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Paediatric intensive care

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https://www.readbyqxmd.com/read/29775628/-cost-effectiveness-of-interventions-to-improve-hand-hygiene-in-healthcare-workers-in-middle-income-hospital-settings-a-model-based-analysis
#1
Nantasit Luangasanatip, Maliwan Hongsuwan, Yoel Lubell, Direk Limmathurotsakul, Pramot Srisamang, Nicholas Pj Day, Nicholas Graves, Ben S Cooper
BACKGROUND: Multimodal interventions are effective in increasing hand hygiene (HH) compliance amongst healthcare workers, but it is not known whether such interventions are cost-effective outside high-income countries. AIM: To evaluate the cost-effectiveness of multimodal hospital interventions to improve hand hygiene (HH) compliance in a middle-income country. METHOD: We adopted a conservative approach by developing a model to determine whether reductions in Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) alone would make HH interventions cost-effective in intensive care units (ICUs)...
May 15, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29752817/national-treatment-guidelines-decreased-the-use-of-racemic-adrenaline-for-bronchiolitis-in-four-finnish-university-hospitals
#2
Sauli Palmu, Minna Mecklin, Paula Heikkilä, Katri Backman, Ville Peltola, Marjo Renko, Matti Korppi
AIM: Inhaled racemic adrenaline was used for bronchiolitis in many hospitals in Finland prior to new national current care guidelines for bronchiolitis in 2014, which limited its recommendations to on-demand rescue therapy. We studied the drug's use before and after the new guidelines to gauge changes in prescribing habits. METHODS: This 2012-2016 study analysed how many 0.5 ml doses of racemic adrenaline were used for children by emergency rooms, paediatric wards and paediatric intensive care units at four university hospitals and estimated drug and staff costs...
May 12, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29752213/-when-no-one-s-looking-the-application-of-lung-recruitment-and-normal-saline-instillation-with-paediatric-endotracheal-suction-an-exploratory-study-of-nursing-practice
#3
Jessica A Schults, Marie Cooke, Debbie Long, Marion L Mitchell
BACKGROUND: The complex nature of the Paediatric Intensive Care Unit (PICU) patient requires the bedside nurse to make rapid, complex decisions regarding endotracheal suction (ETS) interventions. It is not understood what influences nurses' decision making in the context of ETS, however, the actions of the clinician have a direct impact on the efficacy of the ETS event and patient outcomes. OBJECTIVES: To explore and describe the use of normal saline instillation and lung recruitment with paediatric ETS in a cohort of Australian nurses, and to identify factors that influence normal saline use with ETS...
May 8, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29728212/-admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#4
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29722889/double-arterial-cannulation-a-strategy-for-whole-body-perfusion-during-aortic-arch-reconstruction
#5
Michaela Kreuzer, Eva Sames-Dolzer, Laura Schausberger, Andreas Tulzer, Thomas Ratschiller, Bettina Haizinger, Gerald Tulzer, Rudolf Mair
OBJECTIVES: Double-arterial cannulation enables cerebral perfusion and lower body perfusion during aortic arch reconstruction. The aim of this study was to analyse and report our experience of using this cannulation and perfusion technique on paediatric patients. METHODS: A retrospective single-centre study was carried out on 407 consecutive paediatric patients who underwent an aortic arch reconstruction under double-arterial cannulation between 2003 and 2015. The median age of the patients at surgery was 8 (range 2-5570) days, and body weight was 3...
May 2, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29706495/effect-of-red-blood-cell-storage-duration-on-outcome-after-paediatric-cardiac-surgery-a-prospective-observational-study
#6
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Chandrasekaran Ananthanarayanan, Ritesh Shah, Atul Solanki, Himani Pandya, Sanjay Patel
BACKGROUND: Retrospective reviews have found the use of stored packed red blood cells (PRBCs) in priming to be associated with increased risk of postoperative complications. The purpose of study was to prospectively investigate the influence of duration of storage of PRBCs used in priming the cardiopulmonary bypass (CPB) circuit on the metabolic profile of the patients, and postoperative outcome after paediatric cardiac surgery. METHODS: Between January 2015 and December 2015, 198 consecutive children operated for cardiac surgery using CPB and received blood for priming the circuit were included...
