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Paediatric intensive care

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https://www.readbyqxmd.com/read/29153961/welcoming-expertise-bereaved-parents-perceptions-of-the-parent-healthcare-provider-relationship-when-a-critically-ill-child-is-admitted-to-the-paediatric-intensive-care-unit
#1
Ashleigh E Butler, Beverley Copnell, Helen Hall
BACKGROUND: Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child's well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers' roles in this early stage of their paediatric intensive care journey is currently unknown. PURPOSE: This paper explores bereaved parents' perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29152933/ventilator-induced-lung-injury-does-it-occur-in-children
#2
Martin C Kneyber
Mechanical ventilation is one of the most practiced interventions in the paediatric intensive care unit (PICU). Although unmistakable life-saving, it can also injury the lung, a process coined ventilator induced lung injury (VILI). To date, almost all of our knowledge VILI has been obtained from studies in adults or experimental studies mimicking the adult critical care situation. This leaves the question if VILI is of importance in the paediatric context. Paediatric clinical studies did not confirm an association between large tidal volume (Vt) and adverse outcome...
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29150842/the-effect-of-6-hydroxyethyl-starch-130-0-4-on-acute-kidney-injury-in-paediatric-cardiac-surgery-a-prospective-randomised-trial
#3
H-W Oh, J-H Lee, H-C Kim, E-H Kim, I-K Song, H-S Kim, J-T Kim
We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte(®) ) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg(-1) . In the control group, only crystalloid fluid was used during the peri-operative period. The incidence of acute kidney injury, peri-operative transfusion, clinical outcomes and laboratory data were compared...
November 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29149469/cuffed-versus-uncuffed-endotracheal-tubes-for-general-anaesthesia-in-children-aged-eight-years-and-under
#4
REVIEW
Flavia A De Orange, Rebeca Gac Andrade, Andrea Lemos, Paulo Sgn Borges, José N Figueiroa, Pete G Kovatsis
BACKGROUND: Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29149387/analgosedation-in-paediatric-severe-traumatic-brain-injury-tbi-practice-pitfalls-and-possibilities
#5
N Ketharanathan, Y Yamamoto, U Rohlwink, E D Wildschut, M Hunfeld, E C M de Lange, D Tibboel
Analgosedation is a fundamental part of traumatic brain injury (TBI) treatment guidelines, encompassing both first and second tier supportive strategies. Worldwide analgosedation practices continue to be heterogeneous due to the low level of evidence in treatment guidelines (level III) and the choice of analgosedative drugs is made by the treating clinician. Current practice is thus empirical and may result in unfavourable (often hemodynamic) side effects. This article presents an overview of current analgosedation practices in the paediatric intensive care unit (PICU) and addresses pitfalls both in the short and long term...
October 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29132842/-a-comparison-of-post-surgical-plasma-glucose-levels-in-patients-on-fluids-with-different-glucose-concentrations
#6
Isabel Martínez Carapeto, José Domingo López Castilla, Reyes Fresneda Gutiérrez
OBJECTIVE: To compare plasma glucose levels and incidence of hyperglycaemia in the post-operative period after general surgery using fluids with different glucose. METHODOLOGY: A randomised, open-label, non-blind, clinical trial was conducted on patients admitted to Paediatric Intensive Care Unit after elective surgery. The inclusion criteria were from 6 months to 14 years of age, with a weight greater than 6kg, onset glucose level >60mg/dL, and a signed informed consent, with no oral intake and maintenance intravenous fluid therapy using fluids with 3...
November 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29132259/costs-associated-with-the-management-of-waste-from-healthcare-facilities-an-analysis-at-national-and-site-level
#7
Mentore Vaccari, Terry Tudor, Andrea Perteghella
Given rising spend on the provision of healthcare services, the sustainable management of waste from healthcare facilities is increasingly becoming a focus as a means of reducing public health risks and financial costs. Using data on per capita healthcare spend at the national level, as well as a case study of a hospital in Italy, this study examined the relationship between trends in waste generation and the associated costs of managing the waste. At the national level, healthcare spend as a percentage of gross domestic product positively correlated with waste arisings...
November 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/29131465/psychometric-analysis-of-subjective-sedation-scales-used-for-critically-ill-paediatric-patients
#8
Xiaohua Ge, Tingting Zhang, Lingling Zhou
AIMS: This study evaluated the psychometric properties of subjective sedation scales using one psychometric scoring system to identify the appropriate scale that is most suitable for clinical care practice. BACKGROUND: A number of published sedation assessment scales for paediatric patients are currently used to attempt to achieve a moderate depth of sedation to avoid the undesirable effects caused by over- or undersedation. However, there has been no systematic review of these scales...
