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paediatric ventilation

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https://www.readbyqxmd.com/read/29317348/paediatric-in-hospital-cardiac-arrest-factors-associated-with-survival-and-neurobehavioural-outcome-one-year-later
#1
Kathleen Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, John Berger, George Ofori-Amanfo, Christopher J L Newth, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate clinical characteristics associated with 12-month survival and neurobehavioural function among children recruited to the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital trial. METHODS: Children (n = 329) with in-hospital cardiac arrest who received chest compressions for ≥2 minutes, were comatose, and required mechanical ventilation after return of circulation were included. Neurobehavioural function was assessed using the Vineland Adaptive Behaviour Scale, second edition (VABS-II) at baseline (reflecting pre-arrest status) and 12 months post-arrest...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29300861/asanguineous-priming-of-miniaturized-paediatric-cardiopulmonary-bypass-circuits-for-congenital-heart-surgery-independent-predictors-associated-with-transfusion-requirements-and-effects-on-postoperative-morbidity
#2
Wolfgang Boettcher, Matthias Redlin, Frank Dehmel, Katharina Graefe, Mi-Young Cho, Helmut Habazettl, Marian Kukucka
OBJECTIVES: In paediatric cardiac surgery, body weight-adjusted miniaturized cardiopulmonary bypass (CPB) circuits within a comprehensive blood-sparing approach can reduce transfusion requirements. Haemodilution resulting from mixing the patient's blood with a CPB crystalloid solution may be reduced to the extent that asanguineous priming becomes possible. Therefore, we adopted asanguineous priming in our clinical routine. Our goal was to report the effects of asanguineous priming on transfusion requirements, clinical features associated with transfusion and effects on in-hospital morbidity...
January 2, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29297442/the-significance-of-cytomegalovirus-in-children-with-pneumonia-admitted-for-mechanical-ventilation
#3
P M Jeena, K Govender, R Parboosing, M Adhikari
BACKGROUND: The pathogenic role of cytomegalovirus (CMV) among children with pneumonia is not clear. OBJECTIVES AND DESIGN: We describe the outcome of children on mechanical ventilation with 'probable' CMV-related pneumonitis (CMV DNA polymerase chain reaction [PCR] positive as well as clinical and imaging features of CMV on ganciclovir) and children with pneumonia and CMV infection (CMV DNA PCR-positive without clinical and imaging features of CMV and not on ganciclovir therapy) at a paediatric intensive care unit in South Africa between 2011 and 2013...
December 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/29286529/unanticipated-difficult-airway-management-in-children-the-consensus-statement-of-the-paediatric-anaesthesiology-and-intensive-care-section-and-the-airway-management-section-of-the-polish-society-of-anaesthesiology-and-intensive-therapy-and-the-polish-so
#4
Wojciech Walas, Dawid Aleksandrowicz, Maria Borszewska-Kornacka, Tomasz Gaszyński, Ewa Helwich, Marek Migdał, Andrzej Piotrowski, Grażyna Siejka, Tomasz Szczapa, Alicja Bartkowska-Śniatkowska
Tracheal intubation may be defined as an artificial airway established in order to provide mechanical ventilation of the lungs during surgical procedures under general anaesthesia, treatment in an intensive care unit, as well as in emergency situations. Difficulties encountered during intubation may cause hypoxia, hypoxic brain injury and, in extreme situations, may result in the patient's death. There may be unanticipated and anticipated difficult airway. Children form a specific group of patients as there are significant differences in both anatomy and physiology...
2017: Anaesthesiology Intensive Therapy
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
#5
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/29215159/sleep-disorders-in-obese-children-are-not-limited-to-obstructive-sleep-apnoea-syndrome
#6
C Carriere, O Coste, M C Meiffred-Drouet, P Barat, H Thibault
AIM: This study was to characterised respiratory and non-respiratory sleep disorders in obese children and evaluated the diagnostic and therapeutic impact of a specific sleep consultation. METHODS: A descriptive study was conducted in obese French children who received multidisciplinary care management from the hospital centre for paediatric obesity in Bordeaux. This followed a specific sleep consultation between 2007 and 2015, because their paediatrician had identified symptoms suggestive of sleep disorders...