March 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#7
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29699643/admission-discharge-and-triage-guidelines-for-paediatric-intensive-care-units-in-spain
#8
Pedro de la Oliva, Francisco José Cambra-Lasaosa, Manuel Quintana-Díaz, Corsino Rey-Galán, Juan Ignacio Sánchez-Díaz, María Cruz Martín-Delgado, Juan Carlos de Carlos-Vicente, Ramón Hernández-Rastrollo, María Soledad Holanda-Peña, Francisco Javier Pilar-Orive, Esther Ocete-Hita, Antonio Rodríguez-Núñez, Ana Serrano-González, Luis Blanch
A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs...
May 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29695029/paediatric-acute-care-highlights-from-the-paediatric-acute-care-advanced-paediatric-life-support-conference-gold-coast-2017
#9
Stephen Ss Teo, Arjun Rao, Jason Acworth
The Paediatric Acute Care Conference is an annual conference organised by APLS Australia to advance paediatric acute care topics for clinicians in pre-hospital medicine, EDs, acute paediatrics, intensive care and anaesthesia. The Conference 2017 was held at Surfers Paradise, Queensland. We provide a summary of some of the presentations.
April 25, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29686490/autonomic-instability-in-a-dehydrated-child-on-guanfacine-case-report-and-literature-review
#10
Elizabeth Roach-Fox, Eva Welisch, Amrita Sarpal
An 8-year-old girl on guanfacine extended-release (GXR) for attention-deficit/hyperactivity disorder presented with somnolence, bradycardia and hypotension during a heat wave. No overdose was suspected. She was admitted to the intensive care unit for monitoring and ongoing fluid resuscitation for hypotension. Electrocardiogram showed intermittent atrioventricular dissociation. Upon restarting the drug post-discharge, blood pressures were normal, and follow-up electrocardiograms documented asymptomatic bradycardia but no dissociation...
April 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29681513/antimicrobial-consumption-and-resistance-in-adult-hospital-inpatients-in-53-countries-results-of-an-internet-based-global-point-prevalence-survey
#11
Ann Versporten, Peter Zarb, Isabelle Caniaux, Marie-Françoise Gros, Nico Drapier, Mark Miller, Vincent Jarlier, Dilip Nathwani, Herman Goossens
BACKGROUND: The Global Point Prevalence Survey (Global-PPS) established an international network of hospitals to measure antimicrobial prescribing and resistance worldwide. We aimed to assess antimicrobial prescribing and resistance in hospital inpatients. METHODS: We used a standardised surveillance method to collect detailed data about antimicrobial prescribing and resistance from hospitals worldwide, which were grouped by UN region. The internet-based survey included all inpatients (adults, children, and neonates) receiving an antimicrobial who were on the ward at 0800 h on one specific day between January and September, 2015...
April 19, 2018: Lancet Global Health
https://www.readbyqxmd.com/read/29680409/-usefulness-of-early-lung-ultrasound-in-acute-mild-moderate-acute-bronchiolitis-a-pilot-study
#12
Elia Zoido Garrote, Cristina García Aparicio, Constanza Camila Torrez Villarroel, Antonio Pedro Vega García, Manoel Muñiz Fontán, Ignacio Oulego Erroz
OBJECTIVE: To determine the correlation between the findings seen in early lung ultrasound with the clinical severity scales, and its association with the subsequent progression of the mild-moderate acute bronchiolitis (AB). PATIENTS AND METHODS: An observational prospective study conducted on infants with mild-moderate BA, using lung ultrasound in the first 24hours of hospital care. The lung involvement was graded (range 0-50 points) based on an ultrasound score (ScECO) and 2routinely used clinical scales: the modified Wood Downes Ferres (WDFM), and the Hospital Sant Joan de Deu (HSJD)...
April 18, 2018: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29680262/clinical-implications-of-intravenous-drug-incompatibilities-in-critically-ill-patients
#13
REVIEW
Malik Benlabed, Maxime Perez, Romain Gaudy, Stéphanie Genay, Damien Lannoy, Christine Barthélémy, Pascal Odou, Gilles Lebuffe, Bertrand Décaudin
OBJECTIVE: The aim of this review is to analyse the clinical consequences of intravenous drug incompatibilities in critically ill patients, especially the incidence of organ dysfunctions and mortality. METHODS: A review of literature was conducted according to the PRISMA statement in June 2017, using Medline, ISI Web of Science and Clinicaltrials.gov. DATA EXTRACTION: Eligible studies were case reports and randomised controlled trials (RCTs) that assessed the effects of drug incompatibilities in critically ill patients on morbidity or mortality as primary or secondary outcomes, or adverse events...