November 12, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29125229/observational-review-of-paediatric-intraosseous-needle-placement-in-the-paediatric-emergency-department
#9
Elysha L Pifko, Amanda Price, Carrie Busch, Curren Smith, Yunyun Jiang, Joseph Dobson, Rachel Tuuri
AIM: Intraosseous (IO) access is a life-saving option during resuscitations in the paediatric emergency department (PED). This study aimed to compare success rates and time to placement for Manual IO versus EZ-IO needles in PED patients ≤8 and >8 kg. METHODS: This was a retrospective cross-sectional descriptive study of IO use in a single-centre tertiary PED from 2006 to 2014. Cases were identified through diagnosis codes for IO infusion, cardiopulmonary resuscitation and cardiac arrest and admissions to the intensive care unit...
November 10, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29123603/paediatric-appropriate-facilities-in-emergency-departments-of-community-hospitals-in-ontario-a-cross-sectional-study
#10
Muhammad Akhter Hamid, Sohaib Siddiqui, Jabeen Fayyaz, Ayesha Chandna, Aliya Ariz, Joe Butchey, Elancheliyan Ambalavanar, Niraj Mistry, Aftab Muhammad Azad, Junaid A Bhatti, Dennis Scolnik
BACKGROUND: We assessed whether the paediatric-appropriate facilities were available at Emergency Departments (ED) in community hospitals in a Canadian province. METHODS: We conducted a cross-sectional survey of EDs in community hospitals in Ontario, Canada that had inpatient paediatric facilities and a neonatal intensive care unit. Key informants were ED chiefs, clinical educators, or managers. The survey included questions about paediatric facilities related to environment, triage, training, and staff in EDs...
2017: World Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29119819/stories-of-survival-children-s-narratives-of-psychosocial-well-being-following-paediatric-critical-illness-or-injury
#11
Joseph C Manning, Pippa Hemingway, Sarah A Redsell
Survival from critical illness can expose children to an array of negative physical and psychological problems. While the perspective of parents and professionals have been well documented, there is limited understanding of how childhood critical care survivors make sense of their experiences in relation to psychosocial well-being. We aimed to explore long-term psychosocial well-being of childhood survivors of critical illness through their stories. A qualitative, exploratory study using serial in-depth interviews was employed...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29115202/risk-factors-for-hospital-associated-venous-thromboembolism-in-critically-ill-children-following-cardiothoracic-surgery-or-therapeutic-cardiac-catheterisation
#12
Christie M Atchison, Ernest Amankwah, Jean Wilhelm, Shilpa Arlikar, Brian R Branchford, Arabela Stock, Michael Streiff, Clifford Takemoto, Irmel Ayala, Allen Everett, Gary Stapleton, Marshall L Jacobs, Jeffrey P Jacobs, Neil A Goldenberg
BACKGROUND: Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. OBJECTIVE: The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. METHODS: We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St...
November 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29108859/-spanish-translation-and-validation-of-the-empathic-30-questionnaire-to-measure-parental-satisfaction-in-intensive-care-units
#13
Francisco Javier Pilar Orive, Jasone Basabe Lozano, Aurora López Zuñiga, Yolanda M López Fernández, Julene Escudero Argaluza, Jos M Latour
INTRODUCTION: Few validated surveys measuring parental satisfaction in the Paediatric Intensive Care Unit (PICU) are available, and none of them in Spanish language. The aim of this study is to translate and validate the questionnaire EMpowerment of PArents in THe Intensive Care (EMPATHIC). This questionnaire measures parental perceptions of paediatric intensive care-related satisfaction items in the Spanish language. MATERIAL AND METHODS: A prospective cohort study was carried out using questionnaires completed by relatives of children (range 0-17 years old) admitted into a tertiary PICU...
November 3, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/29102527/functional-assessment-of-a-series-of-paediatric-patients-receiving-neurointensive-treatment-new-functional-status-scale
#14
P Madurga-Revilla, J López-Pisón, P Samper-Villagrasa, R Garcés-Gómez, J P García-Íñiguez, M Domínguez-Cajal, I Gil-Hernández, S Viscor-Zárate
INTRODUCTION: Functional health, a reliable parameter of the impact of disease, should be used systematically to assess prognosis in paediatric intensive care units (PICU). Developing scales for the assessment of functional health is therefore essential. The Paediatric Overall and Cerebral Performance Category (POPC, PCPC) scales have traditionally been used in paediatric studies. The new Functional Status Scale (FSS) was designed to provide more objective results. This study aims to confirm the validity of the FSS compared to the classic POPC and PCPC scales, and to evaluate whether it may also be superior to the latter in assessing of neurological function...
