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paediatric critical care

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https://www.readbyqxmd.com/read/28921175/routine-gastric-residual-volume-measurement-and-energy-target-achievement-in-the-picu-a-comparison-study
#1
Lyvonne N Tume, Anna Bickerdike, Lynne Latten, Simon Davies, Madeleine H Lefèvre, Gaëlle W Nicolas, Frédéric V Valla
Critically ill children frequently fail to achieve adequate energy intake, and some care practices, such as the measurement of gastric residual volume (GRV), may contribute to this problem. We compared outcomes in two similar European Paediatric Intensive Care Units (PICUs): one which routinely measures GRV (PICU-GRV) to one unit that does not (PICU-noGRV). An observational pilot comparison study was undertaken. Eighty-seven children were included in the study, 42 (PICU-GRV) and 45 (PICU-noGRV). There were no significant differences in the percentage of energy targets achieved in the first 4 days of PICU admission although PICU-noGRV showed more consistent delivery of median (and IQR) energy targets and less under and over feeding for PICU-GRV and PICU-noGRV: day 1 37 (14-72) vs 44 (0-100), day 2 97 (53-126) vs 100 (100-100), day 3 84 (45-112) vs 100 (100-100) and day 4 101 (63-124) vs 100 (100-100)...
September 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28882361/relation-between-parental-psychopathology-and-posttraumatic-growth-after-a-child-s-admission-to-intensive-care-two-faces-of-the-same-coin
#2
Rocío Rodríguez-Rey, Jesús Alonso-Tapia
OBJECTIVES: Confronted with the potentially traumatic experience of a child's admission to a paediatric intensive care unit, parents may experience psychopathological post-trauma symptoms as well as posttraumatic growth. The aim of this cross-sectional study was to explore the relation between psychopathology symptoms, namely, posttraumatic stress disorder), anxiety and depression, as well as post traumatic growth in parents following their child's hospitalisation in a paediatric intensive care unit...
September 4, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28871418/time-spent-with-impaired-autoregulation-is-linked-with-outcome-in-severe-infant-paediatric-traumatic-brain-injury
#3
Konstantin Hockel, Jennifer Diedler, Felix Neunhoeffer, Ellen Heimberg, Carmen Nagel, Martin U Schuhmann
BACKGROUND: It could be shown in traumatic brain injury (TBI) in adults that the functional status of cerebrovascular autoregulation (AR), determined by the pressure reactivity index (PRx), correlates to and even predicts outcome. We investigated PRx, cerebral perfusion pressure (CPP) and intracranial pressure (ICP) and their correlation to outcome in severe infant and paediatric TBI. METHODS: Seventeen patients (range, 1 day to 14 years) with severe TBI (median GCS at presentation, 4) underwent long-term computerised ICP and mean arterial pressure (MAP) monitoring using dedicated software to determine CPP and PRx and optimal CPP (CPP level where PRx shows best autoregulation) continuously...
September 4, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28843537/sophia-observation-withdrawal-symptoms-paediatric-delirium-scale-a-tool-for-early-screening-of-delirium-in-the-picu
#4
Erwin Ista, Harma Te Beest, Joost van Rosmalen, Matthijs de Hoog, Dick Tibboel, Babette van Beusekom, Monique van Dijk
BACKGROUND: Delirium in critically ill children is a severe neuropsychiatric disorder which has gained increased attention from clinicians. Early identification of delirium is essential for successful management. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale was developed to detect Paediatric Delirium (PD) at an early stage. OBJECTIVE: The aim of this study was to determine the measurement properties of the PD component of the SOS-PD scale in critically ill children...
August 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28841850/implementing-the-who-integrated-tool-to-assess-quality-of-care-for-mothers-newborns-and-children-results-and-lessons-learnt-from-five-districts-in-malawi
#5
Helen Smith, Atnafu Getachew Asfaw, Kyaw Myint Aung, Lastone Chikoti, Florence Mgawadere, Luigi d'Aquino, Nynke van den Broek
BACKGROUND: In 2014 the World Health Organization (WHO) developed a new tool to be used to assess the quality of care for mothers, newborns and children provided at healthcare facility level. This paper reports on the feasibility of using the tool, its limitations and strengths. METHODS: Across 5 districts in Malawi, 35 healthcare facilities were assessed. The WHO tool includes checklists, interviews and observation of case management by which care is assessed against agreed standards using a Likert scale (1 lowest: not meeting standard, 5 highest: compliant with standard)...
