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Pediatric ventilation

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https://www.readbyqxmd.com/read/29162982/future-directions-and-molecular-basis-of-ventilator-associated-pneumonia
#1
REVIEW
Kubra Aykac, Yasemin Ozsurekci, Sevgen Tanir Basaranoglu
Mechanical ventilation is a lifesaving treatment and has complications such as ventilator associated pneumonia (VAP) that lead to high morbidity and mortality. Moreover VAP is the second most common hospital-acquired infection in pediatric intensive care units. Although it is still not well understood, understanding molecular pathogenesis is essential for preventing and treating pneumonia. A lot of microbes are detected as a causative agent of VAP. The most common isolated VAP pathogens in pediatric patients are Staphylococcus aureus, Pseudomonas aeruginosa, and other gram negative bacteria...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29158939/mediastinal-tracheostoma-for-treatment-of-tracheostenosis-after-tracheostomy-in-a-patient-with-mucopolysaccharidosis-induced-tracheomalacia
#2
Yasuhiro Chikaishi, Kenichi Kobayashi, Shuichi Shinohara, Akihiro Taira, Yusuke Nabe, Shinji Shinohara, Taiji Kuwata, Masaru Takenaka, Soichi Oka, Ayako Hirai, Kazue Yoneda, Koji Kuroda, Naoko Imanishi, Yoshinobu Ichiki, Fumihiro Tanaka
Background: Treatment of tracheostenosis after tracheostomy in pediatric patients is often difficult. Mucopolysaccharidosis is a lysosomal storage disease that may induce obstruction of the airways. Case Presentation: A 16-year-old male patient underwent long-term follow-up after postnatal diagnosis of type II mucopolysaccharidosis. At 11 years of age, tracheostomy was performed for mucopolysaccharidosis-induced laryngeal stenosis. One week prior to presentation, he was admitted to another hospital on an emergency basis for major dyspnea...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/29153297/pain-management-practice-and-guidelines-in-jordanian-pediatric-intensive-care-units
#3
Ahmad Ismail, Paula Forgeron, Viola Polomeno, Huda Gharaibeh, Denise Harrison
Limited knowledge exists of current pain management practices and supporting guidelines in Jordanian pediatric intensive care units. To determine the current pain management practices and the availability and content of practice guidelines in Jordanian pediatric intensive care units, we conducted a cross-sectional and multisite survey of four pediatric intensive care units in Jordan. A questionnaire was developed and orally administered over the phone or in person to head nurses or their nominees to capture pain management practices and the existence and content of guidelines...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29148150/pressure-flow-characteristics-of-breathing-systems-and-their-components-for-pediatric-and-adult-patients
#4
Christin Wenzel, Stefan Schumann, Johannes Spaeth
BACKGROUND: Breathing circuits connect the ventilator to the patients' respiratory system. Breathing tubes, connectors, and sensors contribute to artificial airway resistance to a varying extent. We hypothesized that the flow-dependent resistance is higher in pediatric breathing systems and their components compared to respective types for adults. AIMS: We aimed to characterize the resistance of representative breathing systems and their components used in pediatric patients (including devices for adults) by their nonlinear pressure-flow relationship...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29148123/donohue-syndrome-a-review-of-literature-case-series-and-anesthetic-considerations
#5
REVIEW
Alana Kirkwood, Grant Stuart, Louise Harding
BACKGROUND: Donohue syndrome is a rare autosomal recessive disorder of insulin resistance, causing a functional defect in insulin receptor function, and affecting the ability of the insulin to bind the receptor. Features include severe hyperinsulinism and fasting hypoglycemia, along with severe failure to thrive despite feeding. An accelerated fasting state results in muscle wasting, decreased subcutaneous fat, and an excess of thick skin. A reduced thoracic diameter is accentuated by increased abdominal distension, which impacts on respiratory reserve...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29144275/the-effect-of-level-of-care-on-gastroschisis-outcomes
#6
Jordan C Apfeld, Zachary J Kastenberg, Karl G Sylvester, Henry C Lee
OBJECTIVE: To examine the relationship between level of care in neonatal intensive care units (NICUs) and outcomes for newborns with gastroschisis. STUDY DESIGN: A retrospective cohort study was conducted at 130 California Perinatal Quality Care Collaborative NICUs from 2008 to 2014. All gastroschisis births were examined according to American Academy of Pediatrics NICU level of care at the birth hospital. Multivariate analyses examined odds of mortality, duration of mechanical ventilation, and duration of stay...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29141315/-clinical-efficacy-of-one-lung-ventilation-in-treatment-of-children-postoperatively-intractable-atelectasis
#7
J M Huo, K Bai, Y Q Fu, C J Liu, F Xu
Objective: To investigate the effect of fiberoptic bronchoscope-guided one-lung ventilation (OLV) on treatment of intractable atelectasis in children. Method: This retrospective cohort study was conducted in Pediatric Intensive Care Unit, Children's Hospital of Chongqing Medical University from December 2014 to May 2017. Six patients with intractable atelectasis of left lung were included. Three cases were male and three female with the age from 1.5 to 11.0 years. The endotracheal tube was intubated to the left main bronchus for OLV by the guidance of fiberoptic bronchoscopy...
