-for-vitamin-d-insufficiency-and-deficiency-at-birth-and-associated-outcome
#3
Ian Marshall, Rajeev Mehta, Charletta Ayers, Smita Dhumal, Anna Petrova
BACKGROUND: Occurrence and consequence of cord blood (CB) vitamin D insufficiency/deficiency has not been adequately explored despite rising concern regarding this topic in pediatrics. This study was designed to determine the rate, maternal risk factors, and clinical outcomes in infants in association with vitamin D insufficient/deficient status at birth. METHODS: American Academy of Pediatrics (AAP) defined levels (ng/mL) were utilized to categorize the vitamin D status in CB samples as deficient (5-15), insufficient (16-20), and sufficient (21-100)...
December 8, 2016: BMC Pediatrics
https://www.readbyqxmd.com/read/27931091/evaluation-of-altered-drug-pharmacokinetics-in-critically-ill-adults-receiving-extracorporeal-membrane-oxygenation
#4
Michael A Ha, Adam C Sieg
Extracorporeal membrane oxygenation (ECMO) is a life-support modality used in patients with refractory cardiac and/or respiratory failure. A significant resurgence in the use ECMO has been seen in recent years due to substantial improvements in technology and survival benefit. With expanding ECMO use, a better understanding of how ECMO affects drug pharmacokinetics (PK) is necessary. The vast majority of PK studies in patients receiving ECMO have been conducted within neonatal or pediatric populations or within a controlled environment (e...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27928843/systemic-inflammatory-response-syndrome-after-pediatric-congenital-heart-surgery-incidence-risk-factors-and-clinical-outcome
#5
Martin Boehne, Michael Sasse, André Karch, Friederike Dziuba, Alexander Horke, Torsten Kaussen, Rafael Mikolajczyk, Philipp Beerbaum, Thomas Jack
BACKGROUND: Systemic inflammatory response syndrome (SIRS) is frequent after cardiac surgery, but data on its incidence and perioperative risk factors are scarce for children with congenital heart disease. METHODS: SIRS incidence within 72 hours following cardiac surgery was evaluated in a secondary analysis of children enrolled to a treatment-free control group of a randomized controlled trial. Intraoperative parameters were investigated for their association with SIRS using multivariable fractional polynomial logistic regression models...
December 7, 2016: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/27927245/congenital-adhesion-band-causing-small-bowel-obstruction-what-s-the-difference-in-various-age-groups-pediatric-and-adult-patients
#6
Kwang-Ho Yang, Tae-Beom Lee, Si-Hak Lee, Soo-Hong Kim, Yong-Hoon Cho, Hae-Young Kim
BACKGROUND: A congenital adhesion band is a rare condition, but may induce a small bowel obstruction (SBO) at any age. However, only a few sporadic case reports exit. We aimed to identify the clinical characteristics of congenital adhesion band manifesting a SBO stratified by age group between pediatric and adult patients. METHODS: The medical records of all patients with a SBO between Jan 1, 2009 and Dec 31, 2015 were retrospectively reviewed. Cases associated with previous surgical procedure and cases of secondary obstruction due to inflammatory processes or tumor and other systemic diseases were excluded...
December 7, 2016: BMC Surgery
https://www.readbyqxmd.com/read/27926352/3d-laparoscopy-in-neonates-and-infants
#7
Yury Kozlov, Konstantin Kovalkov, Vladimir Nowogilov
BACKGROUND: This study focuses on the successful application of three-dimensional (3D) laparoscopic surgeries in the treatment of congenital anomalies and acquired diseases in the young pediatric population. The purpose of this scientific work consists in highlighting the spectrum, indications, applicability, and effectiveness of 3D endosurgery in children. METHODS: Our experience is based on 110 endosurgical procedures performed in neonates and infants in the 3D format between January 2014 and May 2015...
