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mechanical ventilation children

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https://www.readbyqxmd.com/read/28922269/extubation-failure-is-associated-with-increased-mortality-following-first-stage-single-ventricle-reconstruction-operation
#1
Thomas Scodellaro, Jane M McKenzie, Yves d'Udekem, Warwick Butt, Siva P Namachivayam
OBJECTIVES: To identify the prevalence, causes, risk factors, and outcomes associated with extubation failure following first stage single ventricle reconstruction surgery. DESIGN: Retrospective cohort analysis of neonates who underwent a first stage single ventricle reconstruction operation. Extubation failure was defined as endotracheal reintubation within 48 hours of first extubation attempt. SETTING: The Royal Children's Hospital, Melbourne...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28914722/factors-associated-with-pediatric-ventilator-associated-conditions-in-six-u-s-hospitals-a-nested-case-control-study
#2
Noelle M Cocoros, Gregory Priebe, James E Gray, Philip Toltzis, Gitte Y Larsen, Latania K Logan, Susan Coffin, Julia S Sammons, Kathleen Deakins, Kelly Horan, Matthew Lakoma, Jessica Young, Michael Burton, Michael Klompas, Grace M Lee
OBJECTIVES: A newly proposed surveillance definition for ventilator-associated conditions among neonatal and pediatric patients has been associated with increased morbidity and mortality among ventilated patients in cardiac ICU, neonatal ICU, and PICU. This study aimed to identify potential risk factors associated with pediatric ventilator-associated conditions. DESIGN: Retrospective cohort. SETTING: Six U.S. hospitals PATIENTS:: Children less than or equal to 18 years old ventilated for greater than or equal to 1 day...
September 13, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28905374/heat-and-moisture-exchangers-versus-heated-humidifiers-for-mechanically-ventilated-adults-and-children
#3
REVIEW
Donna Gillies, David A Todd, Jann P Foster, Bisanth T Batuwitage
BACKGROUND: Invasive ventilation is used to assist or replace breathing when a person is unable to breathe adequately on their own. Because the upper airway is bypassed during mechanical ventilation, the respiratory system is no longer able to warm and moisten inhaled gases, potentially causing additional breathing problems in people who already require assisted breathing. To prevent these problems, gases are artificially warmed and humidified. There are two main forms of humidification, heat and moisture exchangers (HME) or heated humidifiers (HH)...
September 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28895691/implementation-of-a-checklist-to-increase-adherence-to-evidence-based-practices-in-a-single-pediatric-intensive-care-unit
#4
Pablo Eulmesekian, Augusto Pérez, Silvia Díaz, Mateo Ferrero
INTRODUCTION: The use of checklists to increase adherence to evidence-based practices is not yet widespread in pediatric intensive care units. The objective of this study was to achieve 90% compliance with studied practices using an ad hoc checklist. POPULATION AND METHDOS: Time series quasiexperimental study conducted in ventilated children hospitalized in the pediatric intensive care unit. Studied practices included sedation breaks, plateau pressure ≤ 30 cm H 2O, fraction of inspired oxygen ≤ 60%, maintenance of headboard at > 30°, chlorhexidine mouthwash, weekly ventilator circuit changes, preference for enteral feeding, reduction in the threshold for blood transfusions (hemoglobin: 7 g/dL), daily consideration of spontaneous breathing trials and central venous catheter removal...
October 1, 2017: Archivos Argentinos de Pediatría
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
#5
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/28879448/pre-decannulation-flexible-bronchoscopy-in-tracheostomized-children
#6
Anil Sachdev, Amrit Ghimiri, Neeraj Gupta, Dhiren Gupta
OBJECTIVES: This study was aimed to evaluate the utility and benefits of flexible fiberoptic bronchoscopy (FFB) prior to tracheostomy decannulation. METHODS: Besides demographic data, initial cause of tracheostomy, primary diagnosis, pre-tracheostomy and pre-decannulation bronchoscopic findings and duration of tracheostomy were collected from medical charts. The type of active intervention following bronchoscopy and outcome after decannulation were recorded. Departmental decannulation policy and procedure were used in all patients...
September 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28877001/total-laparoscopic-approach-for-transhiatal-esophagectomy-and-gavriliu-s-esophagoplasty-in-children-with-caustic-esophageal-injuries
#7
Louise Montalva, Jérôme Viala, Daphné Michelet, Fernanda Frade, Hubert Lardy, Christine Vitoux, Arnaud Bonnard
BACKGROUND: Esophageal repair after caustic injury is a surgical challenge in children. The aim of this study was to report the first results of a total laparoscopic approach in transhiatal esophagectomy and esophageal replacement by an anisoperistaltic gastric tube. PATIENTS AND METHODS: A retrospective review of data from children operated on with a laparoscopic approach for transhiatal esophagectomy and Gavriliu's esophagoplasty between 2011 and 2015 was performed...
