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Paediatric intensive care

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https://www.readbyqxmd.com/read/28336313/vancomycin-resistant-enterococci-colonisation-risk-factors-and-risk-for-infection-among-hospitalised-paediatric-patients-a-systematic-review-and-meta-analysis
#1
REVIEW
Myrto Eleni Flokas, Spyridon A Karageorgos, Marios Detsis, Michail Alevizakos, Eleftherios Mylonakis
The objective of this study was to estimate the rate and significance of colonisation with vancomycin-resistant enterococci (VRE) among hospitalised children. The PubMed and EMBASE databases were systematically searched (last accessed on 29 May 2016) to identify studies evaluating VRE colonisation of the gastrointestinal tract of hospitalised children in non-outbreak periods. Of 945 non-duplicate citations, 19 studies enrolling 20 234 children were included. The overall and paediatric intensive care unit (PICU) rate of VRE colonisation were both 5% [95% confidence interval (CI) 3-8% overall and 95% CI 2-9% in the PICU] but was 23% in haematology/oncology units (95% CI 18-29%)...
March 20, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28328787/prone-positioning-improves-ventilation-homogeneity-in-children-with-acute-respiratory-distress-syndrome
#2
Alison Lupton-Smith, Andrew Argent, Peter Rimensberger, Inez Frerichs, Brenda Morrow
OBJECTIVES: To determine the effect of prone positioning on ventilation distribution in children with acute respiratory distress syndrome. DESIGN: Prospective observational study. SETTING: Paediatric Intensive Care at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. PATIENTS: Mechanically ventilated children with acute respiratory distress syndrome. INTERVENTIONS: Electrical impedance tomography measures were taken in the supine position, after which the child was turned into the prone position, and subsequent electrical impedance tomography measurements were taken...
March 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#3
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28306345/a-retrospective-study-on-non-drug-related-poisoning-in-the-community-among-children-from-south-india
#4
Debasis Das Adhikari, Saibal Das, Blessed Winston A, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This retrospective study was performed to determine the incidence, demographic distribution, types and outcomes across various non-drug related poisonings among children attending a tertiary care center in south India. METHODS: All children from 0-16 years who presented to the Paediatric Emergency Department, Christian Medical College, Vellore with non-drug related poisoning from October 2004 to September 2013 were included. RESULTS: Out of the total 997 cases of poisoning, 629 (63...
March 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28302205/-value-of-nutritional-risk-screening-in-evaluating-adverse-clinical-outcomes-in-children-with-severe-pneumonia
#5
Xiao-Hui Guo, Yan-Feng Sun, Jiang-Bo Wang, Shu-Zhen Han, Jing Miao, Min Cui
OBJECTIVE: To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. METHODS: According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53)...
March 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28300495/hospital-acquired-infections-in-paediatric-medical-wards-at-a-tertiary-hospital-in-kwazulu-natal-south-africa
#6
Kevin B Spicer, Jennifer Green, Barnesh Dhada
BACKGROUND: Hospital-acquired infections (HAIs) impact care and costs in hospitals across the globe. There are minimal data on HAIs in sub-Saharan Africa and data specific to paediatrics are especially limited. OBJECTIVE: To describe the incidence of HAIs in the paediatric medical units at Grey's Hospital, a tertiary government hospital in KwaZulu-Natal, South Africa. METHODS: The Infection Prevention and Control (IPC) team collects data on all laboratory-confirmed infections, including from paediatric patients in two medical units (52 beds), the paediatric intensive/high-care unit (PICU, 8 beds) and the neonatal intensive care unit (NICU, 23 beds)...
March 16, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#7
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28296528/the-impact-of-early-hyperglycaemia-on-children-with-traumatic-brain-injury
#8
Yue-Qiang Fu, Shu-Ling Chong, Jan Hau Lee, Cheng-Jun Liu, Sheng Fu, Tsee Foong Loh, Kee Chong Ng, Feng Xu
OBJECTIVE: Hyperglycaemia is common amongst children with traumatic brain injury (TBI). We aim to investigate the association between early hyperglycaemia and poor clinical outcomes in children with moderate to severe TBI. METHODS: We performed a retrospective study in a tertiary paediatric hospital between May 2012 and October 2014 of all patients with TBI who were aged <16 years with a Glasgow Coma Scale (GCS) of ≤13. The primary outcome was death. Secondary outcomes were 14 ventilation-free, 14 paediatric intensive care unit (PICU)-free and 28 hospital-free days...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28292743/-the-score-matters-wide-variations-in-predictive-performance-of-18-paediatric-track-and-trigger-systems
#9
Susan M Chapman, Jo Wray, Kate Oulton, Christina Pagel, Samiran Ray, Mark J Peters
OBJECTIVE: To compare the predictive performance of 18 paediatric early warning systems (PEWS) in predicting critical deterioration. DESIGN: Retrospective case-controlled study. PEWS values were calculated from existing clinical data, and the area under the receiver operator characteristic curve (AUROC) compared. SETTING: UK tertiary referral children's hospital. PATIENTS: Patients without a 'do not attempt resuscitation' order admitted between 1 January 2011 and 31 December 2012...