August 25, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28797314/intravenous-sotalol-use-in-a-complex-critically-ill-child-balancing-the-systems-in-choosing-antiarrhythmic-medication
#6
Michele M Pasierb, Stephen P Seslar
In critically ill children, multi-organ-system disease can influence the choice of antiarrhythmic medication. Intravenous therapy is often necessary. There is a scarcity of paediatric critical-care cases demonstrating the dosing, monitoring, and efficacy of intravenous sotalol. This case demonstrates the effective use of intravenous sotalol in an adolescent with renal, hepatic, and haematological dysfunctions.
August 11, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28771680/safety-and-efficacy-of-rescue-flexible-bronchoscopic-intubation-using-the-bentson-floppy-tip-guidewire-via-a-supraglottic-airway-in-critically-ill-children
#7
D Cross, A Nyman, P James, A Durward
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation...
August 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28760690/validity-of-contents-of-a-paediatric-critical-comfort-scale-using-mixed-methodology
#8
A Bosch-Alcaraz, I Jordan-Garcia, S Alcolea-Monge, R Fernández-Lorenzo, E Carrasquer-Feixa, M Ferrer-Orona, A Falcó-Pegueroles
INTRODUCTION: Critical illness in paediatric patients includes acute conditions in a healthy child as well as exacerbations of chronic disease, and therefore these situations must be clinically managed in Critical Care Units. The role of the paediatric nurse is to ensure the comfort of these critically ill patients. To that end, instruments are required that correctly assess critical comfort. OBJECTIVE: To describe the process for validating the content of a paediatric critical comfort scale using mixed-method research...
July 28, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28738850/brain-biomarkers-and-pre-injury-cognition-are-associated-with-long-term-cognitive-outcome-in-children-with-traumatic-brain-injury
#9
Amy A Wilkinson, Maureen Dennis, Nevena Simic, Margot J Taylor, Benjamin R Morgan, Helena Frndova, Karen Choong, Craig Campbell, Douglas Fraser, Vicki Anderson, Anne-Marie Guerguerian, Russell Schachar, Jamie Hutchison
BACKGROUND: Children with traumatic brain injury (TBI) are frequently at risk of long-term impairments of attention and executive functioning but these problems are difficult to predict. Although deficits have been reported to vary with injury severity, age at injury and sex, prognostication of outcome remains imperfect at a patient-specific level. The objective of this proof of principle study was to evaluate a variety of patient variables, along with six brain-specific and inflammatory serum protein biomarkers, as predictors of long-term cognitive outcome following paediatric TBI...
July 24, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28705790/children-with-life-limiting-conditions-in-paediatric-intensive-care-units-a-national-cohort-data-linkage-study
#10
Lorna K Fraser, Roger Parslow
OBJECTIVE: To determine how many children are admitted to paediatric intensive care unit (PICU) with life-limiting conditions (LLCs) and their outcomes. DESIGN: National cohort, data-linkage study. SETTING: PICUs in England. PATIENTS: Children admitted to a UK PICU (1 January 2004 and 31 March 2015) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to hospital episodes statistics enabled identification of children with a LLC using an International Classification of Diseases (ICD10) code list...
July 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28705560/les-enjeux-de-la-transition-de-la-p%C3%A3-diatrie-vers-la-m%C3%A3-decine-d%C3%A2-adultes
#11
Nizar Mahlaoui, Béatrice Langellier-Bellevue
The transfer or transition from paediatric care to adult medicine is, for a large number of adolescents and young adults being monitored for a rare and/or chronic pathology, as well as for the care teams, a critical period in their medical journey and in their life. It is both an individual and a public health issue, with medical-economic consequences. At the hôpital Necker-Enfants malades in Paris, a specific programme has been implemented aimed at the patients and carers.
July 2017: Soins. Pédiatrie, Puériculture
https://www.readbyqxmd.com/read/28692913/particle-and-bioaerosol-characteristics-in-a-paediatric-intensive-care-unit
#12
Congrong He, Ian M Mackay, Kay Ramsay, Zhen Liang, Timothy Kidd, Luke D Knibbs, Graham Johnson, Donna McNeale, Rebecca Stockwell, Mark G Coulthard, Debbie A Long, Tara J Williams, Caroline Duchaine, Natalie Smith, Claire Wainwright, Lidia Morawska
The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens...
July 7, 2017: Environment International
https://www.readbyqxmd.com/read/28688998/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#13
Alain Cariou, Jean-Francois Payen, Karim Asehnoune, Gérard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigué, Laure de Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
July 5, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28687343/the-montreux-definition-of-neonatal-ards-biological-and-clinical-background-behind-the-description-of-a-new-entity
#14
REVIEW
Daniele De Luca, Anton H van Kaam, David G Tingay, Sherry E Courtney, Olivier Danhaive, Virgilio P Carnielli, Luc J Zimmermann, Martin C J Kneyber, Pierre Tissieres, Joe Brierley, Giorgio Conti, Jane J Pillow, Peter C Rimensberger
Acute respiratory distress syndrome (ARDS) is undefined in neonates, despite the long-standing existing formal recognition of ARDS syndrome in later life. We describe the Neonatal ARDS Project: an international, collaborative, multicentre, and multidisciplinary project which aimed to produce an ARDS consensus definition for neonates that is applicable from the perinatal period. The definition was created through discussions between five expert members of the European Society for Paediatric and Neonatal Intensive Care; four experts of the European Society for Paediatric Research; two independent experts from the USA and two from Australia...
