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Paediatric intensive care

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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28215137/the-australian-and-new-zealand-intensive-care-society-clinical-trials-group-point-prevalence-program-2009-2016
#3
Kelly Thompson, Naomi Hammond, Glenn Eastwood, Marino Festa, Parisa Glass, Dorrilyn Rajbhandari, Ian Seppelt, Colman Taylor, Nicola Watts, John Myburgh
BACKGROUND: Cross-sectional point prevalence studies collect observational data at a single time point and may be used to facilitate subsequent research hypotheses and discovery. METHODS: We report the process of implementation and substantive outputs of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) point prevalence program, conducted in participating intensive care units from 2009 to 2016. RESULTS: Seventy-seven of a maximum 197 adult ICUs across Australia and New Zealand participated in 9 specified study days over 18 days of data collection and collected data on 5043 participants, with an average of 44 ICUs per study day...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28215128/the-characteristics-pattern-of-injury-and-outcome-of-children-admitted-to-a-paediatric-intensive-care-unit-following-an-inflicted-injury
#4
Anna K Butlinski, Warwick W Butt
OBJECTIVE: To describe the characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit (PICU) following an inflicted injury. DESIGN, SETTING AND PARTICIPANTS: A retrospective review of hospital records from a 30-bed PICU in a university teaching hospital, examining data for children admitted to the PICU after an inflicted injury from 1 January 2005 to 31 December 2013. MAIN OUTCOME MEASURES: The hospital records of 46 children with an inflicted injury were reviewed...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213828/screening-for-non-alcoholic-fatty-liver-disease-in-children-and-adolescents-with-type-1-diabetes-mellitus-a-cross-sectional-analysis
#5
Sebastian Kummer, Dirk Klee, Gerald Kircheis, Michael Friedt, Joerg Schaper, Dieter Häussinger, Ertan Mayatepek, Thomas Meissner
: The liver is intensely involved in glucose metabolism and is thereby closely related to diabetes pathophysiology. Adult patients with type 1 diabetes mellitus (DM) are at an increased risk for non-alcoholic fatty liver disease (NAFLD). Here, we studied the prevalence of NAFLD in a cohort of children and adolescents with type 1 DM in a tertiary care paediatric diabetes centre in Germany. We screened 93 children and adolescents with type 1 DM using ultrasound, laboratory investigations, and liver stiffness measurements (Fibroscan® [FS] and acoustic radiation force imaging [ARFI])...
February 17, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28208985/pattern-of-inpatient-dermatology-consultations-in-a-tertiary-care-centre-from-northern-india
#6
Abhilasha Williams, Anuradha Bhatia, Bimal Kanish, Paulina Rose Chaudhary, Clarence James Samuel
INTRODUCTION: The importance of dermatology inpatient consultation is of significant importance yet is not well documented. AIM: To retrospectively analyse the spectrum of dermatology inpatient consultations from the various departments and to document the most commonly occurring dermatological disorders from each speciality. MATERIALS AND METHODS: This study was done in an 800 bedded premier teaching hospital in Ludhiana, Punjab, North Western India...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28208972/ventilator-associated-pneumonia-in-paediatric-intensive-care-unit
#7
Anirban Mandal, Amitabh Singh, Puneet Kaur Sahi, Bhavika Rishi
No abstract text is available yet for this article.
