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https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#1
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28421191/prospective-multicentre-study-on-the-epidemiology-and-current-therapeutic-management-of-severe-bronchiolitis-in-spain
#2
Jose C Flores-González, Juan Mayordomo-Colunga, Iolanda Jordan, Alicia Miras-Veiga, Cristina Montero-Valladares, Marta Olmedilla-Jodar, Andrés J Alcaraz-Romero, Miren Eizmendi-Bereciartua, Francisco Fernández-Carrión, Carmen Santiago-Gutierrez, Esther Aleo-Luján, Sonia Pérez-Quesada, Cristina Yun-Castilla, Carmen Martín, Álvaro Navarro-Mingorance, Concha Goñi-Orayen
Objective. To determine the epidemiology and therapeutic management of patients with severe acute bronchiolitis (AB) admitted to paediatric intensive care units (PICUs) in Spain. Design. Descriptive, prospective, multicentre study. Setting. Sixteen Spanish PICUs. Patients. Patients with severe AB who required admission to any of the participating PICUs over 1 year. Interventions. Both epidemiological variables and medical treatment received were recorded. Results. A total of 262 patients were recruited; 143 were male (54...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28410544/does-respiratory-variation-in-inferior-vena-cava-diameter-predict-fluid-responsiveness-a-systematic-review-and-meta-analysis
#3
Elliot Long, Ed Oakley, Trevor Duke, Franz E Babl
BACKGROUND: The aim of fluid resuscitation is to increase stroke volume, yet this effect is observed in only 50% of patients. Prediction of fluid responsiveness may allow fluid resuscitation to be administered to those most likely to benefit. The aim of this study was to systematically review the test characteristics of respiratory variation in inferior vena cava (IVC) diameter as a predictor of fluid responsiveness in patients with acute circulatory failure. METHODS: Electronic searches combined with reference review of identified studies...
May 2017: Shock
https://www.readbyqxmd.com/read/28408467/isolated-mild-sleep-associated-hypoventilation-in-children-with-down-syndrome
#4
Wai Wong, Dennis Rosen
INTRODUCTION: Children with Down syndrome (DS) have a high incidence of obstructive sleep apnea (OSA) that is often associated with hypoventilation. Little is known, however, about the prevalence of sleep-associated hypoventilation independent of OSA in these children. METHODS: Retrospective chart review of all children with DS under 18 years of age undergoing polysomnography at a tertiary care paediatric hospital during a 2-year period. Exclusion criteria were as follow: those requiring oxygen or positive-pressure ventilation; with tracheostomy, baseline hypoxia, unrepaired cyanotic heart disease, pulmonary hypertension, and cerebral palsy; or OSA with >5 obstructions/hour...
April 13, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28368490/nasosorption-is-a-minimally-invasive-diagnostic-procedure-for-measurement-of-viral-load-and-markers-of-mucosal-inflammation-in-rsv-bronchiolitis
#5
Ryan S Thwaites, Kazuhiro Ito, Jasmine M S Chingono, Matthew Coates, Hannah C Jarvis, Tanushree Tunstall, Lauren Anderson-Dring, Lindsey Cass, Garth Rapeport, Peter J Openshaw, Simon Nadel, Trevor T Hansel
Background: Existing respiratory mucosal sampling methods are flawed, particularly in a paediatric bronchiolitis setting. Methods: Twenty-four infants with bronchiolitis were recruited: 12 were Respiratory syncytial virus (RSV)+, 12 were RSV-. Infants were sampled by nasosorption (NS) and nasopharyngeal-aspiration (NPA). Results: NS was well tolerated and identified all RSV+ samples. RSV load measured by NS (but not NPA) correlated with length of hospital stay (P=0...
March 27, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28353318/high-flow-nasal-cannula-therapies-for-respiratory-management-in-pediatric-patients
#6
Gang Liu, Conghai Fan, Hongwei Wu
High flow nasal cannula (HFNC) oxygen therapy is a non-invasive form of respiratory support that is rapidly being taken up in paediatric intensive care units (PICU). For infants with bronchiolitis - who are the largest non-elective source of admissions to a PICU - there is some evidence that using HFNC therapy reduces the need for intubation and mechanical ventilation. The aim of this review article is is to explore, describe, critique and add to the evidence surrounding the use of HFNC therapy in the pediatric population for the management of respiratory distress...
March 27, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28347624/efficacy-and-safety-of-normal-saline-instillation-and-paediatric-endotracheal-suction-an-integrative-review
#7
REVIEW
Jessica O'Leary, Marion L Mitchell, Marie Cooke, Andreas Schibler
OBJECTIVE: To synthesise research findings regarding the efficacy and safety of normal saline instillation (NSI) during endotracheal suction in the paediatric intensive care unit. DATA SOURCES: The Cochrane Library, PROSPERO, the National Health Service Centre for Reviews and Dissemination, PubMed and Cumulative Index to Nursing and Allied Health (CINAHL) databases were systematically searched. Subject headings included "suctioning, endotracheal", "suction", "sodium chloride", "normal saline" and "paediatrics"...