December 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27925622/relation-between-amniotic-fluid-infection-or-cytokine-levels-and-hearing-screen-failure-in-infants-at-32-wk-gestation-or-less
#8
Eun Young Jung, Byung Yoon Choi, Jihye Rhee, Jaehong Park, Soo-Hyun Cho, Kyo Hoon Park
BACKGROUND: To determine whether the presence of intra-amniotic infection and elevated proinflammatory cytokine levels in amniotic fluid (AF) are associated with failure in the newborn hearing screen (NHS) test in very preterm neonates. METHODS: This is a retrospective cohort study of 112 premature singleton neonates born to women with preterm labor or preterm premature rupture of membranes at ≤32 wk. AF obtained through amniocentesis was cultured, and interleukin-6 (IL-6) and IL-8 levels were determined...
December 7, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27925621/presepsin-for-the-detection-of-early-onset-sepsis-in-preterm-newborns
#9
Paolo Montaldo, Roberto Rosso, Alfredo Santantonio, Giovanni Chello, Paolo Giliberti
BACKGROUND: Early-onset sepsis (EOS) is responsible for an important fraction of neonatal morbidity and mortality all over the world. The aim of this study was to assess whether presepsin (P-SEP) can be a more accurate biomarker of EOS compared with pro-calcitonin (PCT) and C-reactive protein (CRP). STUDY DESIGN: Consecutive preterm neonates (<34 wk gestational age, admitted to Neonatal Intensive Care Unit by 6 h of age and undergoing sepsis evaluation) were recruited as part of a case-matched control study...
December 7, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27925243/hemodiafiltration-a-technique-for-physiological-correction-of-priming-solution-in-pediatric-cardiac-surgery-an-in-vitro-study
#10
Pankaj Garg, Arvind Kumar Bishnoi, Kartik Patel, Vivek Wadhawa, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
Pediatric cardiopulmonary bypass (CPB) circuit invariably requires priming with packed red blood cells (PRBCs). Metabolic composition of stored PRBCs is unphysiological and becomes worse with increasing duration of storage. It is recommended to correct these abnormalities before initiation of CPB. We tested the hypothesis that hemodiafiltration of the prime with 0.45% saline is sufficient for reducing the metabolic load and reaching a physiologic state. In an in vitro study, 100 mL of blood each from 45 units of PRBCs stored for 3-20 days were used for priming the 45 neonatal CPB circuits...
December 7, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27923247/patterns-of-empiric-antibiotic-administration-for-presumed-early-onset-neonatal-sepsis-in-neonatal-intensive-care-units-in-the-united-states
#11
Emily A Oliver, Patricia B Reagan, Jonathan L Slaughter, Catalin S Buhimschi, Irina A Buhimschi
Objective To evaluate current patterns in empiric antibiotic use for early-onset neonatal sepsis (EONS). Study Design Retrospective population-based cohort study of newborns admitted on postnatal day 0 to 1 and discharged from NICUs participating in the Pediatric Health Information System (PHIS 2006-2013). Analyses included frequency of antibiotic initiation within 3 days of birth, duration of first course, and variation among hospitals. Results Of 158,907 newborns, 118,624 (74.7%) received antibiotics on or before postnatal day 3...
December 6, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27919877/pharmacist-driven-respiratory-syncytial-virus-prophylaxis-stewardship-service-in-a-neonatal-intensive-care-unit
#12
Sara E Rostas, Christopher McPherson
PURPOSE: The development and implementation of a pharmacist-driven respiratory syncytial virus (RSV) prophylaxis stewardship program in a neonatal intensive care unit (NICU) are described. SUMMARY: An RSV prophylaxis stewardship service was created in the NICU at Brigham and Women's Hospital to align with the newly updated 2014 American Academy of Pediatrics (AAP) recommendations for palivizumab. The service comprised two NICU clinical pharmacists with oversight from the NICU medical director and the chair of the NICU infection control committee...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#13
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27910218/octreotide-use-and-safety-in-infants-with-hyperinsulinism
#14
Ann W McMahon, Gerold T Wharton, Paul Thornton, Diva D De Leon
BACKGROUND: Octreotide is a synthetic peptide analog of naturally occurring somatostatin. Octreotide is used off-label in children <6 years of age for hyperinsulinism, chylothorax, and gastrointestinal bleeding. There is a lack of controlled data on efficacy or potential adverse events from this off-label use. METHODS: Three pediatric hospitals participated in this study. Patients were hospitalized January 2007-December 2010 and administered octreotide for congenital hyperinsulinism (CHI) at least 1 day...