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28196820/combined-use-of-neurally-adjusted-ventilatory-assist-nava-and-vertical-expandable-prostethic-titanium-rib-veptr-in-a-patient-with-spondylocostal-dysostosis-and-associated-bronchomalacia
#8
Martí Pons-Odena, Alba Verges, Natalia Arza, Francisco José Cambra
Jarcho-Levin syndrome is a rare disorder characterised by defects in vertebral and costal segmentation of varying severity. Respiratory complications are the main cause of death or severe comorbidity due to a restrictive rib cage. A 3 months old infant with Spondylocostal dysostosis and associated bronchomalacia experiencing severe asynchrony during the weaning process is reported. The Neurally Adjusted Ventilatory Assist (NAVA) mode was used to improve adaptation to mechanical ventilation after Vertical Expandable Prosthetic Titanium Ribs (VEPTRs) were implanted...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28179700/calvarial-remodelling-surgery-neurosurgical-experience-of-multidisciplinary-craniofacial-reconstruction
#9
Abdul Ghaffar, Zahid Hussain, Shahzad Ahmed Qasmi, Shahid Hameed Chaudhry
OBJECTIVE: To evaluate the safety, cosmetic and functional outcome of craniofacial reconstruction surgery for primary craniosynostosis and clefts. METHODS: This quasi-experimental study was conducted at the Combined Military Hospital, Rawalpindi, Pakistan, from June 2011 to December 2014, and comprised paediatric patients undergoing calvarial reconstructive procedures. Fronto-orbital advancement and reconstruction, total calvarial remodelling and box flap reconstruction techniques were used...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28179270/is-there-a-role-for-clowns-in-paediatric-intensive-care-units
#10
REVIEW
Guillaume Mortamet, Nadia Roumeliotis, Florence Vinit, Caroline Simonds, Laurent Dupic, Philippe Hubert
Hospital clowning is a programme in healthcare facilities involving visits from specially trained actors. In the paediatric intensive care unit (PICU), clowning may appear inappropriate and less intuitive. The patient could appear too ill and/or sedated, the environment too crowded or chaotic and the parents too stressed. Relying on our experience with professionally trained clowns both in France and Canada, the purpose of this article is to offer a model for hospital clowning and to suggest standards of practice for the implementation of clowning in PICUs...
February 8, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28176380/factors-influencing-plasma-transfusion-practices-in-paediatric-intensive-care-units-around-the-world
#11
O Karam, P Demaret, A Duhamel, A Shefler, P C Spinella, M Tucci, S Leteurtre, S J Stanworth
BACKGROUND AND OBJECTIVES: Plasma transfusions are a frequent treatment worldwide, but many studies have reported a wide variation in the indications to transfuse. Recently, an international paediatric study also showed wide variation in frequency in the use of plasma transfusions: 25% of the centres transfused plasma to >5% of their patients, whereas another 25% transfused plasma to <1% of their patients. The objective of this study was to explore the factors associated with different plasma transfusion practices in these centres...
February 7, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28162130/influenza-hospitalizations-in-australian-children
#12
J Li-Kim-Moy, J K Yin, C C Blyth, A Kesson, R Booy, A C Cheng, K Macartney
Australia's National Immunisation Program (NIP) provides free influenza vaccination for children at high risk of severe influenza; a pilot-funded programme for vaccine in all children aged 6 months to <5 years in one of eight states, has seen poor vaccine impact, related to recent vaccine safety concerns. This retrospective review examined influenza hospitalizations in children aged <16 years from three seasons (2011-2013) at two paediatric hospitals on opposite sides of the country. Comparisons of this cohort were made with state-based data on influenza-coded hospitalizations and national immunization register data on population-level immunization coverage...
February 6, 2017: Epidemiology and Infection
https://www.readbyqxmd.com/read/28157809/withdrawal-assessment-tool-1-monitoring-in-picu-a-multicenter-study-on-iatrogenic-withdrawal-syndrome
#13
Angela Amigoni, Maria Cristina Mondardini, Ilaria Vittadello, Federico Zaglia, Emanuele Rossetti, Francesca Vitale, Stefania Ferrario, Fabio Savron, Giancarlo Coffaro, Luca Brugnaro, Roberta Amato, Andrea Wolfler, Linda S Franck
OBJECTIVES: Withdrawal syndrome is an adverse reaction of analgesic and sedative therapy, with a reported occurrence rate between 17% and 57% in critically ill children. Although some factors related to the development of withdrawal syndrome have been identified, there is weak evidence for the effectiveness of preventive and therapeutic strategies. The main aim of this study was to evaluate the frequency of withdrawal syndrome in Italian PICUs, using a validated instrument. We also analyzed differences in patient characteristics, analgesic and sedative treatment, and patients' outcome between patients with and without withdrawal syndrome...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28152666/provision-of-critical-care-services-to-hiv-infected-children-in-an-era-of-advanced-intensive-care-and-availability-of-combined-antiretroviral-therapy
#14
Prakash M Jeena, Miriam Adhikari
Intensive care facilities are always in demand in the public sector and there is constant competition for beds. Appropriate allocation of children to these resources is based on the ethical principles of distributive justice and beneficence that is determined on the presumed short-term outcome of the acute illness, long-term outcome of the underlying chronic disease and the overall demand for these facilities. At the onset of the HIV epidemic in South Africa, HIV-infected children were refused admission to the paediatric intensive care unit (PICU) on the basis of poor ICU outcomes and the lack of provision of combined antiretroviral therapy (cART) for survivors...
