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Pediatric cardiac intensive care

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https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#1
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28622279/hydrogen-sulphide-in-exhaled-gases-from-ventilated-septic-neonates-and-children-a-preliminary-report
#2
Natalie Bee, Ruth White, Andy J Petros
OBJECTIVES: There is increasing interest in hydrogen sulphide as a marker of pathologic conditions or predictors of outcome. We speculate that as hydrogen sulphide is a diffusible molecule, if there is an increase in plasma hydrogen sulphide in sepsis, it may accumulate in the alveolar space and be detected in exhaled gas. "We wished to determine whether we could detect hydrogen sulphide in exhaled gases of ventilated children and neonates and if the levels changed in sepsis." DESIGN: Prospective, observational study...
June 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#3
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28575484/comprehensive-analysis-of-liberal-and-restrictive-transfusion-strategies-in-pediatric-intensive-care-unit
#4
Basak Akyildiz, Nazan Ulgen Tekerek, Ozge Pamukcu, Adem Dursun, Musa Karakukcu, Nazmi Narin, Mehmet Yay, Ferhan Elmali
Background: We prospectively compared restrictive and liberal transfusion strategies for critically ill children regarding hemodynamic and laboratory parameters. Methods: A total of 180 children requiring packed red blood cells (PRBCs) were randomized into two groups: the liberal transfusion strategy group (transfusion trigger < 10 g/dL, Group 1) and the restrictive transfusion strategy group (transfusion trigger ≤ 7 g/dL, Group 2). Basal variables including venous/arterial hemoglobin, hematocrit and lactate levels; stroke volume; and cardiac output were recorded at the beginning and end of the transfusion...
May 30, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#5
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28572103/interprofessional-team-s-perception-of-care-delivery-after-implementation-of-a-pediatric-pain-and-sedation-protocol
#6
Sandra L Staveski, May Wu, Tiffany M Tesoro, Stephen J Roth, Michael J Cisco
BACKGROUND: Pain and agitation are common experiences of patients in pediatric cardiac intensive care units. Variability in assessments by health care providers, communication, and treatment of pain and agitation creates challenges in management of pain and sedation. OBJECTIVES: To develop guidelines for assessment and treatment of pain, agitation, and delirium in the pediatric cardiac intensive unit in an academic children's hospital and to document the effects of implementation of the guidelines on the interprofessional team's perception of care delivery and team function...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28571730/serum-neuronal-biomarkers-in-neonates-with-congenital-heart-disease-undergoing-cardiac-surgery
#7
Erin Trakas, Yuliya Domnina, Ashok Panigrahy, Tracy Baust, Patrick M Callahan, Victor O Morell, Ricardo Munoz, Michael J Bell, Joan Sanchez-de-Toledo
BACKGROUND: Newborns with congenital heart disease have associated brain damage that affects short-and long-term neurodevelopment. Several neuronal biomarkers exist that could predict brain damage. We investigated the pattern of neuron-specific enolase (NSE) and s100B levels after cardiopulmonary bypass surgery in neonates with congenital heart disease. METHODS: We completed a prospective observational study of neonates with congenital heart disease who were undergoing cardiopulmonary bypass surgery...
July 2017: Pediatric Neurology
https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#8
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28542655/-risk-factors-associated-with-postoperative-acute-renal-failure-in-pediatric-patients-undergoing-cardiopulmonary-bypass-surgery
#9
Elsa Nohemí Reyes-Flandes, Alejandro Herrera-Landero, Pascual Bobadilla-González, Juan Carlos Núñez-Enríquez
Acute renal failure (ARF) is a complication associated with cardiac surgery with cardiopulmonary bypass (CPB) with an impact on morbidity and mortality. OBJECTIVE: To identify risk factors associated with postoperative IRA according to pediatric Risk, Injury, Failure, Loss, End-Stage Renal Disease scale in children undergoing cardiac surgery with CPB. PATIENTS AND METHOD: A nested case-control study was conducted. We included children under 16 years of age attended postoperative for CBP in a pediatric intensive care unit over a period of 18 months...