November 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29140969/risk-factors-for-ventilator-associated-events-in-a-picu
#8
Raeley Guess, Jarin Vaewpanich, Jorge A Coss-Bu, Siriporn Phongjitsiri, Curtis Kennedy, Jeffrey Starke, Satid Thammasitboon
OBJECTIVE: The term ventilator-associated events includes ventilator-associated condition, infection-related ventilator-associated complication, and ventilator-associated pneumonia. We sought to identify potential new risk factors for ventilator-associated condition and infection-related ventilator-associated complication in the PICU population. DESIGN: Matched case control study. SETTING: Children's hospital at a tertiary care academic medical center...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29139100/-guidelines-for-non-invasive-and-invasive-home-mechanical-ventilation-for-treatment-of-chronic-respiratory-failure-update-2017
#9
W Windisch, M Dreher, J Geiseler, K Siemon, J Brambring, D Dellweg, B Grolle, S Hirschfeld, T Köhnlein, U Mellies, S Rosseau, B Schönhofer, B Schucher, A Schütz, H Sitter, S Stieglitz, J Storre, M Winterholler, P Young, S Walterspacher
Today, invasive and non-invasive home mechanical ventilation have become a well-established treatment option. Consequently, in 2010 the German Society of Pneumology and Mechanical Ventilation (DGP) has leadingly published the guidelines on "Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure". However, continuing technical evolutions, new scientific insights, and health care developments require an extensive revision of the guidelines.For this reason, the updated guidelines are now published...
November 2017: Pneumologie
https://www.readbyqxmd.com/read/29135805/failure-of-invasive-airway-placement-on-the-first-attempt-is-associated-with-progression-to-cardiac-arrest-in-pediatric-acute-respiratory-compromise
#10
Hannah R Stinson, Vijay Srinivasan, Alexis A Topjian, Robert M Sutton, Vinay M Nadkarni, Robert A Berg, Tia T Raymond
OBJECTIVES: The aim of this study was to describe the proportion of acute respiratory compromise events in hospitalized pediatric patients progressing to cardiopulmonary arrest, and the clinical factors associated with progression of acute respiratory compromise to cardiopulmonary arrest. We hypothesized that failure of invasive airway placement on the first attempt (defined as multiple attempts at tracheal intubation, and/or laryngeal mask airway placement, and/or the creation of a new tracheostomy or cricothyrotomy) is independently associated with progression of acute respiratory compromise to cardiopulmonary arrest...
November 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29132458/-efficacy-of-analgesic-and-sedative-treatments-in-children-with-mechanical-ventilation-in-the-pediatric-intensive-care-unit
#11
Xiao-Fang Cai, Fu-Rong Zhang, Long Zhang, Ji-Min Sun, Wen-Bin Li
OBJECTIVE: To compare the efficacy and safety of different analgesic and sedative treatments in children with mechanical ventilation in the pediatric intensive care unit (PICU). METHODS: Eighty children with mechanical ventilation in the PICU who needed analgesic and sedative treatments were equally and randomly divided into midazolam group and remifentanil+midazolam group. The sedative and analgesic effects were assessed using the Ramsay Scale and the Face, Legs, Activity, Cry and Consolability (FLACC) Scale...
November 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29129151/false-positive-diagnosis-of-brain-death-following-the-pediatric-guidelines-case-report-and-discussion
#12
D Alan Shewmon
A 2-year-old boy with severe head trauma was diagnosed brain dead according to the 2011 Pediatric Guidelines. Computed tomographic (CT) scan showed massive cerebral edema with herniation. Intracranial pressures were extremely high, with cerebral perfusion pressures around 0 for several hours. An apnea test was initially contraindicated; later, one had to be terminated due to oxygen desaturation when the Pco2 had risen to 57.9 mm Hg. An electroencephalogram (EEG) was probably isoelectric but formally interpreted as equivocal...