February 3, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28152345/the-burden-of-invasive-infections-in-critically-ill-indigenous-children-in-australia
#15
Justyna A Ostrowski, Graeme MacLaren, Janet Alexander, Penny Stewart, Sheena Gune, Joshua R Francis, Subodh Ganu, Marino Festa, Simon J Erickson, Lahn Straney, Luregn J Schlapbach
OBJECTIVES: To describe the incidence and mortality of invasive infections in Indigenous children admitted to paediatric and general intensive care units (ICUs) in Australia. DESIGN: Retrospective multi-centre cohort study of Australian and New Zealand Paediatric Intensive Care Registry data. PARTICIPANTS: All children under 16 years of age admitted to an ICU in Australia, 1 January 2002 - 31 December 2013. Indigenous children were defined as those identified as Aboriginal and/or Torres Strait Islander in a mandatory admissions dataset...
February 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28148335/a-pediatric-cardiology-fellowship-boot-camp-improves-trainee-confidence
#16
Catherine K Allan, Paul Tannous, Elizabeth DeWitt, Michael Farias, Laura Mansfield, Christina Ronai, David Schidlow, Stephen P Sanders, James E Lock, Jane W Newburger, David W Brown
: Introduction New paediatric cardiology trainees are required to rapidly assimilate knowledge and gain clinical skills to which they have limited or no exposure during residency. The Pediatric Cardiology Fellowship Boot Camp (PCBC) at Boston Children's Hospital was designed to provide incoming fellows with an intensive exposure to congenital cardiac pathology and a broad overview of major areas of paediatric cardiology practice. METHODS: The PCBC curriculum was designed by core faculty in cardiac pathology, echocardiography, electrophysiology, interventional cardiology, exercise physiology, and cardiac intensive care...
December 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/28124406/recombinant-porcine-factor-viii-for-high-risk-surgery-in-paediatric-congenital-haemophilia-a-with-high-titre-inhibitor
#17
S E Croteau, Y L Abajas, A S Wolberg, B I Nielsen, G R Marx, C W Baird, E J Neufeld, P E Monahan
INTRODUCTION: High-titre factor VIII (FVIII) inhibitors complicate peri-operative haemostasis. Recombinant porcine FVIII (r-pFVIII) may provide an alternative haemostatic agent for high-risk procedures and allow FVIII activity monitoring. AIM: Devise an effective haemostatic plan for repair of a progressively symptomatic aortic coarctation in a 5-year-old male with immune tolerance induction (ITI) refractory high-titre FVIII inhibitors. METHODS: Preprocedure human FVIII inhibitor titre was 58 Bethesda Units mL(-1) (BU) and cross-reacted to neutralize porcine FVIII at 30 BU...
January 25, 2017: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/28112095/characteristics-and-outcome-of-long-stay-patients-in-a-paediatric-intensive-care-unit-in-cape-town-south-africa
#18
T L Nupen, A C Argent, B Morrow
BACKGROUND: Paediatric intensive care is a costly, specialised and limited resource in low- and middle-income countries. The implications of extended paediatric intensive care unit (PICU) stay in South Africa (SA) are not known. OBJECTIVES: To describe the characteristics, outcomes and resource consumption of long-stay patients (LSPs) and to identify predictive factors for long PICU stay. METHODS: A retrospective review of routinely collected data on all children admitted to an SA PICU over one calendar year...
December 21, 2016: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28110616/oncotic-pressure-and-paediatric-cardiopulmonary-bypass-establishing-baseline-data-for-complex-congenital-cardiac-surgery-and-its-relation-to-risk-stratification
#19
Richard Crook, Richard Issitt
OBJECTIVES: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very few baseline data are available for those patients requiring surgery within the first few weeks and months of life. Our aim was to determine if our CHD population exhibited COP similar to that of other extremely ill subsets of patients and, if so, whether this related to risk stratification model scores...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28108132/-toxic-shock-syndrome-in-a-paediatric-intensive-care-unit-over-the-last-15-years
#20
Laura Butragueño Laiseca, Marina García Morín, Estíbaliz Barredo Valderrama, Andrés J Alcaraz Romero
No abstract text is available yet for this article.
January 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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