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pediatric intensive care unit

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https://www.readbyqxmd.com/read/28807643/-use-of-subcutaneous-route-for-comfort-care%C3%A2-in-neonatal-palliative-population-systematic-review-and-survey-of-practices-in-france
#1
N Pouvreau, J Tandonnet, O Tandonnet, L Renesme
INTRODUCTION: Subcutaneous hydration (hypodermoclysis) and drug administration is a widely used method of analgesic therapy in adult palliative care medicine. Very little is known about its use in neonatal medicine. Evidence-based guidelines do not exist due to a lack of data. In this study, the advantages of subcutaneous analgesic therapy in terms of comfort in neonatal palliative care situations were investigated. METHODS: This report details the results of a systematic review associated with a survey in neonatal intensive care units (NICUs) and pediatric palliative care departments (PPCTs) in France...
August 11, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28806579/access-to-emergency-care-services-a-transversal-ecological-study-about-brazilian-emergency-health-care-network
#2
T A H Rocha, N C da Silva, P V Amaral, A C Q Barbosa, J V M Rocha, V Alvares, D G de Almeida, E Thumé, E B A F Thomaz, R C de Sousa Queiroz, M R de Souza, A Lein, N Toomey, C A Staton, J R N Vissoci, L A Facchini
OBJECTIVES: Studies of health geography are important in the planning and allocation of emergency health services. The geographical distribution of health facilities is an important factor in timely and quality access to emergency services; therefore, the present study analyzed the emergency health care network in Brazil, focusing the analysis at the roles of small hospitals (SHs). STUDY DESIGN: Cross-sectional ecological study. METHODS: Data were collected from 9429 hospitals of which 3524 were SHs and 5905 were high-complexity centers (HCCs)...
August 11, 2017: Public Health
https://www.readbyqxmd.com/read/28803574/retrospective-evaluation-of-the-big-score-to-predict-mortality-in-pediatric-blunt-trauma
#3
Charlotte Grandjean-Blanchet, Guillaume Emeriaud, Marianne Beaudin, Jocelyn Gravel
OBJECTIVES: This study's objective was to measure the criterion validity of the BIG score (a new pediatric trauma score composed of the initial base deficit [BD], international normalized ratio [INR], and Glasgow Coma Scale [GCS]) to predict in-hospital mortality among children admitted to the emergency department with blunt trauma requiring an admission to the intensive care unit, knowing that a score <16 identifies children with a high probability of survival. METHODS: This was a retrospective cohort study performed in a single tertiary care pediatric hospital between 2008 and 2016...
August 14, 2017: CJEM
https://www.readbyqxmd.com/read/28797189/impact-of-pediatric-intensive-care-unit-admission-on-family-financial-status-and-productivity-a-pilot-study
#4
Maureen E Clark, Brian M Cummings, Karen Kuhlthau, Natalie Frassica, Natan Noviski
OBJECTIVE: A child's pediatric intensive care unit (PICU) admission may have wide-ranging family implications. We assessed nonmedical out-of-pocket expenses (NMOOPEs) and disruptions in work and normal life for parents with a child admitted to the PICU for at least 2 days with acute, new onset, or exacerbation of a critical condition. DESIGN: We conducted a prospective, single-center study; administered a daily verbal response survey on NMOOPEs; stratified families by annual income (<$50 999, $51-99 000, >$100 000); and calculated daily expenditures (DEs), estimated daily budgets (DBs), and percentage of NMOOPEs (%DE/DB)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28794838/relationship-between-dexmedetomidine-dose-and-plasma-dexmedetomidine-concentration-in-critically-ill-infants-a-prospective-observational-cohort-study
#5
Yoshihito Fujita, Koichi Inoue, Tasuku Sakamoto, Saya Yoshizawa, Maiko Tomita, Toshimasa Toyo'oka, Kazuya Sobue
BACKGROUND: Dexmedetomidine is a highly selective central α2-agonist used as a sedative in pediatric intensive care unit (PICU). However, little is known about the relationship between dexmedetomidine dose and its plasma concentration during long-term infusion. We have previously demonstrated that the sedative plasma dexmedetomidine concentration is moderately correlated with the administered dose in adults (r = 0.653, P = 0.001). We hypothesized that there would be a similar relationship between the sedative dexmedetomidine concentration and administered dose in infants...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28793780/iatrogenic-opioid-withdrawal-in-critically-ill-patients-a-review-of-assessment-tools-and-management
#6
Ada W Chiu, Sofia Contreras, Sangeeta Mehta, Jennifer Korman, Marc M Perreault, David R Williamson, Lisa D Burry
OBJECTIVE: To (1) provide an overview of the epidemiology, clinical presentation, and risk factors of iatrogenic opioid withdrawal in critically ill patients and (2) conduct a literature review of assessment and management of iatrogenic opioid withdrawal in critically ill patients. DATA SOURCES: We searched MEDLINE (1946-June 2017), EMBASE (1974-June 2017), and CINAHL (1982-June 2017) with the terms opioid withdrawal, opioid, opiate, critical care, critically ill, assessment tool, scale, taper, weaning, and management...
