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paediatric ventilation

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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
#1
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
https://www.readbyqxmd.com/read/28208972/ventilator-associated-pneumonia-in-paediatric-intensive-care-unit
#2
Anirban Mandal, Amitabh Singh, Puneet Kaur Sahi, Bhavika Rishi
No abstract text is available yet for this article.
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28196820/combined-use-of-neurally-adjusted-ventilatory-assist-nava-and-vertical-expandable-prostethic-titanium-rib-veptr-in-a-patient-with-spondylocostal-dysostosis-and-associated-bronchomalacia
#3
Martí Pons-Odena, Alba Verges, Natalia Arza, Francisco José Cambra
Jarcho-Levin syndrome is a rare disorder characterised by defects in vertebral and costal segmentation of varying severity. Respiratory complications are the main cause of death or severe comorbidity due to a restrictive rib cage. A 3 months old infant with Spondylocostal dysostosis and associated bronchomalacia experiencing severe asynchrony during the weaning process is reported. The Neurally Adjusted Ventilatory Assist (NAVA) mode was used to improve adaptation to mechanical ventilation after Vertical Expandable Prosthetic Titanium Ribs (VEPTRs) were implanted...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28157809/withdrawal-assessment-tool-1-monitoring-in-picu-a-multicenter-study-on-iatrogenic-withdrawal-syndrome
#4
Angela Amigoni, Maria Cristina Mondardini, Ilaria Vittadello, Federico Zaglia, Emanuele Rossetti, Francesca Vitale, Stefania Ferrario, Fabio Savron, Giancarlo Coffaro, Luca Brugnaro, Roberta Amato, Andrea Wolfler, Linda S Franck
OBJECTIVES: Withdrawal syndrome is an adverse reaction of analgesic and sedative therapy, with a reported occurrence rate between 17% and 57% in critically ill children. Although some factors related to the development of withdrawal syndrome have been identified, there is weak evidence for the effectiveness of preventive and therapeutic strategies. The main aim of this study was to evaluate the frequency of withdrawal syndrome in Italian PICUs, using a validated instrument. We also analyzed differences in patient characteristics, analgesic and sedative treatment, and patients' outcome between patients with and without withdrawal syndrome...
February 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28153465/-prevention-and-treatment-of-skin-lesions-associated-with-non-invasive-mechanical-ventilation-recommendations-of-experts
#5
M Raurell-Torredà, A Romero-Collado, M Rodríguez-Palma, M Farrés-Tarafa, J D Martí, B Hurtado-Pardos, L Peñarrubia-San Florencio, P Saez-Paredes, A M Esquinas
INTRODUCTION: In the last two decades, non-invasive mechanical ventilation (NIV) has been consolidated as an initial strategy for the management of respiratory failure in critical adult and paediatric patients. OBJECTIVES: To identify risk factors and preventive strategies to reduce the incidence of skin lesions associated with clinical devices (LESADIC) related to NIV, as well as the most effective treatment for injuries that cannot be avoided. METHODOLOGY: Review in the MEDLINE, CINAHL and Cochrane databases of studies published in the last 10years to reach consensus through an expert panel...
January 30, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28135759/regional-paediatric-palliative-care-model-improves-the-quality-of-life-of-children-on-long-term-ventilation-at-home
#6
F Rusalen, C Agosto, L Brugnaro, F Benini
In the last 20 years, the prevalence of children on domiciliary long-term ventilation (LTV) has increased in many countries and in Italy it is now 4.3/100,000 (1). The complex management of these patients' conditions requires highly specialised expertise that is provided by integrated multi-disciplinary teams and calls for solutions from a number of institutional agencies (2). The global care offered to these patients by paediatric palliative care (PPC) also embraces their social needs (3-4). This article is protected by copyright...
January 30, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28110616/oncotic-pressure-and-paediatric-cardiopulmonary-bypass-establishing-baseline-data-for-complex-congenital-cardiac-surgery-and-its-relation-to-risk-stratification
#7
Richard Crook, Richard Issitt
OBJECTIVES: Colloid osmotic pressure (COP) is a major determinant of fluid shift in paediatric patients undergoing corrective surgery for congenital heart disease (CHD) using cardiopulmonary bypass (CPB). However, very few baseline data are available for those patients requiring surgery within the first few weeks and months of life. Our aim was to determine if our CHD population exhibited COP similar to that of other extremely ill subsets of patients and, if so, whether this related to risk stratification model scores...