December 2, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27909385/biomarkers-of-inflammation-in-pediatric-arterial-ischemic-stroke
#15
COMMENT
Mary Dunbar, Aleksandra Mineyko
Investigators from Switzerland studied inflammatory markers in children and neonates with acute arterial ischemic stroke (AIS).
November 2016: Pediatric neurology briefs
https://www.readbyqxmd.com/read/27908329/pediatric-sepsis
#16
REVIEW
Melanie K Prusakowski, Audrey P Chen
Pediatric sepsis is distinct from adult sepsis in its definitions, clinical presentations, and management. Recognition of pediatric sepsis is complicated by the various pediatric-specific comorbidities that contribute to its mortality and the age- and development-specific vital sign and clinical parameters that obscure its recognition. This article outlines the clinical presentation and management of sepsis in neonates, infants, and children, and highlights some key populations who require specialized care.
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27906764/buttressing-the-pediatric-endotracheal-tube-in-neonates-a-simple-but-useful-technique
#17
Georgene Singh, Ramamani Mariappan, Arun K Gautham
No abstract text is available yet for this article.
November 30, 2016: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/27906195/congenital-hypothyroidism-with-delayed-thyroid-stimulating-hormone-elevation-in-premature-infants-born-at-less-than-30-weeks-gestation
#18
D C Kaluarachchi, T T Colaizy, L M Pesce, M Tansey, J M Klein
OBJECTIVE: Congenital hypothyroidism (CH) with delayed thyroid-stimulating hormone (TSH) elevation is a common form of thyroid dysfunction among premature infants. Routine newborn screening (NBS) may miss infants with CH with delayed TSH elevation. The objective of the study is to determine the prevalence of CH with delayed TSH elevation in premature infants and to identify associated risk factors. STUDY DESIGN: Retrospective analysis of serum thyroid function screening (TFS) at day of life 30 in premature infants <30 weeks gestation, admitted to University of Iowa Neonatal Intensive Care Unit between 1 July 2012 to 30 June 2015...
December 1, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27902668/pneumatosis-intestinalis-due-to-child-abuse
#19
Stephanie Anne Deutsch, Cindy W Christian
Pneumatosis intestinalis (PI) and the presence of portal venous gas (PVG) are commonly considered pathognomonic for necrotizing enterocolitis in the neonatal period; however, these 2 radiographic findings have been documented in all age groups in a variety of clinical settings and medical conditions including respiratory, cardiac, rheumatologic, gastrointestinal disorders, and traumatic injury. In children, intramural dissection of intestinal gas in the absence of clinical symptoms suggestive of necrotizing enterocolitis should raise concern for a traumatic etiology, including injuries sustained from child physical abuse...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27902503/bedside-placement-of-the-postpyloric-tube-in-infants
#20
Patricia Clifford, Elizabeth Ely, Lauren Heimall
BACKGROUND: Patients in the neonatal intensive care unit are a vulnerable population with specific nutritional requirements, which include increased protein and caloric needs for adequate growth. Some infants cannot tolerate gastric feeds and need to have postpyloric feeds to grow. Placement of a postpyloric tube can be done by gastric insufflation. Gastric insufflation is a technique where air is inserted into the stomach as a nasogastric tube is advanced through the pylorus to the duodenum...
November 29, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
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