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https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#1
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29750427/evaluation-of-knowledge-of-students-in-paediatric-dentistry-concerning-cardiopulmonary-resuscitation-skills-in-children
#2
L M De Mauro, L B Oliveira, C De Cássia Bergamaschi, J C Ramacciato, R H L Motta
AIM: The study evaluated the theoretical knowledge and practical ability of students in paediatric dentistry concerning basic life support (BLS) and cardiopulmonary resuscitation (CPR) in children and babies. METHODS: Seventy paediatric dentistry students answered a questionnaire and also performed a simulation of the manoeuvres of BLS and CPR on baby and child manikins. RESULTS: The results showed that 41 (58%) students had never received BLS training...
May 10, 2018: European Archives of Paediatric Dentistry: Official Journal of the European Academy of Paediatric Dentistry
https://www.readbyqxmd.com/read/29722906/manikin-study-showed-that-counting-inflation-breaths-out-loud-improved-the-speed-of-resuming-chest-compressions-during-two-person-paediatric-cardiopulmonary-resuscitation
#3
Jang Hee Lee, Ji Ung Na, Dong Hyuk Shin, Sang Kuk Han, Pil Cho Choi, Jun Hwi Cho
AIM: We investigated whether counting inflation breaths out loud during cardiopulmonary resuscitation (CPR) led to an earlier resumption of chest compressions. METHODS: In this randomised controlled manikin simulation study, conducted from February 2015 to April 2015, 32 fourth-year Korean medical students, equally divided into study and control groups, performed 10 cycles of 15:2 CPR while administering inflation breaths using a bag mask. The first study participant counted the number of inflation breaths out loud and the second study participant was told to perform chest compressions as soon as they heard their colleague say two...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29720752/current-practice-patterns-of-supraglottic-airway-device-usage-in-paediatric-patients-amongst-anaesthesiologists-a-nationwide-survey
#4
Ruchi A Jain, Devangi A Parikh, Anila D Malde, Bhuvneshwari Balasubramanium
Background and Aims: Supraglottic airway devices (SGADs) are increasingly being used for airway management in paediatric patients undergoing general anaesthesia. This survey was designed to assess the nationwide practice patterns of SGAD usage in paediatric patients. Methods: A questionnaire of 28 questions was circulated amongst 16,532 members of the Indian Society of Anaesthesiologists through online survey engine Google Forms® and served manually to 500 delegates attending the Asian Society of Paediatric Anaesthesiologists conference 2017...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29706495/effect-of-red-blood-cell-storage-duration-on-outcome-after-paediatric-cardiac-surgery-a-prospective-observational-study
#5
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Chandrasekaran Ananthanarayanan, Ritesh Shah, Atul Solanki, Himani Pandya, Sanjay Patel
BACKGROUND: Retrospective reviews have found the use of stored packed red blood cells (PRBCs) in priming to be associated with increased risk of postoperative complications. The purpose of study was to prospectively investigate the influence of duration of storage of PRBCs used in priming the cardiopulmonary bypass (CPB) circuit on the metabolic profile of the patients, and postoperative outcome after paediatric cardiac surgery. METHODS: Between January 2015 and December 2015, 198 consecutive children operated for cardiac surgery using CPB and received blood for priming the circuit were included...
March 31, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29699897/development-of-regional-extracorporeal-life-support-system-the-importance-of-innovative-simulation-training
#6
Mateusz Puślecki, Marcin Ligowski, Marek Dąbrowski, Sebastian Stefaniak, Małgorzata Ładzińska, Aleksander Pawlak, Marcin Zieliński, Łukasz Szarpak, Bartłomiej Perek, Marek Jemielity
BACKGROUND: Despite advances in mechanical ventilation, severe acute respiratory distress syndrome (ARDS) is associated with high morbidity and mortality rates ranging from 30% to 60%. Extracorporeal Membrane Oxygenation (ECMO) can be used as a "bridge to recovery". ECMO is a complex network that provides oxygenation and ventilation and allows the lungs to rest and recover from respiratory failure, while minimizing iatrogenic ventilator-induced lung injury. In the critical care settings, ECMO is shown to improve survival rates and outcomes in patients with severe ARDS...
April 18, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29690945/a-protocol-to-decrease-postoperative-chylous-effusion-duration-in-children
#7
Melissa M Winder, Aaron W Eckhauser, Claudia Delgado-Corcoran, Randall J Smout, Jennifer Marietta, David K Bailly
OBJECTIVE: Our primary goal was to decrease time to resolution of postoperative chylothorax as demonstrated by total days of chest tube utilisation through development and implementation of a management protocol. METHODS: A chylothorax management protocol was implemented as a quality improvement project at a tertiary-care paediatric hospital in July, 2015. Retrospective analysis was completed on patients aged 0-17 years diagnosed with chylothorax within 30 days of cardiac surgery in a pre-protocol cohort (February, 2014 to June, 2015, n=20) and a post-protocol cohort (July, 2015 to March, 2016, n=22)...