December 7, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29210305/detection-of-early-nocturnal-hypoventilation-in-neuromuscular-disorders
#7
Federica Trucco, Marina Pedemonte, Chiara Fiorillo, Hui-Leng Tan, Annalisa Carlucci, Giacomo Brisca, Paola Tacchetti, Claudio Bruno, Carlo Minetti
Objective Nocturnal hypoventilation (NH) is a complication of respiratory involvement in neuromuscular disorders (NMD) that can evolve into symptomatic daytime hypercapnia if not treated proactively with non-invasive ventilation. This study aimed to assess whether NH can be detected in the absence of other signs of nocturnal altered gas exchange. Methods We performed nocturnal transcutaneous coupled (tc) pCO2/SpO2 monitoring in 46 consecutive cases of paediatric-onset NMD with a restrictive respiratory defect (forced vital capacity < 60%)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29201634/innovative-chest-physiotherapy-techniques-the-metaneb%C3%A2-system-in-the-intubated-child-with-extensive-burns
#8
Alexandra Ferguson, Sarah Wright
Introduction: The Metaneb® is a new generation Intrapulmonary Percussive Ventilation device utilised by the physiotherapist to assist airway clearance by providing calibrated oscillations during inspiration up to 3.8Hz. Predominantly used in the adult chronic respiratory patient, with anecdotal evidence in intubated patients, it was also proven to be safe in a paediatric lung model lab study. This case report outlines the first use of the Metaneb® with an intubated child in Australia...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29174374/tracheobronchial-stenting-for-airway-malacia
#9
REVIEW
Colin Wallis, Clare A McLaren
Tracheobronchomalacia is a rare but clinically troublesome condition in paediatrics. The softening of the major airways - which can include some or all of the tracheobronchial tree can lead to symptoms ranging from the minor (harsh barking cough, recurrent chest infections) to severe respiratory difficulties including prolonged ventilator support and 'near death attacks'. The causes are broadly divided into intrinsic softening of the airway wall which is considered a primary defect (e.g. syndromes; post tracheo-oesophageal fistula repair; extreme prematurity) or secondary malacia due to external compression from vascular structures or cardiac components...
October 13, 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/29168575/cuffed-vs-uncuffed-tracheal-tubes-in-children-a-randomised-controlled-trial-comparing-leak-tidal-volume-and-complications
#10
N A Chambers, A Ramgolam, D Sommerfield, G Zhang, T Ledowski, M Thurm, M Lethbridge, M Hegarty, B S von Ungern-Sternberg
Cuffed tracheal tubes are increasingly used in paediatric anaesthetic practice. This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0-16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time-points: during volume-controlled ventilation 6 ml...
November 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29168220/number-needed-to-suffer-replying-to-comments-on-my-paper
#11
Per-Arne Lönnqvist
I would like to reply to the issues raised by the letter from Dr Barrington (1) on my Different View article on disability-free survival and number needed to suffer (2). However, first of all I would like to provide some important background on my interest in this area.First, I worked in NICU care for more than 10 years before focusing on paediatric anaesthesia and I am the proud father of premature triplets born at 31+4 weeks. As such, I have also been a parent who has witnessed NICU care three times for three months, including surfactant replacement, mechanical ventilation, surgical ductus ligation, sepsis and necrotising entercolitis treated by nil-by-mouth, total parenteral nutrition and antibiotics...
November 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29152933/ventilator-induced-lung-injury-does-it-occur-in-children
#12
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
#13
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/29114417/an-alternative-lung-isolation-technique-in-paediatric-pulmonary-alveolar-proteinosis
#14
Tümay Umuroğlu, Merve Altıntaş, Tural Abdullayev, Gürsu Kıyan, Hilmi Ö Ayanoğlu
Lung isolation during the lung lavage of children with pulmonary alveolar proteinosis (PAP) poses challenges to anaesthesiologists. There is no established technique in the management of lung lavage in children; each described technique has its own advantages and disadvantages. We described a patient (2.5-year-old) with PAP, who has undergone left lung lavage. While his lung was isolated by a Fogarty catheter, lavage was performed via a feeding tube, and the right lung was ventilated with a rigid bronchoscope...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29067985/point-prevalence-risk-factor-assessment-for-hospital-acquired-infections-in-a-tertiary-care-hospital-in-pune-india
#15
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/29062558/bilateral-diaphragmatic-paralysis-following-paediatric-cardiac-surgery-experience-of-four-cases-at-the-royal-hospital-muscat-oman
#16
Said A M Al-Hanshi, Mohammed H R Al-Ghafri
Bilateral diaphragmatic paralysis (BDP) is a rare complication of paediatric cardiac surgery. We report four children who developed BDP following cardiac surgery who were managed at the Royal Hospital, Muscat, Oman, between 2009 and 2014. All four children suffered severe respiratory distress soon after extubation and required re-intubation within two hours. In addition, all of the children underwent a tracheostomy as an interim method for ventilation. The four children were successfully weaned from positive pressure ventilation following the functional recovery of at least one side of the diaphragm...