December 2017: Journal of Child Neurology
https://www.readbyqxmd.com/read/29124036/surgical-repair-of-a-traumatic-tracheobronchial-injury-in-a-pediatric-patient-assisted-with-venoarterial-extracorporeal-membrane-oxygenation
#13
Jee Won Suh, Hong Ju Shin, Chang Young Lee, Seung Hwan Song, Kyoung Sik Narm, Jin Gu Lee
Tracheobronchial rupture due to blunt chest trauma is a rare but life-threatening injury in the pediatric population. Computed tomography (CT) is not always reliable in the management of these patients. An additional concern is that ventilation may be disrupted during surgical repair of these injuries. This report presents the case of a 4 -year-old boy with an injury to the lower trachea and carina due to blunt force trauma that was missed on the initial CT scan. During surgery, he was administered venoarterial extracorporeal membrane oxygenation (ECMO)...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29119122/pediatric-inhalation-injury
#14
REVIEW
Soman Sen
Smoke inhalation injury can cause severe physiologic perturbations. In pediatric patients, these perturbations cause profound changes in cardiac and pulmonary physiology. In this review, we examine the pathology, early management options, ventilator strategy, and long-term outcomes in pediatric patients who have suffered a smoke inhalation injury.
2017: Burns and trauma
https://www.readbyqxmd.com/read/29119086/can-acute-phase-response-biomarkers-differentiate-infection-from-inflammation-postpediatric-cardiac-surgery
#15
Bana Agha Nasser, Abdu Rahman Mesned, Mohamad Tageldein, Mohamed S Kabbani, Nada Siddig Sayed
Background: Infection is a common serious complication postpediatric cardiac surgery. Diagnosis of infection after cardiopulmonary bypass (CPB) is difficult in the presence of surgical stress, hemodynamic instability, and inflammatory reaction. Aim: The purpose of this study is to investigate the value of available inflammatory biomarkers and its validity to differentiate infection from inflammation postpediatric cardiac surgery and to find the trend and the change in the level of these biomarkers shortly after cardiac surgery...
October 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/29114700/invasive-candidiasis-in-pediatric-patients-at-king-fahad-medical-city-in-central-saudi-arabia-a-5-year-retrospective-study
#16
Zainab Almooosa, Gasmelseed Y Ahmed, Abeer Omran, Ayah AlSarheed, Afnan Alturki, Abdulaziz Alaqeel, Mohammed Alshehri, Tariq Alfawaz, Dayel AlShahrani
To identify predisposing factors, species distribution, antifungal susceptibility, and outcome. Methods: This study is a retrospective chart review that was conducted at a children's hospital at King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. One hundred twenty-nine children with invasive candidiasis who were admitted between January 2010 and January 2015. Results: The statistical analysis results have revealed a group of risk factors; prematurity in 37 (28.7%) of patients, low birth weight in 42 (32...
November 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#17
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29113557/correlation-of-lactic-acid-and-base-deficit-values-obtained-from-arterial-and-peripheral-venous-samples-in-a-pediatric-population-during-intraoperative-care
#18
Brianne M Bordes, Hina Walia, Roby Sebastian, David Martin, Dmitry Tumin, Joseph D Tobias
Lactic acid and base deficit (BD) values are frequently monitored in the intensive care unit and operating room setting to evaluate oxygenation, ventilation, cardiac output, and peripheral perfusion. Although generally obtained from an arterial cannula, such access may not always be available. The current study prospectively investigates the correlation of arterial and peripheral venous values of BD and lactic acid. The study cohort included 48 patients. Arterial BD values ranged from -8 to 4 mEq/L and peripheral venous BD values ranged from -8 to 4 mEq/L...
December 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29113508/outcomes-of-children-with-critical-bronchiolitis-living-in-poor-communities
#19
Katherine N Slain, Steven L Shein, Anne G Stormorken, Meredith C G Broberg, Alexandre T Rotta
There are established associations between adverse health outcomes and poverty, but little is known regarding these associations in critically ill children. We hypothesized that living in poorer communities would be associated with unfavorable outcomes in children with critical bronchiolitis. This retrospective study included children with bronchiolitis admitted to a pediatric intensive care unit (PICU) over a 2-year period. Median household income was estimated from patient ZIP codes and 2014 US Census Bureau data...
November 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29112540/aeromedical-transport-in-children-a-descriptive-analysis-of-96-cases
#20
Guillaume Mortamet, Karen Harrington, Hervé Raffin, Mehdi Oualha, Sylvain Renolleau
OBJECTIVE: Pediatric aeromedical transport (AT) is highly challenging. We aim to describe a series of 96 cases of children requiring medical transport in terms of the indication, modalities, and related adverse events. METHODS: In this single-center retrospective study, we included air-transported patients less than 18 years old. RESULTS: During the study period, 96 patients, with median age of 120 months (range, 0-204), were air transported...
November 6, 2017: Pediatric Emergency Care
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