January 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#8
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28058755/characteristics-of-bordetella-pertussis-infection-among-infantsand-children-admitted-to-paediatric-intensive-care-units-in-greece-a-multicentre-11-year-study
#9
Maria S Kazantzi, Anargyroula Prezerakou, Serafeia N Kalamitsou, Stavroula Ilia, Panagiotis K Kalabalikis, John Papadatos, Maria M Sdougka, George Briassoulis, Maria N Tsolia
AIM: To describe children with pertussis who required intensive care. METHODS: This is a retrospective analysis of pertussis admissions to all (six) national intensive care units in Greece from 2003 to 2013. RESULTS: A total of 31 children were included, 28 of whom were younger than 12 months old. Cough was the most prominent symptom, being present in 27 of 31 (87%) patients, and on admission, only 7 (22.6%) satisfied the case definition...
January 6, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28058141/ultrasonographic-measurement-of-subglottic-diameter-for-paediatric-cuffed-endotracheal-tube-size-selection-feasibility-report
#10
Demet Altun, Mukadder Orhan Sungur, Achmet Ali, Emre Sertaç Bingül, Tülay Özkan Seyhan, Emre Çamcı
OBJECTIVE: The aim of this feasibility study was to investigate the first attempt success of ultrasonography (USG) in paediatric patients in predicting an appropriate cuffed endotracheal tube (ETT) size. METHODS: Fifty children who were 1-10 years of age and who received general anaesthesia with endotracheal intubation for adenoidectomy or adenotonsillectomy were enrolled in the study. In all participants, the transverse diameter of the subglottic airway was measured with USG at the cricoid level without ventilation...
December 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28040749/lung-ultrasound-profile-after-cardiopulmonary-bypass-in-paediatric-cardiac-surgery-first-experience-in-a-simple-cohort%C3%A2
#11
Vincenzo Vitale, Zaccaria Ricci, Serena Gaddi, Giuseppina Testa, Paolo Toma, Paola Cogo
OBJECTIVES: To explore the association between lung ultrasound (LUS) and clinical variables in children undergoing cardiopulmonary bypass (CPB). METHODS: A retrospective analysis was conducted in patients weighing <20 kg and with an Aristotle score <9, scanned with LUS on postoperative day (POD) 0, 1 and 2. We defined three LUS profiles: profile A: the prevalence of confluent B lines ("white lung"); profile B: the prevalence of B lines and profile C: the prevalence of A lines (normal lung)...
December 31, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28029591/cardiorespiratory-interactions-in-paediatrics-it-s-almost-always-the-circulation-stupid
#12
REVIEW
M L Rigby, M Rosenthal
The interaction of the heart and lungs is probably the most important aspect of life and survival. Fortunately, it is not difficult to understand the fundamentals. The purpose of the lungs and their ventilation is to present oxygen to the circulation via the alveoli and to receive carbon dioxide from the circulation and then expel it. The relations of the heart and lungs and the matching of blood flow to the various organs with ventilation and lung perfusion may be disrupted by a variety of congenital or acquired heart malformations...
August 12, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27986977/risk-factors-for-postoperative-mortality-in-congenital-diaphragmatic-hernia-a-single-centre-observational-study
#13
Darya Kadir, Helene Engstrand Lilja
BACKGROUND: The management of congenital diaphragmatic hernia (CDH) is a major challenge. The mortality is dependent on associated malformations, the severity of pulmonary hypoplasia, pulmonary hypertension and iatrogenic lung injury associated with aggressive mechanical ventilation. The aims of the study were to investigate the mortality over time in a single paediatric surgical centre, to compare the results with recent reports and to define the risk factors for mortality. METHODS: The medical records of infants with CDH from two time periods: 1995-2005 and 2006-2016 were reviewed...
December 16, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27890335/device-associated-infections-in-a-paediatric-intensive-care-unit-in-pakistan
#14
A Haque, S A Ahmed, Z Rafique, Q Abbas, H Jurair, S A Ali
This study assessed the effect of implementation of active infection control and surveillance on the occurrence of device-associated infections (DAIs) in a paediatric intensive care unit (PICU) from 2012 to 2015. There were 1378 patients, equating to 4632 patient-days, on the PICU, and 29 DAI episodes, giving an incidence rate of 2.1% and an incidence density rate of 6.26 per 1000 patient-days. The rates of central-line-associated bloodstream infections, ventilator-associated pneumonia and catheter-related urinary tract infections were 7/1000 central-line-days, 1...