April 19, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29670762/rolling-refresher-simulation-improves-performance-and-retention-of-paediatric-intensive-care-unit-nurse-code-cart-management
#14
Marcy N Singleton, Kimberly F Allen, Zhongze Li, Kevin McNerney, Urs H Naber, Matthew S Braga
Introduction: Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. Methods: An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29667311/how-japanese-nurses-participate-in-decision-making-infants-with-congenital-life-threatening-conditions
#15
Sohei Shitaya, Nobue Nakamura, Naho Sato
BACKGROUND: In Japan, owing to the progress in medical technology, more children with congenital life-threatening conditions survive than ever before. Nurses who care for these children may also influence decision making in difficult situations. AIM: We aimed to describe Japanese nurses' approach toward medical decision making when caring for families of infants with congenital life-threatening conditions. Frequently, these nurses must care for and support parents with ambivalent feelings...
April 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29666125/patient-safety-climate-in-general-public-hospitals-in-china-differences-associated-with-department-and-job-type-based-on-a-cross-sectional-survey
#16
Ping Zhou, Fei Bai, Hui-Qin Tang, Jie Bai, Min-Qi Li, Di Xue
OBJECTIVE: This study analysed differences in the perceived patient safety climate among different working departments and job types in public general hospitals in China. DESIGN: Cross-sectional survey. SETTING: Eighteen tertiary hospitals and 36 secondary hospitals from 10 areas in Shanghai, Hubei Province and Gansu Province, China. PARTICIPANTS: Overall, 4753 staff, including physicians, nurses, medical technicians and managers, were recruited from March to June 2015...
April 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29656490/cross-cultural-adaptation-reliability-and-validity-of-the-spanish-version-of-the-neonatal-skin-risk-assessment-scale
#17
Pablo García-Molina, Evelin Balaguer López, José Verdú, Andreu Nolasco, Francisco P García Fernández
AIM: To adapt the Neonatal Skin Risk Assessment Scale to the Spanish context and to test its validity and reliability. BACKGROUND: Currently, in Spain there are no validated scales to evaluate the risk of pressure ulcers in infants. METHOD: The research was performed in 10 neonatal units. Overall, we use an observational study design, but divided it in to three stages. In the first stage, the transcultural adaptation of the scale and its content validation was performed...
April 14, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29655596/validation-of-the-nursing-workload-scoring-systems-nursing-activities-score-nas-and-therapeutic-intervention-scoring-system-for-critically-ill-children-tiss-c-in-a-greek-paediatric-intensive-care-unit
#18
Alexandra-Stavroula Nieri, Kalliopi Manousaki, Maria Kalafati, Katia Grilio Padilha, Siv K Stafseth, Theodoros Katsoulas, Vasiliki Matziou, Margarita Giannakopoulou
OBJECTIVES: To assess the reliability and validity of the Greek version of Nursing Activities Score (NAS), and Therapeutic Intervention Scoring System for Critically Ill Children (TISS-C) in a Greek Paediatric Intensive Care Unit (PICU). RESEARCH METHODOLOGY: A methodological study was performed in one PICU of the largest Paediatric Hospital in Athens-Greece. The culturally adapted and validated Greek NAS version, enriched according to the Norwegian paediatric one (P-NAS), was used...
April 11, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29643555/ultrasound-guided-internal-jugular-vein-cannulation-in-infants-comparative-evaluation-of-novel-modified-short-axis-out-of-plane-approach-with-conventional-short-axis-out-of-plane-approach
#19
Amit Rastogi, Aarti Agarwal, Puneet Goyal, Vansh Priya, Sanjay Dhiraaj, Rudrashish Haldar
Background and Aims: Central venous cannulation (CVC) through right internal jugular vein (IJV) route is routinely performed in paediatric patients undergoing major surgery and in those admitted to intensive care units. A novel technique (modified short-axis out-of-plane [MSA-OOP]) to improve first pass success rate of ultrasound-guided IJV CVC in neonates and infants is being compared with conventional SA-OOP method. Methods: A total of 120 patients were enroled in the study over a period of 6 months...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29629684/hypertension-as-the-trigger-for-posterior-reversible-encephalopathy-syndrome-in-paediatric-renal-patients-an-important-diagnosis-that-should-not-be-missed
#20
J K Strong, K L Petersen, U Kala
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a reversible neurological condition presenting with seizures and visual disturbances and diagnosed on magnetic resonance imaging (MRI). Little is understood about its pathogenesis, particularly in children, but it is thought to be related to hypertension. OBJECTIVES: To review the presentation, diagnosis and outcome of PRES in paediatric renal patients at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa, between 1 January 2000 and 31 January 2017 and compare these with published case reports to date...
March 28, 2018: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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