March 24, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28341980/implementation-and-evaluation-of-a-paediatric-nurse-driven-sedation-protocol-in-a-paediatric-intensive-care-unit
#8
Lélia Dreyfus, Etienne Javouhey, Angélique Denis, Sandrine Touzet, Fabienne Bordet
BACKGROUND: Optimal sedation and analgesia is a challenge in paediatric intensive care units (PICU) because of difficulties in scoring systems and specific metabolism inducing tolerance and withdrawal. Excessive sedation is associated with prolonged mechanical ventilation and hospitalisation. Adult and paediatric data suggest that goal-directed sedation algorithms reduce the duration of mechanical ventilation. We implemented a nurse-driven sedation protocol in a PICU and evaluated its impact...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28341888/the-respiratory-control-of-carbon-dioxide-in-children-and-adolescents-referred-for-treatment-of-psychogenic-non-epileptic-seizures
#9
Kasia Kozlowska, Reena Rampersad, Catherine Cruz, Ubaid Shah, Catherine Chudleigh, Samantha Soe, Deepak Gill, Stephen Scher, Pascal Carrive
Psychogenic non-epileptic seizures (PNES) are a common problem in paediatric neurology and psychiatry that can best be understood as atypical responses to threat. Threats activate the body for action by mediating increases in arousal, respiration, and motor readiness. In previous studies, a range of cardiac, endocrine, brain-based, attention-bias, and behavioral measures have been used to demonstrate increases in arousal, vigilance, and motor readiness in patients with PNES. The current study uses respiratory measures to assess both the motor readiness of the respiratory system and the respiratory regulation of CO2...
March 24, 2017: European Child & Adolescent Psychiatry
https://www.readbyqxmd.com/read/28329112/comparison-of-paracorporeal-and-continuous-flow-ventricular-assist-devices-in-children-preliminary-results
#10
Mohamed S Nassar, Asif Hasan, Teresa Chila, Stephan Schueler, Carola Pergolizzi, Zdenka Reinhardt, Stephen Lord, Fabrizio De Rita, Lee Ferguson, Jon Smith, Simon Haynes, John O'Sullivan, Bari Murtuza
OBJECTIVES: With the scarcity of organs, a durable, reliable ventricular assist device (VAD) is required. The Berlin Heart EXCOR ® (BH) remains the most established VAD in the paediatric population. Implantable continuous flow (CF) VADs have been introduced to the paediatric field with encouraging early results. In this study, we compared the results of a newly introduced CF VAD (HeartWare VAD [HVAD] ® ) to results in a matched group of BH recipients. METHODS: The study included patients aged <16 years who received mechanical left VAD (LVAD) support between December 2005 and January 2016...
April 1, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28328787/prone-positioning-improves-ventilation-homogeneity-in-children-with-acute-respiratory-distress-syndrome
#11
Alison Lupton-Smith, Andrew Argent, Peter Rimensberger, Inez Frerichs, Brenda Morrow
OBJECTIVES: To determine the effect of prone positioning on ventilation distribution in children with acute respiratory distress syndrome. DESIGN: Prospective observational study. SETTING: Paediatric Intensive Care at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. PATIENTS: Mechanically ventilated children with acute respiratory distress syndrome. INTERVENTIONS: Electrical impedance tomography measures were taken in the supine position, after which the child was turned into the prone position, and subsequent electrical impedance tomography measurements were taken...
March 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28315043/the-intensive-care-medicine-clinical-research-agenda-in-paediatrics
#12
REVIEW
Mark J Peters, Andrew Argent, Marino Festa, Stéphane Leteurtre, Jefferson Piva, Ann Thompson, Douglas Willson, Pierre Tissières, Marisa Tucci, Jacques Lacroix
BACKGROUND: Intensive Care Medicine set us the task of outlining a global clinical research agenda for paediatric intensive care (PIC). In line with the clinical focus of this journal, we have limited this to research that may directly influence patient care. METHODS: Clinician researchers from PIC research networks of varying degrees of formality from around the world were invited to answer two main questions: (1) What have been the major recent advances in paediatric critical care research? (2) What are the top 10 studies for the next 10 years? RESULTS: (1) Inclusive databases are well established in many countries...
March 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28302205/-value-of-nutritional-risk-screening-in-evaluating-adverse-clinical-outcomes-in-children-with-severe-pneumonia
#13
Xiao-Hui Guo, Yan-Feng Sun, Jiang-Bo Wang, Shu-Zhen Han, Jing Miao, Min Cui
OBJECTIVE: To investigate the nutritional risk in children with severe pneumonia using the Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the association between nutritional risk and adverse clinical outcomes. METHODS: According to the STAMP score, 216 children with severe pneumonia were classified into high nutritional risk group (HR group; n=98), moderate nutritional risk group (MR group; n=65), and low nutritional risk group (LR group; n=53)...