April 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28539208/birth-weight-length-and-head-circumference-progression-and-impact-over-the-outcome-of-patients-with-congenital-heart-disease
#10
Daniélle Bernardi Silveira, Ernani Bohrer da Rosa, Jamile Dutra Correia, Patrícia Trevisan, Marilu Fiegenbaum, Ceres Andréia Oliveira, Carolina Geitens Grapiglia, Mauricio Rouvel Nunes, Rosana Cardoso Manique Rosa, Tatiana Diehl Zen, Paulo Ricardo Gazzola Zen, Rafael Fabiano Machado Rosa
BACKGROUND: There are few studies assessing the birth measures of patients with congenital heart disease (CHD). Our aim to evaluate their progression and impact over the outcome. METHODS: The cases consisted of patients with CHD during their first hospitalization in a reference cardiac and pediatric intensive care unit (ICU) from Southern Brazil. Controls were composed of patients with no clinical evidence of CHD hospitalized soon after cases. The cases underwent high-resolution karyotype and fluorescence in situ hybridization (FISH) for 22q11 microdeletion...
May 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28533072/relationship-between-transfusion-of-blood-products-and-the-incidence-of-thrombotic-complications-in-neonates-and-infants-undergoing-cardiac-surgery
#11
David Faraoni, Sirisha Emani, Erin Halpin, Rachel Bernier, Sitaram Emani, James A DiNardo, Juan C Ibla
OBJECTIVES: The authors hypothesized that transfusion of blood products in neonates and infants undergoing high-risk cardiac surgery in the absence of intraoperative coagulation monitoring increases the risk of thrombotic complications. DESIGN: Prospective observational study. SETTING: Neonates and infants undergoing cardiac surgery at a tertiary pediatric center. PARTICIPANTS: Neonates weighing >2.5 kg and infants ≤12 months of age undergoing elective cardiac surgery with cardiopulmonary bypass were included in this prospective observational study...
April 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28531789/do-picu-patients-meet-technical-criteria-for-performing-indirect-calorimetry
#12
Megan R Beggs, Gonzalo Garcia Guerra, Bodil M K Larsen
BACKGROUND & AIMS: Indirect calorimetry (IC) is considered gold standard for assessing energy needs of critically ill children as predictive equations and clinical status indicators are often unreliable. Accurate assessment of energy requirements in this vulnerable population is essential given the high risk of over or underfeeding and the consequences thereof. The proportion of patients and patient days in pediatric intensive care (PICU) for which energy expenditure (EE) can be measured using IC is currently unknown...
October 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#13
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28520538/treatment-strategies-for-paradoxical-hypertension-following-surgical-correction-of-coarctation-of-the-aorta-in-children
#14
Peter P Roeleveld, Eline G Zwijsen
BACKGROUND: Paradoxical hypertension after repair of coarctation of the aorta is a well-known phenomenon. The pathogenesis involves the activation of the sympathetic nervous system (first phase) and renin-angiotensin system (second phase). Only a limited number of different treatment strategies have been published in the literature, without any comparative studies. METHODS: Our aim was to describe the current international practice variation surrounding pharmacological treatment currently being employed to treat paradoxical hypertension following the repair of coarctation of the aorta in children...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28503704/use-of-eeg-in-critically-ill-children-and-neonates-in-the-united-states-of-america
#15
Marina Gaínza-Lein, Iván Sánchez Fernández, Tobias Loddenkemper
The objective of the study was to estimate the proportion of patients who receive an electroencephalogram (EEG) among five common indications for EEG monitoring in the intensive care unit: traumatic brain injury (TBI), extracorporeal membrane oxygenation (ECMO), cardiac arrest, cardiac surgery and hypoxic-ischemic encephalopathy (HIE). We performed a retrospective cross-sectional descriptive study utilizing the Kids' Inpatient Database (KID) for the years 2010-2012. The KID is the largest pediatric inpatient database in the USA and it is based on discharge reports created by hospitals for billing purposes...
