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Paediatric intensive care

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https://www.readbyqxmd.com/read/28818651/genomic-characterization-of-a-paediatric-mrsa-outbreak-by-next-generation-sequencing
#1
Elisabetta Ugolotti, Eddi Di Marco, Roberto Bandettini, Roberto Biassoni
INTRODUCTION: Twelve strains of meticillin-resistant Staphylococcus aureus (MRSA) isolated during a suspected outbreak in a Paediatric Intensive Care Unit were analyzed by Whole Genome Sequence (WGS). AIM: To define the clonality of MRSA strains to a high discriminative power and to evaluate the presence of genetic determinants responsible for antibiotic resistance and for virulence. RESULTS: Ten out of 12 strains belonged to the MLST ST2625, while the other two were ST8...
August 14, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28814489/right-ventricular-outflow-tract-stent-versus-bt-shunt-palliation-in-tetralogy-of-fallot
#2
Daniel Quandt, Bharat Ramchandani, Gemma Penford, John Stickley, Vinay Bhole, Chetan Mehta, Timothy Jones, David James Barron, Oliver Stumper
OBJECTIVE: This study sets out to compare morbidity, mortality and reintervention rates after stenting of the right ventricular outflow tract (RVOT) versus modified Blalock-Taussig shunt (mBTS) for palliation in patients with tetralogy of Fallot (ToF)-type lesions. METHODS: Retrospective case review study evaluating 101 patients (64 males) with ToF lesions who underwent palliation with either mBTS (n=41) or RVOT stent (n=60) to augment pulmonary blood flow over a 10-year period...
August 16, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28807835/the-role-of-antimicrobial-stewardship-programmes-in-children-a-systematic-review
#3
REVIEW
André Ricardo Araujo da Silva, Déborah Cardoso Albernaz de Almeida Dias, Amanda Fáris Marques, Clara Biscaia di Biase, Indah K Murni, Angela Dramowski, Mike Sharland, Johanes Huebner, Walter Zingg
The United Nations and the World Health Organization have designated antimicrobial resistance (AMR) as a major health priority and developed action plans to reduce AMR in all healthcare settings. Establishment of institutional antimicrobial stewardship programmes (ASPs) is advocated as a key intervention to reduce antibiotic consumption in hospitals and address high rates of multi-drug resistant (MDR) bacteria. We searched PUBMED and the Cochrane database of systematic reviews (1/2007-3/2017) to identify studies reporting about the effectiveness of ASPs in general paediatric wards and paediatric intensive care units (PICU), on reducing antibiotic consumption, on using broad spectrum/restricted antibiotics, and on antibiotic resistance and healthcare-associated infections (HAIs)...
August 11, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28801148/assessing-and-addressing-the-problem-of-pain-and-distress-during-wound-care-procedures-in-paediatric-patients-with-burns
#4
Marianne J E van der Heijden, Alette de Jong, Heinz Rode, Roux Martinez, Monique van Dijk
OBJECTIVE: While the prevalence of burns in children is highest in low and middle-income countries, most research on burn-related pain intensity and distress is carried out in high-income countries. In this study we assessed pain intensity and distress in paediatric patients with burns undergoing wound care procedures without distraction and parental presence in a South-African children's hospital and sought to identify predictors for the outcomes. METHODS: This observational study, carried out as part of a randomized controlled trial, took place at a burns unit in Cape Town, South Africa and included patients between the ages of 0 and 13 years undergoing their first or second wound care procedure...
August 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28799175/low-age-low-birth-weight-and-congenital-heart-disease-are-risk-factors-for-intensive-care-in-infants-with-bronchiolitis
#5
Minna Mecklin, Paula Heikkilä, Matti Korppi
AIM: This study evaluated the incidence and risk factors for intensive care and respiratory support in infant bronchiolitis. METHODS: This retrospective descriptive case-control study focused on 105 patients treated in the paediatric intensive care unit (PICU) and 210 controls treated in the emergency department or on the paediatric ward in Tampere University Hospital in Finland between 2000-2015. Statistically significant risk factors in non-adjusted analyses were included in the adjusted logistic regression...
August 11, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28793861/viral-and-bacterial-upper-respiratory-tract-infection-in-hospital-health-care-workers-over-time-and-association-with-symptoms
#6
C Raina MacIntyre, Abrar Ahmad Chughtai, Yi Zhang, Holly Seale, Peng Yang, Joshua Chen, Yang Pan, Daitao Zhang, Quanyi Wang
BACKGROUND: Bacterial colonisation of the respiratory tract is commonly described and usually thought to be of no clinical significance. The aim of this study was to examine the presence and significance of bacteria and viruses in the upper respiratory tract of healthcare workers (HCWs), and association with respiratory symptoms. METHODS: A prospective cohort study was conducted in China and 223 HCWs were recruited from fever clinics and respiratory, paediatric, emergency/Intensive medication wards...
