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https://www.readbyqxmd.com/read/28639999/the-neutrophil-to-lymphocyte-ratio-in-bordetella-pertussis-infection
#1
Anusha Ganeshalingham, Justin Wilde, Brian J Anderson
Twin infants with pertussis demonstrated contrasting differential white cell counts and clinical course. A change towards increased neutrophil production, which is associated with increased mortality, may be more easily recognized by serial documentation of the neutrophil-to-lymphocyte ratio. A ratio that is greater than one may indicate evolving life-threatening pertussis allowing early transfer to a pediatric intensive care unit.
June 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28639944/clinical-impact-and-efficacy-of-bedside-echocardiography-on-patient-management-in-pediatric-intensive-care-units-picus-a-prospective-study
#2
Sanliay Şahin, Mutlu Uysal Yazıcı, Ganime Ayar, Tülin Köksal, İbrahim İlker Çetin, Filiz Ekici, Abdullah Kocabaş
OBJECTIVE: To determine the indication and necessity of echocardiographic assessment and therapeutic interventions in critically ill children. METHODS: A total of 140 children, including 75 mechanically ventilated (MV) and 65 spontaneously breathing (SB) children, who were admitted consecutively from March to August 2013 were evaluated prospectively. Data regarding the indication for echocardiography and therapeutic approaches used were documented. For evaluating disease severity, the Pediatric Risk of Mortality Score III (PRISM) was ascertained...
June 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28638278/lifespan-and-associated-factors-of-peripheral-intravenous-cannula-among-infants-admitted-in-public-hospitals-of-mekelle-city-tigray-ethiopia-2016
#3
Eskedar Birhane, Kalayou Kidanu, Mekuria Kassa, Dawit Gerezgiher, Lidia Tsegay, Brhanu Weldu, Genet Kidane, Hadgu Gerensea
BACKGROUND: Peripheral Intravenous cannula (IV) is the most common vascular access device used to administer medications with the exception of medication or fluid with high or low PH or hyperosmolarity which may cause severe damage to small veins. The insertion of a peripheral intravenous cannula in newborn infants can be difficult. Appropriate veins with sufficient capacity to insert a cannula become less available throughout the hospital stay. Once a peripheral intravenous cannula is inserted, it is desirable that its patency can be maintained as long as possible...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28638248/evaluation-of-microorganisms-causing-ventilator-associated-pneumonia-in-a-pediatric-intensive-care-unit
#4
Ayse Betul Ergul, Serife Cetin, Yasemin Ay Altintop, Sefika Elmas Bozdemir, Alper Ozcan, Umit Altug, Hasan Samsa, Yasemin Altuner Torun
OBJECTIVE: The aim of this study was to identify microorganisms causing ventilator-associated pneumonia (VAP) and also study the antibiotic resistance/susceptibility. MATERIALS AND METHODS: We retrospectively assessed microorganisms isolated from patients diagnosed with VAP in a pediatric intensive care unit between January 1, 2014, and June 30, 2016. RESULTS: We included 44 patients diagnosed with VAP. The prevalence thereof was 8.6 patients per 1,000 ventilator days...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28637571/workforce-issues-in-pediatric-surgery
#5
Don K Nakayama
High salaries indicate a demand for pediatric surgeons in excess of the supply, despite only a slight growth in the pediatric-age population and a sharp increase in numbers of trainees. Top-level neonatal intensive care units require 24-hour-7-day pediatric surgical availability, so hospitals are willing to pay surgeons a premium and engage high-priced locum tenens surgeons to fill vacancies in coverage. With increased supply comes an erosion of the numbers of cases performed by trainees and surgeons in practice...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#6
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28625557/-more-than-3-hours-and-less-than-3-years-safety-of-anaesthetic-procedures-in-infants-less-than-3-years-old-subected-to-surgery-for-more-the-3-hours
#7
Julián Álvarez Escudero, Rosa María Paredes Esteban, Francisco José Cambra Lasaosa, Máximo Vento, Maite López Gil, Juan Carlos de Agustín Asencio, María Teresa Moral Pumarega
An FDA alert in December 2016 on the safety of general anesthesia and sedations in patients less than 3 years of age and pregnant women has raised doubts in relation to the attitude that professionals implicated in these procedures should adopt in relation to these specific group of patients. Confronted with this situation, the following medical scientific societies: Sociedad Española de Anestesia y Reanimación (SEDAR), Sociedad Española de Cirugía Pediátrica (SECP), Sociedad Española de Cuidados Intensivos Pediátricos (SECIP) y Sociedad Española de Neonatología (SENeo), have established a working group to analyze and clarify the safety of these techniques...