August 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28793199/impact-of-obesity-on-outcomes-in-critically-ill-children
#7
Esther T Davis, Li Xie, Yosef Levenbrown
PURPOSE: To examine whether obesity confers a protective effect on critically ill pediatric patients, similar to what has been reported in critically ill adults. METHODS: A retrospective cohort study including patients aged 2-18 years admitted to a 24-bed pediatric intensive care unit from 2009 to 2014. Patients were divided into 1 of 3 weight categories: normal weight (body mass index [BMI], 5%-84.9%), overweight (BMI, 85%-94.9%), and obese (BMI ≥95%). Outcomes investigated included mortality, need for intubation, need for inotropic support, and duration of mechanical ventilation...
August 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28792509/regional-citrate-anticoagulation-for-continuous-renal-replacement-therapy-in-pediatric-patients-with-liver-failure
#8
Keila Rodriguez, Poyyapakkam R Srivaths, Leyat Tal, Mary N Watson, Alyssa A Riley, Ryan W Himes, Moreshwar S Desai, Michael C Braun, Ayse Akcan Arikan
Pediatric liver failure patients frequently develop multiple organ failure and require continuous renal replacement therapy (CRRT) as part of supportive therapy in the pediatric intensive care unit. While many centers employ no anticoagulation for fear of bleeding complications, balanced coagulation disturbance predisposes these patients to clotting as well as bleeding, making maintenance of longer circuit life to deliver adequate dialysis clearance challenging. Regional citrate anticoagulation (RCA) is an attractive option as it avoids systemic anticoagulation, but since citrate metabolism is impaired in liver failure, concerns about toxicity has limited its use...
2017: PloS One
https://www.readbyqxmd.com/read/28792355/factors-related-to-parent-attendance-at-a-follow-up-meeting-with-an-intensivist-after-a-child-s-death-in-the-pediatric-intensive-care-unit
#9
Markita L Suttle, Cynthia A Gerhardt, Marci Z Fults
Parents who experience the death of a child are at high risk for psychopathology. Because a large percentage of pediatric deaths occur in the pediatric intensive care unit each year, a follow-up meeting between bereaved parents and intensivists could provide essential emotional support, although some parents may not attend. The aim of this study was to explore demographic and medical factors that may distinguish between bereaved parents who attend a follow-up meeting with their child's pediatric intensivist and those who do not...
January 1, 2017: Omega
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#10
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28779880/investigation-of-a-nosocomial-outbreak-of%C3%A2-fungemia-caused-by-candida-pelliculosa-pichia-anomala-in-a-korean-tertiary-care-center
#11
Jiwon Jung, Young Sook Moon, Jung A Yoo, Ji-Hun Lim, Joseph Jeong, Jae-Bum Jun
BACKGROUND: Candida pelliculosa is a rare pathogen of fungemia. There have been a few nosocomial outbreaks of C. pelliculosa fungemia in nurseries and pediatric intensive care units (ICU), hematologic units, and surgical ICU. We describe an epidemiologic outbreak investigation, including case findings of C. pelliculosa fungemia in South Korea. METHODS: This outbreak investigation conducted in a 940-bed, tertiary referral center, Ulsan, South Korea and included active microbial surveillance and a case-control study...
June 28, 2017: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
https://www.readbyqxmd.com/read/28774507/clinical-factors-associated-with-in-hospital-death-in-pediatric-surgical-patients-admitted-to-the-neonatal-intensive-care-unit-a-15-year-single-tertiary-center-experience
#12
Kohei Otake, Keiichi Uchida, Michiko Kubo, Akira Yamamoto, Yuka Nagano, Ryo Uratani, Kiyoshi Hashimoto, Kohei Matsushita, Mikihiro Inoue, Hirofumi Sawada, Masato Kusunoki
BACKGROUND/PURPOSE: The purpose of this study was to explore clinical characteristics and primary surgical diagnoses associated with in-hospital death in pediatric surgical patients admitted to the neonatal intensive care unit (NICU) of a tertiary hospital. METHODS: This retrospective study includes all patients admitted to our NICU for pediatric surgical diseases between January 2001 and December 2015. Univariate and multivariate binary logistic regression were performed to assess independent factors associated with in-hospital death...