January 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27869053/incidence-risk-factors-and-outcomes-of-acute-kidney-injury-in-adults-undergoing-surgery-for-congenital-heart-disease
#15
David M Kwiatkowski, Elizabeth Price, David M Axelrod, Anitra W Romfh, Brian S Han, Scott M Sutherland, Catherine D Krawczeski
BACKGROUND: Acute kidney injury after cardiac surgery is a frequent and serious complication among children with congenital heart disease (CHD) and adults with acquired heart disease; however, the significance of kidney injury in adults after congenital heart surgery is unknown. The primary objective of this study was to determine the incidence of acute kidney injury after surgery for adult CHD. Secondary objectives included determination of risk factors and associations with clinical outcomes...
November 21, 2016: Cardiology in the Young
https://www.readbyqxmd.com/read/27836871/patient-safety-events-in-out-of-hospital-paediatric-airway-management-a-medical-record-review-by-the-csi-ems
#16
Matthew Hansen, Garth Meckler, William Lambert, Caitlin Dickinson, Kathryn Dickinson, Joshua Van Otterloo, Jeanne-Marie Guise
OBJECTIVE: To describe the frequency and characterise the nature of patient safety events in paediatric out-of-hospital airway management. METHODS: We conducted a retrospective cross-sectional medical record review of all 'lights and sirens' emergency medicine services transports from 2008 to 2011 in patients <18 years of age in the Portland Oregon metropolitan area. A chart review tool (see online supplementary appendix) was adapted from landmark patient safety studies and revised after pilot testing...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27830927/observational-clinical-study-on-organ-dysfunction-associated-with-dosing-of-antibiotics-in-a-paediatric-intensive-care-unit
#17
Sascha Tafelski, Alexander Gratopp, Florian Richter, Sylvia Kramer, Claudia Spies, Klaus D Wernecke, Irit Nachtigall
BACKGROUND: Medication errors are of concern especially in paediatric patients. This study investigates impact of dosing errors of antibiotics on outcome in critically ill paediatric patients. METHODS: Retrospective study including all consecutive patients admitted to one university paediatric intensive care unit (PICU) in 2010 with length of PICU stay >24hrs, age <18 years and antibiotic therapy. Antibiotic dosages were evaluated for compliance with recommended dosing individually adapted for bodyweight, age and organ function...
November 10, 2016: Minerva Pediatrica
https://www.readbyqxmd.com/read/27790437/ventilator-associated-pneumonia-in-an-infant-caused-by-stenotrophomonas-maltophila-a-case-report
#18
Neelima Angaali, Nina Dutta Roy, Sudharshan Raj Chitgupikar, Preeti Subramanian, Jaya Lakshmi Pabbati
Stenotrophomonas maltophila (S.maltophila) is an aerobic Gram-negative bacillus that is a frequent colonizer of fluids used in the hospital setting. The organism is known to cause life threatening infections in immuno-compromised patients especially in those who are neutropenic, on chemotherapy or on broad spectrum antibiotics. We report a case of ventilator associated pneumonia caused by Stenotrophomonas maltophila in a two-month old infant who later developed multi organ dysfunction syndrome. In seriously ill paediatric patients, S...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27761035/a-randomised-trial-to-compare-i-gel-and-proseal%C3%A2-laryngeal-mask-airway-for-airway-management-in-paediatric-patients
#19
R Nirupa, Satinder Gombar, Vanita Ahuja, Preeti Sharma
BACKGROUND AND AIMS: i-gel™ is a newer supraglottic airway device with a unique non-inflatable cuff. We aimed to compare i-gel™ with ProSeal™ laryngeal mask airway (PLMA™) in children scheduled for surgery under general anaesthesia (GA) with controlled ventilation. METHODS: This prospective, randomised controlled study was conducted in 100 surgical patients, aged 2-6 years of American Society of Anesthesiologists Physical Status I-II scheduled under GA. Patients were randomly allocated to receive either size 2 i-gel™ or PLMA™ as an airway device...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27749233/clinical-course-and-outcomes-of-childhood-onset-granulomatosis-with-polyangiitis
#20
Karen E James, Rui Xiao, Peter A Merkel, Pamela F Weiss
OBJECTIVES: To characterise the clinical course and outcomes of a cohort of children with granulomatosis with polyangiitis (GPA). METHODS: Retrospective cohort study of children diagnosed with GPA in a tertiary care facility from 2000-2014. All subjects met the American College of Rheumatology 1990 criteria for GPA or the 2008 European League against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society criteria for GPA...
October 6, 2016: Clinical and Experimental Rheumatology
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