March 14, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28288231/-primary-immunodeficiencies-in-seriously-ill-children-report-of-3-clinical-cases
#10
Leticia Yáñez, Pamela Lama, Carolina Rivacoba, Juanita Zamorano, María Angélica Marinovic
Primary immunodeficiency diseases (PID) are congenital disorders secondary to an impaired immune response. Infections, autoimmune disorders, atopy, and lymphoproliferative syndromes are commonly associated with this disorder. OBJECTIVE: To present and discuss 3 infants diagnosed with PID. CLINICAL CASES: The cases are presented of three patients with PID diagnosed during their first admission to a Paediatric Intensive Critical Care Unit. The first patient, a 4-month-old infant affected by a severe pneumonia, and was diagnosed as a Severe Combined Immunodeficiency Disease...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28284593/nurse-titrated-analgesia-and-sedation-in-intensive-care-increases-the-frequency-of-comfort-assessment-and-reduces-midazolam-use-in-paediatric-patients-following-cardiac-surgery
#11
Grace E Larson, Stephen McKeever
BACKGROUND: Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within individual units. OBJECTIVES: Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit. METHODS: A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol...
March 8, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28281427/trends-in-admissions-morbidity-and-outcomes-at-red-cross-war-memorial-children-s-hospital-cape-town-2004-2013
#12
Y Isaacs-Long, L Myer, H J Zar
BACKGROUND: Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA) hospitals. OBJECTIVES: To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children's Hospital (RCWMCH), a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28276281/in-vitro-susceptibility-and-resistance-phenotypes-in-contemporary-citrobacter-isolates-in-a-university-hospital-in-crete-greece
#13
Sofia Maraki, Konstantinos Z Vardakas, Viktoria-Eirini Mavromanolaki, Margarita Kyriakidou, George Spais, Diamantis P Kofteridis, George Samonis, Matthew E Falagas
BACKGROUND: Data on Citrobacter spp. susceptibility are scarce. We sought to study the evolution in the susceptibility of 385 Citrobacter spp. at the University Hospital of Heraklion, Crete, Greece during a six-year period (2010-2015). METHODS: Non-duplicate strains isolated from inpatients (intensive care unit, oncology, surgery, internal medicine, paediatrics) and outpatients were studied using Vitek 2. Phenotypic confirmatory tests were applied for detection of β-lactamases and aminoglycoside modifying enzymes...
March 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/28263341/risk-factors-for-mortality-in-asian-children-admitted-to-the-paediatric-intensive-care-unit-after-haematopoietic-stem-cell-transplantation
#14
Haripriya Santhanam, Jacqueline Sm Ong, Liang Shen, Poh Lin Tan, Pei Lin Koh
INTRODUCTION: This study aimed to investigate the risk factors associated with mortality in haematopoietic stem cell transplant (HSCT) patients admitted to our paediatric intensive care unit (PICU) over an 8-year period. MATERIALS AND METHODS: A retrospective chart review was conducted of all HSCT patients requiring PICU admission at our centre (a tertiary care university hospital in Singapore) from January 2002 to December 2010. Chief outcome measures were survival at the time of PICU discharge and survival at 6 months after initial PICU admission...
February 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28263089/good-quality-research-a-vital-step-in-improving-outcomes-in-paediatric-intensive-care-units-in-low-and-middle-income-countries
#15
Elizabeth C George
No abstract text is available yet for this article.
March 6, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#16
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...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28262913/pharmacological-interventions-for-recurrent-abdominal-pain-in-childhood
#17
REVIEW
Alice E Martin, Tamsin V Newlove-Delgado, Rebecca A Abbott, Alison Bethel, Joanna Thompson-Coon, Rebecca Whear, Stuart Logan
BACKGROUND: Between 4% and 25% of school-aged children at some stage complain of recurrent abdominal pain (RAP) of sufficient severity to interfere with their daily lives. When no clear organic cause is found, the children are managed with reassurance and simple measures; a large range of pharmacological interventions have been recommended for use in these children. OBJECTIVES: To determine the effectiveness of pharmacological interventions for RAP in children of school age...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28254165/content-validity-testing-of-the-esat-%C3%A2-a-decision-aid-tool-for-performing-endotracheal-suction-in-children
#18
K Davies, M Bulsara, A S Ramelet, L Monterosso
BACKGROUND AND PURPOSE: Endotracheal tube suction performed in children can affect clinical stability. Previous research has identified clinical indicators used to perform endotracheal suction. These were used to develop the Endotracheal Suction Assessment Tool(©) (ESAT(©)). This study sought to evaluate the degree to which the Endotracheal Suction Assessment Tool(©) items as a whole constitute an operational definition of the construct used to determine whether a paediatric intensive care nurse should perform the endotracheal tube suction procedure...
February 18, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28222699/suspicion-of-respiratory-tract-infection-with-multidrug-resistant-enterobacteriaceae-epidemiology-and-risk-factors-from-a-paediatric-intensive-care-unit
#19
Hanna Renk, Lenja Stoll, Felix Neunhoeffer, Florian Hölzl, Matthias Kumpf, Michael Hofbeck, Dominik Hartl
BACKGROUND: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. METHODS: A retrospective single-centre analysis of Enterobacteriaceae isolates from the lower respiratory tract of ventilated PICU patients from 2005 to 2014 was performed...
February 21, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#20
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
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