August 9, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28792829/mental-health-problems-among-nurses-in-paediatric-cardiac-intensive-care
#7
Renata Santos Tito, Patrícia Campos Pavan Baptista, Fabio José da Silva, Vanda Elisa Andres Felli
At present, there are growing rates of psychiatric symptoms among some occupational categories, with emphasis on health professionals who work in hospitals. This study aimed to identify the occurrence of mental health problems (anxiety and depression) among 92 nursing workers in a paediatric cardiac intensive care unit. This is an exploratory, cross-sectional study, with a quantitative approach. The research was conducted in a public university hospital specialising in cardiology, pneumology, and thoracic and cardiac surgery...
August 10, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28780917/filling-a-significant-gap-in-the-cardiac-icu-implementation-of-individualised-developmental-care
#8
Samantha C Butler, Kate Huyler, Aditya Kaza, Chris Rachwal
Mortality rates among children with CHD have significantly declined, although the incidence of neurological abnormalities and neurodevelopmental impairment has increased. Research has focussed on outcomes, with limited attention on prevention and intervention. Although some developmental differences and challenges seen in children with CHD are explained by the cumulative effect of medical complications associated with CHD, many sequelae are not easily explained by medical complications alone. Although cardiac intensive care is lifesaving, it creates high levels of environmental and tactile stimulation, which potentially contribute to adverse neurodevelopmental outcomes...
August 7, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28771680/safety-and-efficacy-of-rescue-flexible-bronchoscopic-intubation-using-the-bentson-floppy-tip-guidewire-via-a-supraglottic-airway-in-critically-ill-children
#9
D Cross, A Nyman, P James, A Durward
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation...
August 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28770972/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#10
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
August 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28768249/paediatric-home-parenteral-nutrition-in-the-czech-republic-and-its-development-multicentre-retrospective-study-1995-2011
#11
Jitka Stýblová, Jana Kalousová, Miroslava Adamcová, Kateřina Bajerová, Jiří Bronský, Filip Fencl, Eva Karásková, Petra Keslová, Jan Melek, Oldřich Pozler, Václav Sebroň, Astrid Šuláková, Jana Tejnická, Peter Tláskal, Ladislav Tomášek, Barbora Vlková, Peter Szitányi
BACKGROUND: Treatment quality and outcomes of paediatric home parenteral nutrition (HPN) program during its development in the Czech Republic. METHODS: A retrospective study of patients receiving HPN from May 1995 till June 2011. RESULTS: Sixty-six patients were treated in 8 centres. In 48 patients, long-term PN began in the first year of life and in 35 of them in the first month. Sixty children had gastrointestinal and 6 had non-gastrointestinal disease...
July 29, 2017: Annals of Nutrition & Metabolism
https://www.readbyqxmd.com/read/28752472/technical-challenges-related-to-implementation-of-a-formula-one-real-time-data-acquisition-and-analysis-system-in-a-paediatric-intensive-care-unit
#12
B Rajeswari Matam, Heather Duncan
Most existing, expert monitoring systems do not provide the real time continuous analysis of the monitored physiological data that is necessary to detect transient or combined vital sign indicators nor do they provide long term storage of the data for retrospective analyses. In this paper we examine the feasibility of implementing a long term data storage system which has the ability to incorporate real-time data analytics, the system design, report the main technical issues encountered, the solutions implemented and the statistics of the data recorded...
July 27, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28746800/the-changing-nature-of-relationships-between-parents-and-healthcare-providers-when-a-child-dies-in-the-paediatric-intensive-care-unit
#13
Ashleigh E Butler, Helen Hall, Beverley Copnell
AIM: To explore bereaved parents' interactions with healthcare providers when a child dies in a paediatric intensive care unit. BACKGROUND: Though most children admitted to a paediatric intensive care unit will survive, 2-5% will die during their stay. The parents of these children interact and form relationships with numerous healthcare staff during their child's illness and death. Though previous studies have explored the parental experience of child death in intensive care generally, the nature of their relationships with healthcare providers during this time remains unknown...