June 15, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28625245/-effects-of-different-sedation-regimens-on-sedation-and-inflammatory-response-in-critically-ill-children-with-multiple-trauma
#8
Wenjia Tong, Conglei Song, Danqun Jin, Jingmin Sun, Yating Wang, Daliang Xu
OBJECTIVE: To compare the sedation and anti-inflammatory effects of dexmedetomidine and midazolam on critical ill children with multiple trauma. METHODS: A prospective randomized controlled trial was conducted. Sixty-five critical ill children with multiple trauma admitted to pediatric intensive care unit (PICU) of Anhui Province Children's Hospital from January 2014 to September 2016 were enrolled, who were randomly divided into dexmedetomidine group (33 cases) and midazolam group (32 cases)...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28622279/hydrogen-sulphide-in-exhaled-gases-from-ventilated-septic-neonates-and-children-a-preliminary-report
#9
Natalie Bee, Ruth White, Andy J Petros
OBJECTIVES: There is increasing interest in hydrogen sulphide as a marker of pathologic conditions or predictors of outcome. We speculate that as hydrogen sulphide is a diffusible molecule, if there is an increase in plasma hydrogen sulphide in sepsis, it may accumulate in the alveolar space and be detected in exhaled gas. "We wished to determine whether we could detect hydrogen sulphide in exhaled gases of ventilated children and neonates and if the levels changed in sepsis." DESIGN: Prospective, observational study...
June 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28616708/comparison-of-different-definitions-of-acute-kidney-injury-in-extremely-low-birth-weight-infants
#10
Vikas Chowdhary, Ramya Vajpeyajula, Mohit Jain, Syeda Maqsood, Rupesh Raina, Deepak Kumar, Maroun J Mhanna
BACKGROUND: The definition of acute kidney injury (AKI) has evolved over the years, and three definitions have been adapted including pediatric risk injury failure, loss of kidney function (pRIFLE), Acute Kidney Injury Network (AKIN), and Neonatal Modified Kidney Disease Improving Global Outcomes (KDIGO). We sought to report the prevalence and outcome of (AKI) according to the three existing definitions in extremely low birth weight (ELBW) infants. METHODS: In a retrospective cohort study, medical records of all ELBW infants (<1000 g) admitted to our neonatal intensive care unit (NICU) between Jan 2002 and Dec 2011 were reviewed...
June 14, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28616369/management-of-an-obstructed-tracheostomy-in-a-limited-resource-setting
#11
Julie Chiaravalli, Norman Lufesi, Elwin Shawa, Vitumbiko Nkhoma, Elaine Sigalet, Adam Dubrowski
Obstruction of a tracheostomy tube is a common cause of respiratory compromise in adults and pediatric patients, which can lead to a life-threatening emergency if it is not properly managed. Compromised airway patency has many potential etiologies; however, the scenario described in this technical report focuses specifically on the management of tracheostomy obstruction through the presence of a mucus plug, blood clot, or highly viscous secretions. The simulation described in this technical report was written to be conducted as an in-situ simulation within the intensive care unit (ICU) at Mzuzu Central Hospital, Malawi...
May 13, 2017: Curēus
https://www.readbyqxmd.com/read/28612677/an-unusual-complication-with-the-administration-of-a-volatile-anesthetic-agent-for-status-asthmaticus-in-the-pediatric-intensive-care-unit-case-report-and-review-of-the-literature
#12
Brittany Shutes, W Joshua Frazier, Joseph D Tobias
In severe cases of status asthmaticus, when conventional therapies fail, volatile anesthetic agents remain a therapeutic option. When delivered outside of the operating room setting, specialized delivery techniques are needed to ensure the safe and effective use of volatile anesthetic agents. We present a 16-year-old adolescent with status asthmaticus who required the therapeutic administration of the volatile anesthetic agent, sevoflurane, in the pediatric intensive care unit (PICU). Although initially effective in reducing bronchospasm, progressive hypercarbia developed due to defective functioning of the carbon dioxide absorber of the anesthesia machine...
July 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28612133/brain-specific-serum-biomarkers-predict-neurological-morbidity-in-diagnostically-diverse-pediatric-intensive-care-unit-patients
#13
Alicia K Au, Michael J Bell, Ericka L Fink, Rajesh K Aneja, Patrick M Kochanek, Robert S B Clark
BACKGROUND: Unexpected neurological morbidity in Pediatric Intensive Care Units (PICUs) remains high and is difficult to detect proactively. Brain-specific biomarkers represent a novel approach for early detection of neurological injury. We sought to determine whether serum concentrations of neuron-specific enolase (NSE), myelin basic protein (MBP), and S100B, specific for neurons, oligodendrocytes, and glia, respectively, were predictive of neurological morbidity in critically ill children...
June 13, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28609315/the-role-of-extracorporeal-membrane-oxygenation-simulation-training-at-extracorporeal-life-support-organization-centers-in-the-united-states
#14
Mark F Weems, Philippe S Friedlich, Lara P Nelson, Alyssa J Rake, Laura Klee, James E Stein, Theodora A Stavroudis
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) requires a multidisciplinary healthcare team. The Extracorporeal Life Support Organization publishes training guidelines but leaves specific requirements up to each institution. Simulation training has shown promise, but it is unclear how many institutions have incorporated simulation techniques into ECMO training to date. METHODS: We sent an electronic survey to ECMO coordinators at Extracorporeal Life Support Organization sites in the United States...
