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Paediatric intensive care

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https://www.readbyqxmd.com/read/28924282/overcrowding-and-possible-solutions-for-a-busy-paediatric-emergency-department
#1
Muhammad Irfan Habib, Khalid Mehmood Khan
OBJECTIVE: To quantify the extent of emergency department overcrowding in a tertiary care hospital and to identify possible solutions. METHODS: This retrospective study was conducted at the National Institute of Child Health, Karachi, and comprised data of all patients presenting to the emergency department from November 2014 to January 2015. Data was collected through the health management information system which generates daily report of patients. Patients who stayed at the emergency department for 4 or more hours were included...
September 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28921175/routine-gastric-residual-volume-measurement-and-energy-target-achievement-in-the-picu-a-comparison-study
#2
Lyvonne N Tume, Anna Bickerdike, Lynne Latten, Simon Davies, Madeleine H Lefèvre, Gaëlle W Nicolas, Frédéric V Valla
Critically ill children frequently fail to achieve adequate energy intake, and some care practices, such as the measurement of gastric residual volume (GRV), may contribute to this problem. We compared outcomes in two similar European Paediatric Intensive Care Units (PICUs): one which routinely measures GRV (PICU-GRV) to one unit that does not (PICU-noGRV). An observational pilot comparison study was undertaken. Eighty-seven children were included in the study, 42 (PICU-GRV) and 45 (PICU-noGRV). There were no significant differences in the percentage of energy targets achieved in the first 4 days of PICU admission although PICU-noGRV showed more consistent delivery of median (and IQR) energy targets and less under and over feeding for PICU-GRV and PICU-noGRV: day 1 37 (14-72) vs 44 (0-100), day 2 97 (53-126) vs 100 (100-100), day 3 84 (45-112) vs 100 (100-100) and day 4 101 (63-124) vs 100 (100-100)...
September 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28911288/impact-of-thrombelastography-in-paediatric-intensive-care
#3
B G Carter, E Carland, P Monagle, S B Horton, W Butt
We assessed the clinical impact of thrombelastography (TEG®) results (TEG® 5000, Haemonetics Corporation, Braintree, MA, USA) by measuring their ability to cause changes in a theoretical treatment plan and contribute to the understanding of haemostasis. We prospectively included paediatric intensive care unit (PICU) patients who had standard tests of haemostasis and TEG ordered and had an arterial catheter or extracorporeal access port in situ. Blood for standard tests and TEG was taken simultaneously. Independent of patient care, general patient information and results of standard laboratory tests were presented to five clinicians who were asked to document their theoretical treatment plan...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28889825/enhancement-of-diuresis-with-metolazone-in-infant-paediatric-cardiac-intensive-care-patients
#4
Russell T Wise, Brady S Moffett, Ayse Akcan-Arikan, Marianne Galati, Natasha Afonso, Paul A Checchia
BACKGROUND: Few data are available regarding the use of metolazone in infants in cardiac intensive care. Researchers need to carry out further evaluation to characterise the effects of this treatment in this population. METHODS: This is a descriptive, retrospective study carried out in patients less than a year old. These infants had received metolazone over a 2-year period in the paediatric cardiac intensive care unit at our institution. The primary goal was to measure the change in urine output from 24 hours before the start of metolazone therapy to 24 hours after...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28889818/efficacy-and-safety-of-recombinant-tissue-plasminogen-activator-for-venous-thrombosis-after-paediatric-heart-surgery
#5
Lindsey B Justice, David P Nelson, Joseph Palumbo, Jaclyn Sawyer, Manish N Patel, Jonathan W Byrnes
OBJECTIVE: Reports in the literature of treatment with recombinant tissue plasminogen activator following cardiac surgery are limited. We reviewed our experience to provide a case series of the therapeutic use of tissue plasminogen activator for the treatment of venous thrombosis in children after cardiac surgery. The data describe the morbidity, mortality, and clinical outcomes of tissue plasminogen activator administration for treatment of venous thrombosis in children following cardiac surgery...
September 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28886496/convulsive-status-epilepticus-in-a-quaternary-hospital-paediatric-intensive-care-unit-picu-in-south-africa-an-8-year-review
#6
Yavini Reddy, Yusentha Balakrishna, Lawrence Mubaiwa
PURPOSE: Convulsive status epilepticus (CSE) is associated with a high morbidity and mortality. This study aimed to describe the clinical profile, aetiology, neuroimaging and EEG findings as well as outcome of children with CSE in Sub-Saharan Africa. METHODS: This was a retrospective analysis of electronic records of children with CSE admitted to the Paediatric Intensive Care Unit (PICU) over an 8-year period from January 2007 to December 2014. RESULTS: Seventy six patients were admitted to the PICU with CSE and 55(72%) had refractory status epilepticus...