July 26, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28745959/closed-arterial-lab-sampling-devices-a-study-of-compliance-and-best-practice
#14
Ann Benedict, Adam Mayer, Heather Craven
As the quality of patient care continues to improve, nursing professionals are continuously tasked with researching, implementing, and evaluating best practices. The practice of obtaining blood samples from paediatric patients, using a conventional three-way stopcock method, has been associated with peripheral arterial catheter intraluminal contamination and catheter-related bloodstream infections. A paediatric cardiac intensive care unit (PCICU), in a large medical centre in the USA, set an objective to mitigate the risk of possible contamination by implementing the use of closed arterial lab sampling devices...
July 27, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28737301/vaccine-preventable-admissions-to-an-irish-paediatric-intensive-care
#15
Y Doyle, M Healy, C McMahon, S Crowe
In the Republic of Ireland, the schedule of state-funded immunisation for children is comprehensive and includes diphtheria, pertussis, tetanus, pneumococcus, hepatitis B, meningococcus C, haemophilus B, polio, measles, rubella and mumps. Varicella and meningococcal B vaccines are commercially available but are not currently funded by the government. Each of the illnesses preventable by these vaccines can cause substantial morbidity, and rarely mortality, in infants and children. Our PICU continues to see serious illness due to avoidable infection...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28714493/handwashing-practices-in-neonatal-intensive-care-unit-paediatric-intensive-care-unit-and-neonatal-nurseries-in-patan-hospital
#16
S Joshi, P Amatya, B Poudel, S A Yadav
BACKGROUND: Hand hygiene has been identified as the single most important factor in minimising hospital acquired infections. However, compliance of handwashing guidelines has remained low. The aim of this study was to study the handwashing practices in the Paediatric and Neonatal intensive care units and Neonatal nurseries in Patan Hospital, and secondly to re-evaluate the improvement on compliance of handwashing guidelines after intervention. METHODS: Pre-intervention study was conducted by covertly observing the handwashing practices by the healthcare workers...
January 2017: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28705790/children-with-life-limiting-conditions-in-paediatric-intensive-care-units-a-national-cohort-data-linkage-study
#17
Lorna K Fraser, Roger Parslow
OBJECTIVE: To determine how many children are admitted to paediatric intensive care unit (PICU) with life-limiting conditions (LLCs) and their outcomes. DESIGN: National cohort, data-linkage study. SETTING: PICUs in England. PATIENTS: Children admitted to a UK PICU (1 January 2004 and 31 March 2015) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to hospital episodes statistics enabled identification of children with a LLC using an International Classification of Diseases (ICD10) code list...
July 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28705570/la-pose-de-voie-veineuse-p%C3%A3-diatrique-par-les-%C3%A3-quipes-de-smur-adultes
#18
REVIEW
Frédéric Lemoine, Hugues Lefort, Sabine Lemoine, Benoît Frattini, Daniel Jost
Paediatric perfusion during pre-hospital care is a major issue in the event of life-threatening emergencies. Access, often restricted, to backup specialising in paediatrics, implies the existence of practices on protocols for the adult mobile emergency and intensive care service (Smur) in partnership with paediatricians. Paediatric perfusion practices were assessed in these teams. The results show the presence of a paediatric protocol in the adult Smur teams is not very common. Nursing practices seem to be evolving towards the recommendations, thanks to technological advances such as the use of the intraosseous device...
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28692913/particle-and-bioaerosol-characteristics-in-a-paediatric-intensive-care-unit
#19
Congrong He, Ian M Mackay, Kay Ramsay, Zhen Liang, Timothy Kidd, Luke D Knibbs, Graham Johnson, Donna McNeale, Rebecca Stockwell, Mark G Coulthard, Debbie A Long, Tara J Williams, Caroline Duchaine, Natalie Smith, Claire Wainwright, Lidia Morawska
The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens...
July 7, 2017: Environment International
https://www.readbyqxmd.com/read/28691745/prospective-evaluation-of-the-whitt-neonatal-trigger-score-in-an-at-risk-neonatal-population
#20
Anna Robinson, Lucinda C Winckworth, Georgios Eleftheriou, Rebecca Hewitson, Harriet Holme
AIM: The aim of this study was to prospectively evaluate the Whitt Neonatal Trigger Score (W-NTS), determining optimum threshold scores for consideration of medical intervention and intensive care unit admission. METHODS: All neonates on the postnatal ward (PNW) with a set of pre-defined risk factors were scored on the W-NTS. Neonates were divided into three groups: 'unwell' admitted to neonatal intensive care unit (NICU); 'well', who remained on the PNW receiving standard care; and 'intervention', who received antibiotics but did not require admission to NICU...
July 10, 2017: Journal of Paediatrics and Child Health
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