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https://www.readbyqxmd.com/read/29344778/the-relationship-between-vancomycin-trough-concentrations-and-auc-mic-ratios-in-pediatric-patients-a-qualitative-systematic-review
#1
REVIEW
Stacey Tkachuk, Kyle Collins, Mary H H Ensom
BACKGROUND: In adults, the area under the concentration-time curve (AUC) divided by the minimum inhibitory concentration (MIC) is associated with better clinical and bacteriological response to vancomycin in patients with methicillin-resistant Staphylococcus aureus who achieve target AUC/MIC ≥ 400. This target is often extrapolated to pediatric patients despite the lack of similar evidence. The impracticalities of calculating the AUC in practice means vancomycin trough concentrations are used to predict the AUC/MIC...
January 17, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29344100/surgical-site-infection-prevention-an-analysis-of-compliance-with-good-practice-in-a-teaching-hospital
#2
Adriana Cristina de Oliveira, Camila Sarmento Gama
Background: Surgical teams play a critical role in reducing surgery-related risks during preoperative and intraoperative phases. Aim: To analyse the preoperative and intraoperative practices adopted by surgical teams in surgical site infections prevention. Methods: This was a cross-sectional study conducted during April-September 2013 in a large university hospital in Belo Horizonte, Minas Gerais, Brazil. It was conducted through observation of the surgical practice during preoperative and intraoperative phases of procedures used by a gastroenterological, cardiovascular and paediatric surgical team...
November 2017: Journal of Infection Prevention
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#3
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29290746/prolonged-dexmedetomidine-infusion-and-drug-withdrawal-in-critically-ill-children
#4
Astrid S Haenecour, Winnie Seto, Charline M Urbain, Derek Stephens, Peter C Laussen, Corrine R Balit
OBJECTIVE: To characterise the incidence, symptoms and risk factors for withdrawal associated with prolonged dexmedetomidine infusion in paediatric critically ill patients. METHODS: Retrospective chart review in the paediatric intensive care unit and the cardiac critical care unit of a single tertiary children's hospital. Patients up to 18 years old, who received dexmedetomidine for longer than 48 hours were included. RESULTS: A total of 52 patients accounted for 68 unique dexmedetomidine treatment courses of more than 48 hours...
November 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29278447/early-initiated-feeding-versus-early-reached-target-enteral-nutrition-in-critically-ill-children-an-observational-study-in-paediatric-intensive-care-units-in-turkey
#5
Soyhan Baǧci, Elif Keleş, Feyza Girgin, Dinçer R Yıldızdaş, Özden Ö Horoz, Nilüfer Yalındağ, Murat Tanyıldız, Benan Bayrakçi, Gökhan Kalkan, Başak N Akyıldız, Alper Köker, Tolga Köroğlu, Ayşe B Anıl, Neslihan Zengin, Ener Ç Dinleyici, Eylem Kıral, Oğuz Dursun, Süleyman Tolga Yavuz, Peter Bartmann, Andreas Müller
AIM: Although early enteral nutrition (EN) is strongly associated with lower mortality in critically ill children, there is no consensus on the definition of early EN. The aim of this study was to evaluate our current practice supplying EN and to identify factors that affect both the initiation of feeding within 24 h after paediatric intensive care unit (PICU) admission and the adequate supply of EN in the first 48 h after PICU admission in critically ill children. METHODS: We conducted a prospective, multicentre, observational study in nine PICUs in Turkey...