June 12, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/28607211/consensus-statement-of-the-indian-academy-of-pediatrics-on-newborn-hearing-screening
#15
Abraham Paul, Chhaya Prasad, S S Kamath, Samir Dalwai, M K C Nair, Waheeda Pagarkar
JUSTIFICATION: Hearing impairment is one of the most critical sensory impairments with significant social and psychological consequences. Reported incidence of congenital hearing loss is 30 per 10,000 children. Evidence-based, standardized national guidelines are needed for professionals to screen for hearing impairment during the neonatal period. PROCESS: The meeting on formulation of national consensus guidelines on developmental disorders was organized by Indian Academy of Pediatrics in Mumbai, on 18th and 19th December, 2015...
June 4, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28602381/variability-of-care-in-infants-with-severe-bronchiolitis-less-invasive-respiratory-management-leads-to-similar-outcomes
#16
Sandrine Essouri, Florent Baudin, Laurent Chevret, Mélanie Vincent, Guillaume Emeriaud, Philippe Jouvet
OBJECTIVE: To compare the management of children with severe bronchiolitis requiring intensive care (based on duration of ventilatory support and duration of pediatric intensive care unit [PICU] stay) in 2 countries with differing pediatric transport and PICU organizations. STUDY DESIGN: This was a prospective observational care study in 2 PICUs of tertiary care university hospitals, 1 in France and 1 in Canada. All children with bronchiolitis who required admission to the PICU between November 1, 2013, and March 31, 2014, were included...
June 8, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28601043/pediatric-intermediate-care-and-pediatric-intensive-care-units-picu-metrics-and-an-analysis-of-patients-that-use-both
#17
Andrew S Geneslaw, Haomiao Jia, Adam R Lucas, Michael S D Agus, Jeffrey D Edwards
PURPOSE: To examine how intermediate care units (IMCUs) are used in relation to pediatric intensive care units (PICUs), characterize PICU patients that utilize IMCUs, and estimate the impact of IMCUs on PICU metrics. MATERIALS & METHODS: Retrospective study of PICU patients discharged from 108 hospitals from 2009 to 2011. Patients admitted from or discharged to IMCUs were characterized. We explored the relationships between having an IMCU and several PICU metrics: physical length-of-stay (LOS), medical LOS, discharge wait time, admission severity of illness, unplanned PICU admissions from wards, and early PICU readmissions...
May 26, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28599698/implementation-of-ventilator-bundle-in-pediatric-intensive-care-unit-of-a-developing-country
#18
Anwarul Haque, Quratulain Riaz, Syed Asad Ali
The aim of this study was to assess the frequency of VAP(ventilator associated pneumonia) after strict implementation of ventilator bundle in PICU. Medical records of all children (age 1 month - 16 years) were retrospectively reviewed, who were on mechanical ventilation (MV) for more than 48 hours and received all key components of "ventilator bundle" from January 2012 to December 2014. Out of 1050, 565 (54%) patients were enrolled. The mean age was 4.02 SD 4.29 years and 62 (69%) were male. The indications of MV were respiratory illness (54%), neurological illness (31%), shock (9%), and postoperative care (6%)...
May 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28598592/hospitalization-rate-and-costs-in-acute-lymphoblastic-leukemia-of-childhood-in-a-low-income-group-financial-impact-in-northeast-mexico
#19
José Carlos Jaime-Pérez, Lucía Teresa Fernández, Raúl Alberto Jiménez-Castillo, Julia Esther Colunga-Pedraza, José Ramón Padilla-Medina, Consuelo Mancías-Guerra, David Gómez-Almaguer
BACKGROUND: Acute lymphoblastic leukemia (ALL) is one of the main and most expensive and prolonged causes of hospitalization for childhood cancer. We describe the hospitalization rate and its costs for an open population with ALL in a low-middle income country. PROCEDURE: We retrospectively analyzed 449 hospital admissions for 101 pediatric patients with ALL over 8 years. Clinical files and electronic databases were scrutinized to document causes, duration, readmission rate, costs, and outcome of each admission...
June 9, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28597060/-early-bilateral-nephrectomy-in-neonatal-autosomal-recessive-polycystic-kidney-disease-improved-prognosis-or-unnecessary-effort
#20
REVIEW
S Riechardt, M Koch, J Oh, M Fisch
BACKGROUND: Neonatal autosomal recessive polycystic kidney disease (ARPKD) is associated with giant kidneys, lung hypoplasia, pulmonal hypertension, and end-stage renal failure. Depending on the study, mortality is reported to range between 20 and 80%. OBJECTIVES: Does bilateral nephrectomy improve survival? PATIENTS AND METHODS: Between 2010 and 2016, we treated 7 children with prenatally diagnosed ARPKD. All had a planned delivery by cesarean section...
June 8, 2017: Der Urologe. Ausg. A
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