March 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28298202/evaluation-of-sublingual-microcirculation-in-a-paediatric-intensive-care-unit-prospective-observational-study-about-its-feasibility-and-utility
#14
Rafael González, Jorge López, Javier Urbano, María José Solana, Sarah Nicole Fernández, María José Santiago, Jesús López-Herce
BACKGROUND: Evaluation of the microcirculation in critically ill patients is usually done by means of indirect parameters. The aim of our study was to evaluate the functional state of the microcirculation by direct visualization of sublingual microcirculation using Sidestream Dark Field Imaging, to determine the correlation between these findings and other parameters that are commonly used in the clinical practice and to assess the applicability of the systematic use of this technique in critically ill children...
March 15, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28296528/the-impact-of-early-hyperglycaemia-on-children-with-traumatic-brain-injury
#15
Yue-Qiang Fu, Shu-Ling Chong, Jan Hau Lee, Cheng-Jun Liu, Sheng Fu, Tsee Foong Loh, Kee Chong Ng, Feng Xu
OBJECTIVE: Hyperglycaemia is common amongst children with traumatic brain injury (TBI). We aim to investigate the association between early hyperglycaemia and poor clinical outcomes in children with moderate to severe TBI. METHODS: We performed a retrospective study in a tertiary paediatric hospital between May 2012 and October 2014 of all patients with TBI who were aged <16 years with a Glasgow Coma Scale (GCS) of ≤13. The primary outcome was death. Secondary outcomes were 14 ventilation-free, 14 paediatric intensive care unit (PICU)-free and 28 hospital-free days...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28288233/-dress-syndrome-in-paediatrics-clinical-case
#16
Marcos Silva-Feistner, Elena Ortiz, María Jesús Rojas-Lechuga, Daniel Muñoz
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, potentially life-threatening, drug-induced hypersensitivity reaction that includes skin eruption, haematological abnormalities, lymphadenopathy, and internal organ involvement. OBJECTIVE: Presenting a rare condition in children, to facilitate a rapid diagnostic suspicion and recognition by doctors. CASE REPORT: An 9 months old infant admitted due to a severe viral pneumonia, managed with non-invasive ventilation and ceftriaxone...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28287056/the-total-inotrope-exposure-score-an-extension-of-the-vasoactive-inotrope-score-as-a-predictor-of-adverse-outcomes-after-paediatric-cardiac-surgery
#17
Harish Bangalore, Michael Gaies, Elena C Ocampo, Jeffrey S Heinle, Danielle Guffey, Charles G Minard, Paul Checchia, Lara S Shekerdemian
OBJECTIVE: The aim of the present study was to explore and compare the association between a new vasoactive score - the Total Inotrope Exposure Score - and outcome and the established Vasoactive Inotrope Score in children undergoing cardiac surgery with cardiopulmonary bypass DESIGN: The present study was a single-centre, retrospective study. SETTING: The study was carried out at a 21-bed cardiovascular ICU in a Tertiary Children's Hospital between September, 2010 and May, 2011 METHODS: The Total Inotrope Exposure Score is a new vasoactive score that brings together cumulative vasoactive drug exposure and incorporates dose adjustments over time...
March 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28263341/risk-factors-for-mortality-in-asian-children-admitted-to-the-paediatric-intensive-care-unit-after-haematopoietic-stem-cell-transplantation
#18
Haripriya Santhanam, Jacqueline Sm Ong, Liang Shen, Poh Lin Tan, Pei Lin Koh
INTRODUCTION: This study aimed to investigate the risk factors associated with mortality in haematopoietic stem cell transplant (HSCT) patients admitted to our paediatric intensive care unit (PICU) over an 8-year period. MATERIALS AND METHODS: A retrospective chart review was conducted of all HSCT patients requiring PICU admission at our centre (a tertiary care university hospital in Singapore) from January 2002 to December 2010. Chief outcome measures were survival at the time of PICU discharge and survival at 6 months after initial PICU admission...
February 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28262914/prophylactic-levosimendan-for-the-prevention-of-low-cardiac-output-syndrome-and-mortality-in-paediatric-patients-undergoing-surgery-for-congenital-heart-disease
#19
REVIEW
Johanna Hummel, Gerta Rücker, Brigitte Stiller
BACKGROUND: Low cardiac output syndrome remains a serious complication, and accounts for substantial morbidity and mortality in the postoperative course of paediatric patients undergoing surgery for congenital heart disease. Standard prophylactic and therapeutic strategies for low cardiac output syndrome are based mainly on catecholamines, which are effective drugs, but have considerable side effects. Levosimendan, a calcium sensitiser, enhances the myocardial function by generating more energy-efficient myocardial contractility than achieved via adrenergic stimulation with catecholamines...
March 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28222699/suspicion-of-respiratory-tract-infection-with-multidrug-resistant-enterobacteriaceae-epidemiology-and-risk-factors-from-a-paediatric-intensive-care-unit
#20
Hanna Renk, Lenja Stoll, Felix Neunhoeffer, Florian Hölzl, Matthias Kumpf, Michael Hofbeck, Dominik Hartl
BACKGROUND: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. METHODS: A retrospective single-centre analysis of Enterobacteriaceae isolates from the lower respiratory tract of ventilated PICU patients from 2005 to 2014 was performed...
February 21, 2017: BMC Infectious Diseases
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