December 26, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29247112/protocol-for-a-randomised-pilot-multiple-centre-trial-of-conservative-versus-liberal-oxygenation-targets-in-critically-ill-children-oxy-picu
#6
Gareth A L Jones, Padmanabhan Ramnarayan, Sainath Raman, David Inwald, Michael P W Grocott, Simon Eaton, Samiran Ray, Michael J Griksaitis, John Pappachan, Daisy Wiley, Paul R Mouncey, Jerome Wulff, David A Harrison, Kathryn M Rowan, Mark J Peters
INTRODUCTION: Optimal targets for systemic oxygenation in paediatric critical illness are unknown. Observational data indicate that high levels of arterial oxygenation are associated with poor outcomes in resuscitation of the newborn and in adult critical illness. Within paediatric intensive care units (PICUs), staff prevent severe hypoxia wherever possible, but beyond this there is no consensus. Practice varies widely with age, diagnosis, treating doctor and local or national guidelines followed, though peripheral blood oxygen saturations (SpO2) of >95% are often targeted...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29246153/referral-patterns-delays-and-equity-in-access-to-advanced-paediatric-emergency-care-in-vietnam
#7
Emily Treleaven, Toan Ngoc Pham, Duy Ngoc Le, Trevor N Brooks, Hai Thanh Le, J Colin Partridge
BACKGROUND: Quality emergency care is a critical component of a well-functioning health system. However, severely ill children often face barriers to timely, appropriate care in less-developed health systems. Such barriers disproportionately affect poorer children, and may be particularly acute when children seek advanced emergency care. We examine predictors of increased acuity and patient outcomes at a tertiary paediatric emergency department to identify barriers to advanced emergency care among children...
December 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/29233755/postoperative-fasting-after-general-anaesthesia-a-survey-of-french-anaesthesiology-practices
#8
Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
BACKGROUND: Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. METHODS: From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric)...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29224906/horse-related-injuries-in-children-unmounted-injuries-are-more-severe-a-retrospective-review
#9
Grace E L Wolyncewicz, Cameron S Palmer, Helen E Jowett, John M Hutson, Sebastian K King, Warwick J Teague
INTRODUCTION: Horse-related injuries account for one quarter of all paediatric sports fatalities. It is not known whether the pattern of injury spectrum and severity differ between children injured whilst mounted, compared with those injured unmounted around horses. We aimed to identify any distinctions between the demographic features, spectrum and severity of injuries for mounted versus unmounted patients. PATIENTS AND METHODS: Trauma registry data were reviewed for 505 consecutive paediatric patients (aged<16years) admitted to a large paediatric trauma centre with horse-related injuries over a 16-year period...
December 6, 2017: Injury
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#10
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29210143/sudden-death-in-paediatrics-as-a-traumatic-experience-for-critical-care-nurses
#11
Lígia Lima, Sandra Gonçalves, Cândida Pinto
BACKGROUND: Research shows that nurses working in critical care units and in particular, paediatric units, are at risk of developing symptoms of secondary traumatic stress (STS). However, little attention has been given to this phenomenon when associated with situations of sudden death in paediatrics. AIM: This study aimed to examine the impact of sudden death in paediatrics on nurses working in paediatrics critical care units and to explore nurses' experiences of this event...
December 5, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29198262/medical-missions-for-the-provision-of-paediatric-cardiac-surgery-in-low-and-middle-income-countries
#12
Frank J Molloy, Nguyenvu Nguyen, Marisa Mize, Gavin Wright, Cecilia St George-Hyslop, Maura O'Callaghan, Emma Scanlan, William M Novick
This review will outline the role of visiting cardiac surgical teams in low- and middle-income countries drawing on the collective experience of the authors in a wide range of locations. Requests for assistance can emerge from local programmes at a beginner or advanced stage. However, in all circumstances, careful pre-trip planning is necessary in conjunction with clinical and non-clinical local partners. The clinical evaluation, surgical procedures, and postoperative care all serve as a template for collaboration and education between the visiting and local teams in every aspect of care...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198257/global-perspective-on-training-and-staffing-for-paediatric-cardiac-critical-care
#13
Ronald A Bronicki, Uri Pollak, Andrew C Argent, R Krishna Kumar, Maria Balestrini, Paola Cogo, Bruna Cury Borim, Kumi De Costa, John Beca, Naoki Shimizu, Troy E Dominguez
This manuscript provides a global perspective on physician and nursing education and training in paediatric cardiac critical care, including available resources and delivery of care models with representatives from several regions of the world including Africa, Israel, Asia, Australasia, Europe, South America, and the United States of America.