September 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28872714/microbial-epidemiology-of-candidemia-in-neonatal-and-pediatric-intensive-care-units-at-children-s-medical-center-tehran
#8
Arezu Charsizadeh, Hossein Mirhendi, Bahram Nikmanesh, Hamid Eshaghi, Koichi Makimura
Invasive candidiasis is a major cause of morbidity and mortality in children. However, limited data is available on the epidemiology of this infection in pediatric settings in Iran. The aim of the present study was to determine the prevalence, microbial epidemiology, risk factors, and clinical outcomes associated with candidemia in intensive care units at Children's Medical Center, Tehran, Iran. All blood and other normally sterile specimen cultures positive for Candida species, were included. Isolates were identified by morphological and molecular methods...
September 5, 2017: Mycoses
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#9
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. We review recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active asthma management during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28866624/severe-acquired-subglottic-stenosis-in-neonatal-intensive-care-graduates-a-case-control-study
#10
Rebecca E Thomas, Shripada C Rao, Corrado Minutillo, Shyan Vijayasekaran, Elizabeth A Nathan
OBJECTIVE: To analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates. DESIGN: Retrospective case-control study. SETTING: Sole tertiary children's hospital. PARTICIPANTS: Patients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth)...
September 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28865973/recovery-of-pulmonary-function-after-allogeneic-hematopoietic-cell-transplantation-in-children-is-associated-with-improved-survival
#11
Ashok Srinivasan, Anusha Sunkara, William Mitchell, Sudeep Sunthankar, Guolian Kang, Dennis C Stokes, Saumini Srinivasan
Abnormal pulmonary function is prevalent in survivors of allogeneic hematopoietic cell transplantation. Post-transplant recovery of pulmonary function, and its effect on survival in children is not known. This is a retrospective cohort study of 308 children followed for 10 years after transplantation at a single institution. There were 2 groups of patients. Group 1 included 188 patients with 3 or more pulmonary function test (PFT) results, of which at least 1 was abnormal, group 2 included 120 patients with 3 or more PFTs, all of which were normal...
August 30, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28861270/phosphate-disturbance-in-critically-ill-children-incidence-associated-risk-factors-and-clinical-outcomes
#12
Ahmed Nabih El Shazly, Doaa Refaey Soliman, Effat Hussien Assar, Eman Gamal Behiry, Ibrahim Abd El Naby Gad Ahmed
BACKGROUND: Hypophosphatemia is one of the common disorders that develop in critically ill patients. It has potential complications and is often unrecognized in those patients. OBJECTIVE: Determining the incidence of hypophosphatemia in critically ill children, its association with clinical outcomes and the possible risk factors. METHODS: 50 patients were enrolled in the study. Levels of serum phosphate were measured on day 1 and day 7 of PICU (Pediatric intensive care unit) stay...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28857356/different-predictivity-of-fluid-responsiveness-by-pulse-pressure-variation-in-children-after-surgical-repair-of-ventricular-septal-defect-or-tetralogy-of-fallot
#13
Ding Han, Shoudong Pan, Xiaonan Wang, Qingyan Jia, Yi Luo, Jia Li, Chuan Ou-Yang
BACKGROUND: Pulse pressure variation derived from the varied pulse contour method is based on heart-lung interaction during mechanical ventilation. It has been shown that pulse pressure variation is predictive of fluid responsiveness in children undergoing surgical repair of ventricular septal defect. Right ventricle compliance and pulmonary vascular capacitance in children with tetralogy of Fallot are underdeveloped as compared to those in ventricular septal defect. We hypothesized that the difference in the right ventricle-pulmonary circulation in the two groups of children would affect the heart-lung interaction and therefore pulse pressure variation predictivity of fluid responsiveness following cardiac surgery...
August 31, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28842971/the-impact-of-pediatric-obesity-on-hospitalized-children-with-lower-respiratory-tract-infections-in-the-united-states
#14
Yusuke Okubo, Kotaro Nochioka, Marcia A Testa
OBJECTIVE: Obesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear. MATERIALS AND METHODS: We conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2-20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States...