April 25, 2018: Cardiology in the Young
https://www.readbyqxmd.com/read/29688024/reduced-nasal-viral-load-and-ifn-responses-in-infants-with-rsv-bronchiolitis-and-respiratory-failure
#8
Ryan S Thwaites, Matthew Coates, Kazuhiro Ito, Marwa Ghazaly, Calandra Feather, Farhana Abdulla, Tanushree Tunstall, Pooja Jain, Lindsey Cass, Garth Rapeport, Trevor T Hansel, Simon Nadel, Peter J Openshaw
RATIONALE: Respiratory syncytial virus (RSV) bronchiolitis is a major cause of morbidity and mortality in infancy. Severe disease is thought to result from uncontrolled viral replication, an excessive immune response, or both. OBJECTIVES: To determine RSV load and immune mediator levels in nasal mucosal lining fluid by serial sampling of nasal fluids from cases of moderate and severe bronchiolitis over the course of infection. METHODS: Infants with viral bronchiolitis necessitating admission (n=55) were recruited from a paediatric centre during 2016/17...
April 24, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29670762/rolling-refresher-simulation-improves-performance-and-retention-of-paediatric-intensive-care-unit-nurse-code-cart-management
#9
Marcy N Singleton, Kimberly F Allen, Zhongze Li, Kevin McNerney, Urs H Naber, Matthew S Braga
Introduction: Paediatric Intensive Care Unit Nurses (PICU RNs) manage the code cart during paediatric emergencies at the Children's Hospital at Dartmouth-Hitchcock. These are low -frequency, high-stakes events. Methods: An uncontrolled intervention study with 6-month follow-up. A collaboration of physician and nursing experts developed a rolling-refresher training programme consisting of five simulated scenarios, including 22 code cart skills, to establish nursing code cart competency...
April 2018: BMJ simulation & technology enhanced learning
https://www.readbyqxmd.com/read/29643549/low-flow-anaesthesia-underused-mode-towards-sustainable-anaesthesia
#10
REVIEW
Madhusudan Upadya, P J Saneesh
Any technique that employs a fresh gas flow that is less than the alveolar ventilation can be classified as low-flow anaesthesia. The complexities involved in the calculation of uptake of anaesthetic agents during the closed-circuit anaesthesia made this technique less popular. However, the awareness of the dangers of theatre pollution with trace amounts of the anaesthetic agents and the prohibitively high cost of the new inhalational agents, have helped in the rediscovery of low-flow anaesthesia. Moreover, the time has arrived for each of us, the practicing anaesthesiologists, to move towards the practice of low-flow anaesthesia, to achieve lesser theatre and environmental pollution and also to make anaesthesia more economical...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29614915/preliminary-experience-of-tigecycline-treatment-in-critically-ill-children-with-ventilator-associated-pneumonia
#11
Shupeng Lin, Lingfang Liang, Chenmei Zhang, Sheng Ye
Objective Ventilator-associated pneumonia (VAP) is a life-threatening complication for children who are treated in a paediatric intensive care unit. Tigecycline treatment of children with VAP has not been well studied. This study aimed to describe tigecycline use in children with VAP in a tertiary care hospital. Methods We conducted a retrospective chart review in a tertiary hospital from May 1, 2012 to May 1, 2017. Results Twenty-four children (20 girls) with median age of 8 months (range, 27 days to 6 years and 9 months) were treated with tigecycline...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29605208/characteristics-and-mortality-risk-of-children-with-life-threatening-influenza-infection-admitted-to-paediatric-intensive-care-in-england-2003-2015
#12
Pia Hardelid, Melpo Kapetanstrataki, Lee Norman, Sarah J Fleming, Paula Lister, Ruth Gilbert, Roger C Parslow
BACKGROUND: Information is lacking about the severity of complications in children with influenza admitted to paediatric intensive care units (PICU) in the UK. In this study, we report risk factors for mortality, invasive ventilation and use of vasoactive drugs for children admitted to PICU with influenza. METHODS: We evaluated all admissions to PICUs in England for resident children with a recorded influenza diagnosis between September 2003 and March 2015. We used the Paediatric Intensive Care Audit Network (PICANet) database linked to hospital admission records to identify influenza cases, and high-risk comorbidities among admitted children...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29601846/burden-of-caregiving-after-a-child-s-in-hospital-cardiac-arrest
#13
Kathleen Meert, Beth S Slomine, James R Christensen, Russell Telford, Richard Holubkov, J Michael Dean, Frank W Moler
OBJECTIVE: To describe caregiver burden among those whose children survive in-hospital cardiac arrest and have high risk of neurologic disability, and explore factors associated with burden during the first year post-arrest. METHODS: The study is a secondary analysis of the Therapeutic Hypothermia after Paediatric Cardiac Arrest In-Hospital (THAPCA-IH) trial. 329 children who had an in-hospital cardiac arrest, chest compressions for >2 minutes, and mechanical ventilation after return of circulation were recruited to THAPCA-IH...