June 2017: Journal of Neurology
https://www.readbyqxmd.com/read/28492405/a-case-control-analysis-of-postoperative-fluid-balance-and-mortality-after-pediatric-cardiac-surgery
#16
Meth R Delpachitra, Siva P Namachivayam, Johnny Millar, Carmel Delzoppo, Warwick W Butt
OBJECTIVES: A positive fluid balance after cardiac surgery may be associated with poor outcomes; however, previous studies looking at this association have been limited by the number of deaths in the study population. Our primary aim was to determine the relationship between postoperative cumulative fluid balance and mortality in cardiac surgical patients. Secondary aims were to study the association between fluid balance and duration of mechanical ventilation, intensive care and hospital length of stay...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28459760/an-international-survey-of-corticosteroid-use-for-the-management-of-low-cardiac-output-syndrome
#17
Saul Flores, Michael R FitzGerald, Ilias Iliopoulos, Joshua A Daily, Marco Rodriguez, David P Nelson, Hector R Wong, Kusum Menon, David S Cooper
OBJECTIVE: Limited evidence exists on use of corticosteroids in low cardiac output syndrome following cardiac surgery. We sought to determine physicians' practices and beliefs with regard to corticosteroids therapy for low cardiac output syndrome. DESIGN: Multinational internet-based survey. SETTING: Pediatric Cardiac Intensive Care Society member database. SUBJECTS: Pediatric cardiac intensive care physicians. INTERVENTIONS: None...
April 27, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28440986/-prognostic-factors-of-postoperative-severe-hyperglycemia-after-cardiac-surgery-in-pediatric-patients
#18
Ramón Raúl Marín-Vivas, Cecilio Ernesto Saldívar-Müller, Cecilia Consuelo Sánchez-Bañuelos, Janet Flores-Lujano, Juan Carlos Núñez-Enríquez
BACKGROUND: Patients who underwent surgery for congenital heart disease requiring cardiopulmonary bypass (CPB) have metabolic complications, like hyperglycemia, which is associated to a greater postoperative morbidity and mortality. Our objective was to identify predictors of severe postoperative hyperglycemia (≥ 200 mg/dL) in pediatric patients after cardiopulmonary bypass. METHODS: A case-control study was conducted from January 1 to December 31, 2014. We included all pediatric patients undergoing cardiac surgery attended at postoperative care in a pediatric intensive care unit from a third level hospital...
May 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28430713/a-national-survey-of-neonatologists-barriers-and-prerequisites-to-introduce-point-of-care-ultrasound-in-neonatal-icus
#19
Hussnain S Mirza, Gregory Logsdon, Anoop Pulickal, Mark Stephens, Rajan Wadhawan
Point-of-care (POC) ultrasound refers to the use of portable imaging. Although POC ultrasound is widely available to the neonatologists in Australia and Europe, neonatologists in the United States report limited availability. Our objective was to seek the US neonatologists' perception of barriers and prerequisites in adopting POC ultrasound in neonatal intensive care units. An online survey link was sent via e-mail to 3000 neonatologists included in the database maintained by the American Academy of Pediatrics...
April 20, 2017: Ultrasound Quarterly
https://www.readbyqxmd.com/read/28408715/postoperative-infection-in-developing-world-congenital-heart-surgery-programs-data-from-the-international-quality-improvement-collaborative
#20
Amitabh Chanchal Sen, Debra Forbes Morrow, Rakhi Balachandran, Xinwei Du, Kimberlee Gauvreau, Byalal R Jagannath, Raman Krishna Kumar, Jennifer Koch Kupiec, Monica L Melgar, Nguyen Tran Chau, Gail Potter-Bynoe, Orlando Tamariz-Cruz, Kathy J Jenkins
BACKGROUND: Postoperative infections contribute substantially to morbidity and mortality after congenital heart disease surgery and are often preventable. We sought to identify risk factors for postoperative infection and the impact on outcomes after congenital heart surgery, using data from the International Quality Improvement Collaborative for Congenital Heart Surgery in Developing World Countries. METHODS AND RESULTS: Pediatric cardiac surgical cases performed between 2010 and 2012 at 27 participating sites in 16 developing countries were included...
April 2017: Circulation. Cardiovascular Quality and Outcomes
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