August 2, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28883098/randomised-trial-of-estimating-oral-endotracheal-tube-insertion-depth-in-newborns-using-weight-or-vocal-cord-guide
#7
Irwin Gill, Aisling Stafford, Madeleine C Murphy, Aisling R Geoghegan, Miranda Crealey, Eoghan Laffan, Colm Patrick Finbarr O'Donnell
BACKGROUND: When intubating newborns, clinicians aim to position the endotracheal tube (ETT) tip in the midtrachea. The depth to which ETTs should be inserted is often estimated using the infant's weight. ETTs are frequently incorrectly positioned in newborns, most often inserted too far. Using the vocal cord guide (a mark at the distal end of the ETT) to guide insertion depth has been recommended. OBJECTIVE: To determine whether estimating ETT insertion depth using the vocal cord guide rather than weight results in more correctly positioned ETT tips...
September 7, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28882361/relation-between-parental-psychopathology-and-posttraumatic-growth-after-a-child-s-admission-to-intensive-care-two-faces-of-the-same-coin
#8
Rocío Rodríguez-Rey, Jesús Alonso-Tapia
OBJECTIVES: Confronted with the potentially traumatic experience of a child's admission to a paediatric intensive care unit, parents may experience psychopathological post-trauma symptoms as well as posttraumatic growth. The aim of this cross-sectional study was to explore the relation between psychopathology symptoms, namely, posttraumatic stress disorder), anxiety and depression, as well as post traumatic growth in parents following their child's hospitalisation in a paediatric intensive care unit...
September 4, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28876668/accidental-and-non-accidental-injury-related-admissions-to-the-paediatric-intensive-care-unit-at-chris-hani-baragwanath-academic-hospital-johannesburg
#9
N Patel, I Khofi-Phiri, R Mathiva, A Grieve, J Loveland, G Nethathe
BACKGROUND: Paediatric trauma is a major cause of morbidity and mortality in low and middle income countries. Data from these regions describing the extent and severity of this problem is scant. Local data is vital to understanding and responding to the problem of childhood injury. METHOD: A retrospective record review of all trauma cases admitted to the PICU at CHBAH from 1 January 2011 to 31 December 2013 was performed. Descriptive statistics were generated using MS Excel...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28875887/the-spectrum-and-outcome-of-paediatric-traumatic-brain-injury-in-kwazulu-natal-province-south-africa-has-not-changed-over-the-last-two-decades
#10
J J P Buitendag, V Y Kong, J L Bruce, G L Laing, D L Clarke, P Brysiewicz
OBJECTIVES: This retrospective review of a prospectively entered and maintained hybrid electronic trauma registry was intended to develop a comprehensive overview of traumatic brain injury (TBI) in children and adolescents and to compare it with previous audits from our local environment and from other developing world centres. All TBI patients admitted to hospital were included in this study. We reviewed the age, gender, outcomes, radiological findings and treatment of the patients. METHODS: All patients aged ≤18 years old who were admitted by the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI between December 2012 and December 2016 were included in this audit...
August 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28875787/observing-the-best-of-care
#11
Ewout van Sabben
In my second year of training as a children's nursing student, I was on placement on a paediatric intensive care unit when I had the opportunity to observe an 11-year-old boy with rheumatic heart disease undergo cardiac surgery.
September 6, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28872351/neuropsychological-outcome-of-children-with-traumatic-brain-injury-and-its-association-with-late-magnetic-resonance-imaging-findings-a-cohort-study
#12
Daniele S J Volpe, Nátali C A C Oliveira, A Carlos Santos, Maria B M Linhares, Ana P C P Carlotti
OBJECTIVES: To evaluate neuropsychological outcome after traumatic brain injury (TBI) and its association with trauma severity and late magnetic resonance imaging (MRI) findings. METHODS: Prospective cohort study of patients with TBI admitted to the paediatric intensive care unit over 5 years. Trauma severity was determined by Glasgow Coma Scale (GCS), neurological outcome by King's Outcome Scale for Childhood Head Injury (KOSCHI) and neuropsychological outcome by Wechsler Intelligence Scale for Children - Fourth Edition...
September 5, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28872281/transitioning-young-adults-from-paediatric-to-adult-care-and-the-hiv-care-continuum-in-atlanta-georgia-usa-a-retrospective-cohort-study
#13
Sophia A Hussen, Rana Chakraborty, Andrea Knezevic, Andres Camacho-Gonzalez, Eugene Huang, Rob Stephenson, Carlos Del Rio
INTRODUCTION: The transition from paediatric to adult HIV care is a particularly high-risk time for disengagement among young adults; however, empirical data are lacking. METHODS: We reviewed medical records of 72 youth seen in both the paediatric and the adult clinics of the Grady Infectious Disease Program in Atlanta, Georgia, USA, from 2004 to 2014. We abstracted clinical data on linkage, retention and virologic suppression from the last two years in the paediatric clinic through the first two years in the adult clinic...