August 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28653434/injury-from-falls-in-infants-under-one-year
#15
Christopher S Mulligan, Susan Adams, Dimitra Tzioumi, Julie Brown
AIM: Falls in infants are a common cause of injury. Compared to older children, infants under age one are likely to have distinctive causation and injury patterns, as they are pre-mobile or have limited independent mobility and falls are more directly the responsibility of the care giver. There is little known about the mechanistic factors, predictors of injury and injury patterns in this age group. METHODS: We conducted a retrospective review of infants under age one who presented after a fall to a paediatric trauma centre in Sydney, Australia...
June 26, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28640510/paediatric-intensive-care-nurses-decision-making-around-gastric-residual-volume-measurement
#16
Lyvonne N Tume, Lynne Latten, Lindsay Kenworthy
BACKGROUND: Measuring gastric residual volume (GRV) to guide enteral feeding is a common nursing practice in intensive care units, yet little evidence supports this practice. In addition, this practice has been shown to potentially contribute to inadequate energy delivery in intensive care, which remains a problem in critically ill children. AIMS: We aimed to explore paediatric intensive care nurses' decision-making surrounding this practice. METHODS: This is a cross-sectional electronic survey in a single mixed general and cardiac surgical PICU in the UK...
September 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/28637741/the-closed-trial-clonidine-compared-with-midazolam-for-sedation-of-paediatric-patients-in-the-intensive-care-unit-study-protocol-for-a-multicentre-randomised-controlled-trial
#17
Antje Neubert, Manuel Alberto Baarslag, Monique van Dijk, Joost van Rosmalen, Joseph F Standing, Yucheng Sheng, Wolfgang Rascher, Deborah Roberts, Jackie Winslade, Louise Rawcliffe, Sara M Hanning, Tuuli Metsvaht, Viviana Giannuzzi, Peter Larsson, Pavla Pokorná, Alessandra Simonetti, Dick Tibboel
INTRODUCTION: Sedation is an essential part of paediatric critical care. Midazolam, often in combination with opioids, is the current gold standard drug. However, as it is a far-from-ideal agent, clonidine is increasingly being used in children. This drug is prescribed off-label for this indication, as many drugs in paediatrics are. Therefore, the CLOSED trial aims to provide data on the pharmacokinetics, safety and efficacy of clonidine for the sedation of mechanically ventilated patients in order to obtain a paediatric-use marketing authorisation...
June 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#18
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28629473/emergency-treatment-with-levetiracetam-or-phenytoin-in-status-epilepticus-in-children-the-eclipse-study-study-protocol-for-a-randomised-controlled-trial
#19
Mark D Lyttle, Carrol Gamble, Shrouk Messahel, Helen Hickey, Anand Iyer, Kerry Woolfall, Amy Humphreys, Naomi E A Bacon, Louise Roper, Franz E Babl, Stuart R Dalziel, Mary Ryan, Richard E Appleton
BACKGROUND: Convulsive status epilepticus (CSE) is the most common life-threatening neurological emergency in childhood. These children are also at risk of significant morbidity, with acute and chronic impact on the family and the health and social care systems. The current recommended first-choice, second-line treatment in children aged 6 months and above is intravenous phenytoin (fosphenytoin in the USA), although there is a lack of evidence for its use and it is associated with significant side effects...
June 19, 2017: Trials
https://www.readbyqxmd.com/read/28627014/review-article-paediatric-status-epilepticus-in-the-pre-hospital-setting-an-update
#20
REVIEW
Jeremy Furyk, Kerriane Watt, Theophilus I Emeto, Stuart Dalziel, Daniel Bodnar, Kate Riney, Franz E Babl
Paediatric status epilepticus (SE) is a medical emergency and a common critical condition confronting pre-hospital providers. Management in the pre-hospital environment is challenging but considered extremely important as a potentially modifiable factor on outcome. Recent data from multicentre clinical trials, quality observational studies and consensus documents have influenced management in this area, and is important to both pre-hospital providers and emergency physicians. The objective of this review was to: (i) present an overview of the available evidence relevant to pre-hospital care of paediatric SE; and (ii) assess the current pre-hospital practice guidelines in Australia and New Zealand...
June 18, 2017: Emergency Medicine Australasia: EMA
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