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29198256/the-global-burden-of-paediatric-heart-disease
#14
Ndidiamaka L Musa, Vibeke Hjortdal, Bistra Zheleva, Indah K Murni, Shunji Sano, Steven Schwartz, Sandra L Staveski
An estimated 15 million children die or are crippled annually by treatable or preventable heart disease in low- and middle-income countries. Global efforts to reduce under-5 mortality have focused on reducing death from communicable diseases in low- and middle-income countries with little to no attention focusing on paediatric CHD and acquired heart disease. Lack of awareness of CHD and acquired heart disease, access to care, poor healthcare infrastructure, competing health priorities, and a critical shortage of specialists are important reasons why paediatric heart disease has not been addressed in low resourced settings...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29196794/ultrasound-guided-or-landmark-techniques-for-central-venous-catheter-placement-in-critically-ill-children
#15
Ignacio Oulego-Erroz, Rafael González-Cortes, Patricia García-Soler, Mónica Balaguer-Gargallo, Manuel Frías-Pérez, Juan Mayordomo-Colunga, Ana Llorente-de-la-Fuente, Paula Santos-Herraiz, Juan José Menéndez-Suso, María Sánchez-Porras, Daniel Palanca-Arias, Carmen Clavero-Rubio, Mª Soledad Holanda-Peña, Luis Renter-Valdovinos, Sira Fernández-De-Miguel, Antonio Rodríguez-Núñez
PURPOSE: To assess whether ultrasound guidance improves central venous catheter placement outcomes compared to the landmark technique in critically ill children. METHODS: A prospective multicentre observational study was carried out in 26 paediatric intensive care units over 6 months. Children 0-18 years old who received a temporary central venous catheter, inserted using either ultrasound or landmark techniques, were eligible. The primary outcome was the first-attempt success rate...
December 1, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/29175882/evidence-and-speculation-reimagining-approaches-to-architecture-and-research-within-the-paediatric-hospital
#16
Rebecca McLaughlan, Alan Pert
As the dominant research paradigm within the construction of contemporary healthcare facilities, evidence-based design (EBD) will increasingly impact our expectations of what hospital architecture should be. Research methods within EBD focus on prototyping incremental advances and evaluating what has already been built. Yet medical care is a rapidly evolving system; changes to technology, workforce composition, patient demographics and funding models can create rapid and unpredictable changes to medical practice and modes of care...
November 25, 2017: Medical Humanities
https://www.readbyqxmd.com/read/29174722/functional-progression-of-patients-with-neurological-diseases-in-a-tertiary-paediatric-intensive-care-unit-our-experience
#17
P Madurga Revilla, J López Pisón, P Samper Villagrasa, J P García Íñiguez, R Garcés Gómez, M Domínguez Cajal, I Gil Hernández
INTRODUCTION: Neurological diseases explain a considerable proportion of admissions to paediatric intensive care units (PICU), and are a significant cause of morbidity and mortality. This study aims to analyse the functional progression of children with critical neurological conditions. MATERIAL AND METHODS: Retrospective descriptive study of children admitted to PICU with neurological diseases over a period of 3 years (2012-2014), assessing vital and functional prognosis at PICU discharge and at one year according to the Pediatric Cerebral and Overall Performance Category scales (PCPC-POPC) and the Functional Status Scale (FSS)...
November 23, 2017: Neurología: Publicación Oficial de la Sociedad Española de Neurología
https://www.readbyqxmd.com/read/29170354/57%C3%A2-support-for-suddenly-bereaved-parents-in-the-emergency-unit
#18
Emily Jones, Steffan Simpson
: The Paediatric Emergency Unit at the University Hospital of Wales provides care for over 33 000 children per year. There was no provision in place to support suddenly bereaved families. Staff felt that we could improve the services provided to families who's children sadly died in the unit.The aim was to provide immediate support for the suddenly bereaved families by working in partnership with local Charity 2 Wish Upon a Star. Together we created a Standard Operating Procedure (SOP) that consisted of a checklist and pathway allowing us to refer relatives for immediate physical and emotional support...
December 2017: Emergency Medicine Journal: EMJ
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
#19
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
#20
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
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