July 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28774273/thrombotic-microangiopathy-associated-with-valproic-acid-toxicity
#13
Sean A Hebert, Timothy P Bohan, Christian L Erikson, Rita D Swinford
BACKGROUND: Thrombotic microangiopathy (TMA) is a serious, sometimes life-threatening disorder marked by the presence of endothelial injury and microvascular thrombi. Drug-induced thrombotic microangiopathy (DI-TMA) is one specific TMA syndrome that occurs following drug exposure via drug-dependent antibodies or direct tissue toxicity. Common examples include calcineurin inhibitors Tacrolimus and Cyclosporine and antineoplastics Gemcitabine and Mitomycin. Valproic acid has not been implicated in DI-TMA...
August 3, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28771554/increased-serum-thrombomodulin-level-is-associated-with-disease-severity-and-mortality-in-pediatric-sepsis
#14
Jainn-Jim Lin, Hsiang-Ju Hsiao, Oi-Wa Chan, Yu Wang, Shao-Hsuan Hsia, Cheng-Hsun Chiu
BACKGROUND: Endothelial dysfunction plays an important role in the pathophysiology of sepsis. As previously reported, the serum thrombomodulin is elevated in diseases associated with endothelial injury. OBJECTIVE: The aim of this study was to investigate the association of serum thrombomodulin level in different pediatric sepsis syndromes and evaluate the relationship with disease severity and mortality. METHODS: We prospectively collected cases of sepsis treated in a pediatric intensive care unit from June 2012 to July 2015 at Chang Gung Children's Hospital in Taoyuan, Taiwan...
2017: PloS One
https://www.readbyqxmd.com/read/28767913/spontaneous-breathing-test-in-the-prediction-of-extubation-failure-in-the-pediatric-population
#15
Milena Siciliano Nascimento, Celso Moura Rebello, Luciana Assis Pires Andrade Vale, Érica Santos, Cristiane do Prado
Objective: To assess whether the spontaneous breathing test can predict the extubation failure in pediatric population. Methods: A prospective and observational study that evaluated data of inpatients at the Pediatric Intensive Care Unit between May 2011 and August 2013, receiving mechanical ventilation for at least 24 hours followed by extubation. The patients were classified in two groups: Test Group, with patients extubated after spontaneous breathing test, and Control Group, with patients extubated without spontaneous breathing test...
April 2017: Einstein
https://www.readbyqxmd.com/read/28765996/non-central-peripherally-inserted-central-catheters-in-neonatal-intensive-care-complication-rates-and-longevity-of-catheters-relative-to-tip-position
#16
Bernard Goldwasser, Catalina Baia, Mimi Kim, Benjamin H Taragin, Robert M Angert
BACKGROUND: Peripherally inserted central catheters (PICCs) represent a mainstay of intravascular access in the neonatal intensive care setting when long-term vascular access is needed. Ideally, PICCs should be inserted and maintained in a central position with the tip ending in the superior or inferior vena cava. This is not always achievable, and sometimes the tip remains in a peripheral location. Higher complication rates have been reported with non-central PICCs; however these findings have not been confirmed in a solely neonatal series and PICCs with tips in peripheral veins have not been studied...
August 1, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28765741/experience-with-mechanical-circulatory-support-for-medically-intractable-low-cardiac-output-in-a-pediatric-intensive-care-unit
#17
Jung Bin Park, Jae Gun Kwak, Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#18
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28761640/predictive-and-diagnostic-value-of-serum-intestinal-fatty-acid-binding-protein-in-neonatal-necrotizing-enterocolitis-case-series
#19
Omima M Abdel-Haie, Eman G Behiry, Eman R Abd Almonaem, Enas S Ahmad, Effat H Assar
OBJECTIVES: In this study, we aimed to investigate the value of serum intestinal fatty acid binding protein (I-FABP) in early diagnosis and predicting the severity of Necrotizing enterocolitis (NEC). METHODS: This prospective study was performed on 160 preterm neonates ageing less than 35 weeks and weighting less than 2000 gm selected from the Neonatal Intensive Care Units (NICUs) of the Pediatric Department at Benha University hospital and Benha children hospital to evaluate which of them will develop NEC, after follow-up these neonates were divided into two groups: Group one compromised eighteen preterm neonates with symptoms and signs of NEC...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28760170/evaluation-of-cardiac-autonomic-function-using-heart-rate-variability-in-children-with-acute-carbon-monoxide-poisoning
#20
Cagdas Vural, Ener Cagri Dinleyici, Pelin Kosger, Ozge Bolluk, Zubeyir Kilic, Birsen Ucar
Introduction Carbon monoxide poisoning may cause myocardial toxicity and cardiac autonomic dysfunction, which may contribute to the development of life-threatening arrhythmias. We investigated the potential association between acute carbon monoxide exposure and cardiac autonomic function measured by heart rate variability. METHOD: The present study included 40 children aged 1-17 years who were admitted to the Pediatric Intensive Care Unit with acute carbon monoxide poisoning and 40 healthy age- and sex-matched controls...
August 1, 2017: Cardiology in the Young
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