March 27, 2018: Resuscitation
https://www.readbyqxmd.com/read/29534186/early-initiation-of-peritoneal-dialysis-improves-postoperative-recovery-in-children-with-right-ventricular-outflow-tract-obstructive-lesions-at-high-risk-of-fluid-overload-a-propensity-score-matched-analysis
#14
Tuo Pan, Dan Li, Shoujun Li, Jun Yan, Xu Wang
OBJECTIVES: Postoperative fluid overload is common in children after cardiac surgery, especially for those with right ventricular outflow tract obstruction, which is associated with poor outcomes. This study was conducted to investigate whether early peritoneal dialysis (PD) was associated with improved outcomes in these children at high risk of fluid overload. METHODS: Between January 2010 and January 2015, a total of 2555 consecutive patients with right ventricular outflow tract obstruction underwent anatomical repair...
March 9, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29522148/dexmedetomidine-improves-the-outcomes-in-paediatric-cardiac-surgery-a-meta-analysis-of-randomized-controlled-trials
#15
Yang Liu, Weishuai Bian, Ping Liu, Xuefeng Zang, Xuyun Gu, Wei Chen
OBJECTIVES: Dexmedetomidine has been shown to decrease cardiac complications in adults undergoing cardiac surgery. Results from clinical trials of dexmedetomidine on outcomes following paediatric cardiac surgery are controversial. METHODS: We searched EMBASE, PubMed and Cochrane CENTRAL databases for randomized controlled trials comparing the effect of dexmedetomidine versus placebo or other anaesthetic drugs in paediatric patients undergoing cardiac surgery. The primary outcome was the duration of mechanical ventilation...
May 1, 2018: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/29520998/does-respiratory-variation-of-inferior-vena-cava-diameter-predict-fluid-responsiveness-in-spontaneously-ventilating-children-with-sepsis
#16
Elliot Long, Trevor Duke, Ed Oakley, Adam O'Brien, Bennett Sheridan, Franz E Babl
OBJECTIVE: The intent of fluid bolus therapy (FBT) is to increase cardiac output and tissue perfusion, yet only 50% of septic children are fluid responsive. We evaluated respiratory variation of inferior vena cava (IVC) diameter as a predictor of fluid responsiveness. METHODS: A prospective observational study in the ED of The Royal Children's Hospital, Melbourne, Australia. Patients were spontaneously ventilating children treated with FBT for sepsis-induced acute circulatory failure...
March 8, 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29516704/use-of-low-dose-dexmedetomidine-in-combination-with-opioids-and-midazolam-in-paediatric-cardiac-surgical-patients-randomized-controlled-trial
#17
Cristiana Garisto, Zaccaria Ricci, Lorenzo Tofani, Simona Benegni, Chiara Pezzella, Paola Cogo
BACKGROUND: Dexmedetomidine is a selective agonist of α2 receptors that induces hypnotic, sedative and mild analgesic effect. The aim of our study was to test the effects of dexmedetomidine in combination with opioids and benzodiazepines compared to benzodiazepine-opioids alone. METHODS: A randomized controlled trial was conducted. Patients (children >30 days and <24 months undergoing correction of complex congenital heart diseases -CHD-) were randomized to receive 0...
March 7, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29507033/-pseudo-calcifications-detection-of-perfluorocarbon-residue-on-a-computed-tomography-scan-15-years-after-liquid-ventilation-therapy-at-3-months-of-age
#18
Sameem Tak, Mary Barraclough
Partial liquid ventilation using perfluorocarbons is a therapy that was once frequently used in paediatric populations for patients with severe respiratory distress. Perfluorocarbon is a non-toxic, insoluble and radiopaque vector through which improved gas exchange can occur. Two previous cases have been reported of persistent perfluorocarbon residua, identified on imaging years after receiving liquid ventilation therapy. We report a case of perfluorocarbon detection on a CT scan 15 years after liquid ventilation at 3 months of age, and propose the probable mechanism of its appearance...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29504128/the-use-of-acute-normovolemic-hemodilution-in-paediatric-cardiac-surgery
#19
W M Crescini, A Muralidaran, I Shen, A LeBlan, J You, C Giacomuzzi, M M Treggiari
BACKGROUND: Acute normovolemic hemodilution (ANH) is considered safe and effective in decreasing perioperative transfusion in paediatric populations undergoing high blood-loss surgeries. We determined the association between ANH and the intraoperative use of allogeneic blood products in paediatric cardiac surgery patients. METHODS: This is a single-centre retrospective cohort study including paediatric patients between 0 and 36 months of age undergoing surgical repair or palliation of their cardiac defect with the use of cardiopulmonary bypass between November 2013 and November 2014...
March 4, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29492954/accuracy-of-near-patient-vs-inbuilt-spirometry-for-monitoring-tidal-volumes-in-an-in-vitro-paediatric-lung-model
#20
S Morgenroth, J Thomas, V Cannizzaro, M Weiss, A R Schmidt
Spirometric monitoring provides precise measurement and delivery of tidal volumes within a narrow range, which is essential for lung-protective strategies that aim to reduce morbidity and mortality in mechanically-ventilated patients. Conventional anaesthesia ventilators include inbuilt spirometry to monitor inspiratory and expiratory tidal volumes. The GE Aisys CS2 anaesthesia ventilator allows additional near-patient spirometry via a sensor interposed between the proximal end of the tracheal tube and the respiratory tubing...
March 1, 2018: Anaesthesia
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