August 26, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28834879/effect-of-acid-base-balance-on-postoperative-course-in-children-with-hypoplastic-left-heart-syndrome-after-the-modified-norwood-procedure
#15
Marcin Gładki, Tomasz Składzień, Rafał Żurek, Elżbieta Broniatowska, Elżbieta Wójcik, Janusz H Skalski
Hypoplastic left heart syndrome (HLHS) is a congenital heart defect that requires 3-stage cardiac surgical treatment and multidirectional specialist care. The condition of newborns in the first postoperative days following the modified Norwood procedure is characterized by considerable hemodynamic instability that may result in a sudden cardiac arrest. It is believed that the most important cause of hemodynamic instability is the fluctuations in redistribution between pulmonary and systemic blood flow.The paper analyzes the postoperative course in 40 neonates with HLHS following the modified Norwood procedure performed under deep hypothermic cardiopulmonary bypass hospitalized in Cardiac Surgical Intensive Care Unit (CSICU) in the years 2014-2015...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28829819/evaluation-of-diaphragmatic-function-in-mechanically-ventilated-children-an-ultrasound-study
#16
En-Pei Lee, Shao-Hsuan Hsia, Hsiu-Feng Hsiao, Min-Chi Chen, Jainn-Jim Lin, Oi-Wa Chan, Chia-Ying Lin, Mei-Chin Yang, Sui-Ling Liao, Shen-Hao Lai
BACKGROUND: The recovery of diaphragmatic function is vital for successful extubation from mechanical ventilation. Recent studies have detected diaphragm atrophy in ventilated adults by using ultrasound, but no similar report has been conducted in children. In the current study, we hypothesized that mechanically ventilated children may also develop diaphragm atrophy and diaphragmatic dysfunction. MATERIALS AND METHODS: Children who were admitted to the pediatric intensive care unit and were newly intubated for mechanical ventilation were enrolled into this prospective case-control study...
2017: PloS One
https://www.readbyqxmd.com/read/28821360/development-and-implementation-of-an-early-mobility-program-for-mechanically-ventilated-pediatric-patients
#17
Kristina A Betters, Kiran B Hebbar, David Farthing, Brittany Griego, Tricia Easley, Hartley Turman, Lauren Perrino, Stephanie Sparacino, Mary L deAlmeida
PURPOSE: Early mobility (EM) is being used in adult ICUs in an effort to treat and prevent intensive care unit acquired weakness (ICU-AW) and Post-Intensive Care Syndrome (PICS). Data supports children suffer from ICU-AW and PICS as well. Our objective was to create and implement an EM protocol for pediatric patients receiving invasive mechanical ventilation. METHODS: A multidisciplinary EM committee was formed to create and implement an EM protocol in a quarternary care PICU...
August 9, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28816920/similar-metabolic-innate-immunity-and-adipokine-profiles-in-adult-and-pediatric-sepsis-versus-systemic-inflammatory-response-syndrome-a-pilot-study
#18
Theonymfi Tavladaki, Anna Maria Spanaki, Helen Dimitriou, Efmorfia Kondili, Christianna Choulaki, Dimitris Georgopoulos, George Briassoulis
OBJECTIVES: To examine whether the septic profiles of heat shock protein 72, heat shock protein 90α, resistin, adiponectin, oxygen consumption, CO2 production, energy expenditure, and metabolic pattern, along with illness severity, nutritional, and inflammatory indices, differ between adult and pediatric patients compared with systemic inflammatory response syndrome and healthy controls. To evaluate whether these biomolecules may discriminate sepsis from systemic inflammatory response syndrome in adult and pediatric patients...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28816919/enteral-nutrition-practices-in-critically-ill-children-requiring-noninvasive-positive-pressure-ventilation
#19
Matthew K Leroue, Ryan J Good, Heather E Skillman, Angela S Czaja
OBJECTIVES: Evaluate the practice of providing enteral nutrition in critically ill children requiring noninvasive positive pressure ventilation. DESIGN: Retrospective cohort study. SETTING: PICU within a quaternary care children's hospital. PATIENTS: PICU patients older than 30 days requiring noninvasive positive pressure ventilation for greater than or equal to 24 hours from August 2014 to June 2015. Invasive mechanical ventilation prior to noninvasive positive pressure ventilation and inability to receive enteral nutrition at baseline were additional exclusionary criteria...
August 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28807197/perioperative-blood-transfusion-and-complications-in-children-undergoing-surgery-for-solid-tumors
#20
Dani O Gonzalez, Jennifer N Cooper, Erica Mantell, Peter C Minneci, Katherine J Deans, Jennifer H Aldrink
BACKGROUND: The objective was to assess whether perioperative blood transfusion (PBT) is associated with postoperative complications in children undergoing surgery for a solid tumor. METHODS: Using 2012-2014 National Surgical Quality Improvement Program Pediatric data, we identified patients aged 0-18 years who underwent surgery (biopsy or resection) for solid tumors. We compared demographic, clinical, and 30-day outcome characteristics between children who did and did not receive a PBT within 72 hours after surgery...
August 2017: Journal of Surgical Research
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