September 1, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28871637/deaths-and-end-of-life-decisions-differed-between-neonatal-and-paediatric-intensive-care-units-at-the-same-children-s-hospital
#14
Maartje C Snoep, Nicolaas J G Jansen, Floris Groenendaal
AIM: We compared neonatal deaths and end-of-life decisions in a neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU) in a Dutch tertiary children's hospital. SUBJECTS: All 235 full-term infants who died within 28 days of life between 2003-2013 in the NICU (n=199) and PICU (n=36) were retrospectively studied. RESULTS: The median length of stay was three days in the NICU and seven days in the PICU (p=0.003). The main reasons for NICU stays were asphyxia (52...
September 4, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28871418/time-spent-with-impaired-autoregulation-is-linked-with-outcome-in-severe-infant-paediatric-traumatic-brain-injury
#15
Konstantin Hockel, Jennifer Diedler, Felix Neunhoeffer, Ellen Heimberg, Carmen Nagel, Martin U Schuhmann
BACKGROUND: It could be shown in traumatic brain injury (TBI) in adults that the functional status of cerebrovascular autoregulation (AR), determined by the pressure reactivity index (PRx), correlates to and even predicts outcome. We investigated PRx, cerebral perfusion pressure (CPP) and intracranial pressure (ICP) and their correlation to outcome in severe infant and paediatric TBI. METHODS: Seventeen patients (range, 1 day to 14 years) with severe TBI (median GCS at presentation, 4) underwent long-term computerised ICP and mean arterial pressure (MAP) monitoring using dedicated software to determine CPP and PRx and optimal CPP (CPP level where PRx shows best autoregulation) continuously...
September 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28867411/toxic-shock-syndrome-in-paediatric-thermal-injuries-a-case-series-and-systematic-literature-review
#16
Linda Gutzler, Clemens Schiestl, Martin Meuli, Carol Oliveira
BACKGROUND: Toxic shock syndrome (TSS) is a rare, but potentially life-threatening complication of thermal injuries in children. The study objective was to systematically review the literature on paediatric TSS after burns or scalds, and describe our experience with this condition in Switzerland. METHODS: All tertiary paediatric healthcare centres managing burns and scalds in Switzerland were inquired. A systematic literature review was performed using EMBASE (1947-2016), MEDLINE (1946-2016), Web of Science (1900-2016) and Google Scholar in October 2016...
August 31, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28862129/duration-of-intravenous-antibiotic-therapy-for-children-with-acute-osteomyelitis-or-septic-arthritis-a-feasibility-study
#17
Hans de Graaf, Priya Sukhtankar, Barbara Arch, Nusreen Ahmad, Amanda Lees, Abigail Bennett, Catherine Spowart, Helen Hickey, Annmarie Jeanes, Kate Armon, Andrew Riordan, Jethro Herberg, Scott Hackett, Carrol Gamble, Delane Shingadia, Ann Pallett, Stuart C Clarke, Philip Henman, Marieke Emonts, Mike Sharland, Adam Finn, Andrew J Pollard, Colin Powell, Peter Marsh, Claire Ballinger, Paula R Williamson, Nicholas Mp Clarke, Saul N Faust
BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28845129/sepsis-epidemiology-and-outcome-in-the-paediatric-intensive-care-unit-of-vilnius-university-children-s-hospital
#18
Odeta Bobelytė, Ieva Gailiūtė, Vytautas Zubka, Virginija Žilinskaitė
Research was carried out at the paediatric intensive care unit (paediatric ICU) of the Children's Hospital, affiliate of Vilnius University Hospital Santariškių klinikos. BACKGROUND: Being the most common cause of children's death, sepsis is a challenge for most physicians. In order to improve the outcomes, it is important to know the aetiology and peculiarities of sepsis in a particular region and hospital. The aim of this study was to analyse the outcomes of sepsis in a paediatric intensive care unit and their relation with patients' characteristics and causative microorganisms...
2017: Acta medica Lituanica
https://www.readbyqxmd.com/read/28840940/research-priorities-for-specialized-nursing-practice-in-the-united-arab-emirates
#19
N Al-Yateem, M Al-Tamimi, M Brenner, H Altawil, A Ahmad, S Brownie
BACKGROUND: Globally, nurses are undertaking expanded and more specialized roles in healthcare planning and service delivery in response to changing patterns and levels of health service demand. This means the nursing profession is increasingly considered as leaders in health service policy, research and practice. The United Arab Emirates has strengthened nursing governance and practice by establishing a Nursing and Midwifery Council and increasing the activity of nursing specialization, service leadership and research...
August 25, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28838627/adherence-to-standard-medication-infusion-concentrations-and-its-impact-on-paediatric-intensive-care-patient-outcomes
#20
Michele L Cree, Christian F Stocker, Quyen M Tu, Loretta F Scaini
AIM: To review compliance with the DERS, and to evaluate the impact on daily fluid balances as a standard outcome in paediatric intensive care. METHOD: A prospective audit of patients admitted to our tertiary level PICU over a 10day period. The audit tool collated information on patient's weight, diagnosis, medication infusions, whether standard concentrations were selected, daily fluid balance, target fluid balance, and renal support including use of diuretics...
August 21, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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