November 1, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29081997/implementation-of-effective-practices-in-health-facilities-a-systematic-review-of-cluster-randomised-trials
#15
Emma R Allanson, Özge Tunçalp, Joshua P Vogel, Dina N Khan, Olufemi T Oladapo, Qian Long, Ahmet Metin Gülmezoglu
BACKGROUND: The capacity for health systems to support the translation of research in to clinical practice may be limited. The cluster randomised controlled trial (cluster RCT) design is often employed in evaluating the effectiveness of implementation of evidence-based practices. We aimed to systematically review available evidence to identify and evaluate the components in the implementation process at the facility level using cluster RCT designs. METHODS: All cluster RCTs where the healthcare facility was the unit of randomisation, published or written from 1990 to 2014, were assessed...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29067985/point-prevalence-risk-factor-assessment-for-hospital-acquired-infections-in-a-tertiary-care-hospital-in-pune-india
#16
Velu Nair, A K Sahni, Dinesh Sharma, Naveen Grover, S Shankar, A Chakravarty, Seema Patrikar, Kailas Methe, S S Jaiswal, S S Dalal, Anupam Kapur, Rajesh Verma, Jyoti Prakash, Ashutosh Gupta, Anvita Bhansali, Deepak Batura, G Gopal Rao, D P Joshi, B K Chopra
BACKGROUND & OBJECTIVES: Hospital-acquired infections (HAIs) are a major challenge to patient safety and have serious public health implications by changing the quality of life of patients and sometimes causing disability or even death. The true burden of HAI remains unknown, particularly in developing countries. The objective of this study was to estimate point prevalence of HAI and study the associated risk factors in a tertiary care hospital in Pune, India. METHODS: A series of four cross-sectional point prevalence surveys were carried out between March and August 2014...
June 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29062561/transposition-of-the-great-arteries-and-coarctation-of-the-aorta-in-an-infant-presenting-with-bronchiolitis-an-incidental-finding
#17
Khaloud S Al-Mukhaini, Ala M Mohamed
The transposition of the great arteries (TGA) is a complex congenital heart disease which usually presents as cyanosis in neonates with limited mixing between the systemic and pulmonary circulatory systems. A delayed diagnosis of TGA can lead to ventricular failure. We report a six-week-old infant who was admitted to the paediatric Intensive Care Unit of the Royal Hospital, Muscat, Oman, in 2016 for bronchiolitis. During admission, she was incidentally diagnosed with TGA and coarctation of the aorta. Postnatal screening, including the use of pulse oximetry, plays a significant role in avoiding a late diagnosis of TGA; however, this screening tool is not widely used in Oman...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29055843/revisiting-the-definition-of-dose-limiting-toxicities-in-paediatric-oncology-phase-i-clinical-trials-an-analysis-from-the-innovative-therapies-for-children-with-cancer-consortium
#18
Francisco Bautista, Lucas Moreno, Lynley Marshall, Andrew D J Pearson, Birgit Geoerger, Xavier Paoletti
BACKGROUND: Dose-escalation trials aim to identify the maximum tolerated dose and, importantly, the recommended phase II dose (RP2D) and rely on the occurrence of dose-limiting toxicities (DLTs) during the first treatment cycle. Molecularly targeted agents (MTAs) often follow continuous and prolonged administrations, displaying a distinct toxicity profile compared to conventional chemotherapeutics, and classical DLT criteria might not be appropriate to evaluate MTAs' toxicity. We investigated this issue in children...
October 19, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29046100/analysis-of-intensive-care-admissions-among-paediatric-obstructive-sleep-apnoea-referrals
#19
S D Sharma, S Gupta, M Wyatt, D Albert, B Hartley
Introduction The aim of this study was to identify the proportion of children referred to a paediatric tertiary referral centre who required admission to the paediatric intensive care unit (PICU) following surgery for obstructive sleep apnoea (OSA) and to establish risk factors for these admissions. Methods Retrospective review of case notes and the operative database was performed for all children undergoing adenotonsillectomy for sleep disordered breathing and OSA symptoms in Great Ormond Street Hospital over a 10-year period...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29032019/-experience-with-infections-in-the-use-of-extracorporeal-membrane-oxygenation
#20
Rosa María Calderón Checa, Pablo Rojo Conejo, Aranzazu Flavia González-Posada Flores, Ana María Llorente de la Fuente, Alba Palacios Cuesta, Juan Miguel Aguilar, Sylvia Belda Hofheinz
OBJECTIVE: To identify risk factors associated with infectious complications acquired by paediatric patients during extracorporeal life support (ECLS). PATIENTS AND METHODS: Patients under ECLS from January 2011 to December 2014 have been retrospectively reviewed and data on demographics, care and infectious complications were collected. RESULTS: There were 50 ECLS assistances in the study period, of which 20 patients had 23 infectious complications: 16 were bloodstream infections, with coagulase negative staphylococci being the predominant isolate (there were 2 cases of candidaemia)...
October 11, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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