August 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29058568/retention-and-use-of-newborn-resuscitation-skills-following-a-series-of-helping-babies-breathe-trainings-for-midwives-in-rural-ghana
#17
Darren Eblovi, Patricia Kelly, Georgina Afua, Sarah Agyapong, Siddhartha Dante, Matthew Pellerite
BACKGROUND: The Helping Babies Breathe (HBB) program teaches basic newborn resuscitation techniques to birth attendants in low-resource settings. Previous studies have demonstrated a decrease in mortality following training, mostly in large hospitals. However, low-volume clinics in rural regions with no physician immediately available likely experience a greater relative burden of newborn mortality. This study aimed to determine the impact of HBB trainings provided to rural Ghanaian midwives on their skills retention and on first 24 hour mortality of the newborns they serve...
2017: Global Health Action
https://www.readbyqxmd.com/read/28994364/comparison-of-the-therapeutic-effects-and-side-effects-of-tadalafil-and-sildenafil-after-surgery-in-young-infants-with-pulmonary-arterial-hypertension-due-to-systemic-to-pulmonary-shunts
#18
Mohammad Reza Sabri, Hamid Bigdelian, Mohsen Hosseinzadeh, Alireza Ahmadi, Mehdi Ghaderian, Mohammad Shoja
Young children with CHD and large systemic-to-pulmonary shunts eventually develop pulmonary hypertension. At present, phosphodiesterase type-5 inhibitors such as sildenafil have been used to control pulmonary pressure before and after cardiac surgery. Recently, tadalafil has been utilised in older children with similar efficacy, but it has been used to a lesser extent in young infants. From April, 2015 to June, 2016, 42 patients aged 3-24 months with a large septal defect and pulmonary arterial hypertension were randomly divided into two equal groups: one group received oral sildenafil (1-3 mg/kg/day every 8 hours), whereas the other group received oral tadalafil (1 mg/kg once a day) from 7-10 days before surgery to 3-4 weeks after surgery...
November 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28984426/caregiver-knowledge-and-skills-to-safely-care-for-pediatric-tracheostomy-ventilation-at-home
#19
Reshma Amin, Chris Parshuram, Jeannie Kelso, Audrey Lim, Dimas Mateos, Ian Mitchell, Hema Patel, Madan Roy, Faiza Syed, Rita Troini, David Wensley, Louise Rose
OBJECTIVE: Caregivers of children using home mechanical ventilation (HMV) via tracheostomy require appropriate knowledge and skills. Existing training curricula are locally developed and content variable. We sought to develop a competency checklist to inform initial training and subsequent assessment of knowledge and skills of family caregivers. METHODS: We used a 2-step process. Candidate items were generated by synthesis of a scoping review, existing checklists, with additional items suggested by an eight member inter-professional group representing pediatric HMV programs across Canada...
October 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28960591/acute-flaccid-paralysis-in-south-african-children-causes-respiratory-complications-and-neurological-outcome
#20
Jolanda van der Pijl, Jo M Wilmshurst, Monique van Dijk, Andrew Argent, Jane Booth, Marco Zampoli
AIM: To describe the causes, clinical presentation and neurological outcome of acute flaccid paralysis in children. METHODS: A retrospective study in a tertiary paediatric hospital in South Africa. Data on clinical presentation, respiratory complications and long-term neurological outcomes of children presenting with acute flaccid paralysis were collected. Logistic regression analysis was applied to determine predictors for the need of mechanical ventilation. RESULTS: The study included 119 patients, 99 of whom had Guillain-Barré syndrome (GBS); 47 patients (39...
September 28, 2017: Journal of Paediatrics and Child Health
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