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pediatric intensive care unit

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https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#1
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29340851/comparison-of-antibiotic-dosing-recommendations-for-neonatal-sepsis-from-established-reference-sources
#2
T B Y Liem, E M A Slob, J U M Termote, T F W Wolfs, A C G Egberts, C M A Rademaker
Background Incorrect dosing is the most frequent prescribing error in neonatology, with antibiotics being the most frequently prescribed medicines. Computer physician order entry and clinical decision support systems can create consistency contributing to a reduction of medication errors. Although evidence-based dosing recommendations should be included in such systems, the evidence is not always available and subsequently, dosing recommendations mentioned in guidelines and textbooks are often based on expert opinion...
January 16, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29340730/age-dependent-association-between-pre-transplant-blood-transfusion-and-outcomes-of-pediatric-heart-transplantation
#3
C McKee, D Tumin, B R Alevriadou, K K Nicol, A R Yates, D Hayes, J D Tobias
Avoidance of red blood cell (RBC) transfusions in patients awaiting heart transplantation (HTx) has been suggested to minimize the risk of allosensitization. Although recent studies have suggested that an immature immune system in younger HTx recipients may reduce risks associated with RBC transfusion, the role of age in moderating the influence of transfusion on HTx outcomes remains unclear. We used available data from a national transplant registry to explore whether the association between pre-transplant transfusions and outcomes of pediatric HTx varies by patient age...
January 16, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29336798/hospital-readmissions-in-children-with-pulmonary-hypertension-a-multi-institutional-analysis
#4
Jordan D Awerbach, George B Mallory, Shelly Kim, Antonio G Cabrera
OBJECTIVE: To assess the rate of and risk factors for 30-day hospital readmission in children with pulmonary hypertension. STUDY DESIGN: The Pediatric Health Information System database was analyzed for patients ≤18 years old with pulmonary hypertension (International Classification of Diseases, Ninth Revision, diagnosis codes of 416.0, 416.1, 416.8, or 416.9) admitted from 2005 through 2014. A generalized hierarchical regression model was used to determine significant ORs and 95% CIs associated with 30-day readmission...
January 12, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29333823/brain-death-and-organ-donation-in-argentine-pediatric-intensive-care-units-a-multicenter-study
#5
Germán Bonetto, Pedro Taffarel, Melisa Gamerman, Facundo Jorro Barón, Carolina Gaviña, Laura Flores, Emanuel Fernández, Andrea Zifferman, Gustavo Debaisi, Marcelo Acerenza, Jorge Selandari, Luis Landry, Ariel Cacciamano, Alfredo Clavel, Patricia Capocasa, Bernardo Calvo, Marcial Angos
Brain death (BD) is a condition determined by the complete and irreversible absence of brain functions. Maintenance of vital functions creates an opportunity for organ donation. A retrospective study was carried out in 7 pediatric intensive care units of Argentina (from 1/1/2013 to 9/30/2016) to determine the incidence of clinical and certified BD, and the proportion of effective transplantations. Among deceased patients, 19.14% (147/768) met the clinical requirements for BD, and the main cause of BD was multiple trauma...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#6
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29329548/the-cost-of-a-pediatric-neurocritical-care-program-for-traumatic-brain-injury-a-retrospective-cohort-study
#7
Steven W Howard, Zidong Zhang, Paula Buchanan, Stephanie L Bernell, Christine Williams, Lindsey Pearson, Michael Huetsch, Jeff Gill, Jose A Pineda
BACKGROUND: Inpatient care for children with severe traumatic brain injury (sTBI) is expensive, with inpatient charges averaging over $70,000 per case (Hospital Inpatient, Children Only, National Statistics. Diagnoses- clinical classification software (CCS) principal diagnosis category 85 coma, stupor, and brain damage, and 233 intracranial injury. Diagnoses by Aggregate charges [ https://hcupnet.ahrq.gov/#setup ]). This ranks sTBI in the top quartile of pediatric conditions with the greatest inpatient costs (Hospital Inpatient, Children Only, National Statistics...
January 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29322987/complications-related-to-sitting-position-during-pediatric-neurosurgery-an-institutional-experience-and-review-of-literature
#8
Priyanka Gupta, Girija P Rath, Hemanshu Prabhakar, Parmod K Bithal
BACKGROUND: Sitting position is preferred during posterior fossa surgeries as it provides better anatomical orientation and a clear surgical field. However, its use has been declining due to its propensity to cause life-threatening complications. This study was carried out to analyze the perioperative complications and postoperative course of children who underwent neurosurgery in sitting position. MATERIALS AND METHODS: Medical records of 97 children (<18 years) who underwent neurosurgery in sitting position over a period of 12 years, were retrospectively analyzed...
January 2018: Neurology India
https://www.readbyqxmd.com/read/29322352/supraclavicular-catheterization-of-the-brachiocephalic-vein-a-way-to-prevent-or-reduce-catheter-maintenance-related-complications-in-children
#9
Flora Habas, Julien Baleine, Christophe Milési, Clémentine Combes, Marie-Noëlle Didelot, Sara Romano-Bertrand, Delphine Grau, Sylvie Parer, Catherine Baud, Gilles Cambonie
Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e., the femoral, the subclavian, and the jugular). We performed a retrospective data collection of prospectively registered data on CVC in young children hospitalized in a pediatric intensive care unit (PICU) during a 4-year period (May 2011 to May 2015)...
January 10, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29321117/emergency-department-resuscitation-of-pediatric-trauma-patients-in-iraq-and-afghanistan
#10
Steven G Schauer, Guyon J Hill, Jason F Naylor, Michael D April, Matthew Borgman, Vikhyat S Bebarta
BACKGROUND: Military hospital healthcare providers treated children during the recent conflicts in Afghanistan and Iraq. Compared to adults, pediatric patients present unique challenges during trauma resuscitations and have notably been discussed in few research reports. We seek to describe ED interventions performed on pediatric trauma patients in Iraq and Afghanistan. METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients in Iraq and Afghanistan from January 2007 to January 2016...
January 4, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29319505/kpc-2-producing-klebsiella-pneumoniae-st11-in-a-children-s-hospital-in-poland
#11
Monika Machulska, Anna Baraniak, Iwona Żak, Katarzyna Bojarska, Dorota Żabicka, Iwona Sowa-Sierant, Waleria Hryniewicz, Marek Gniadkowski
Four Klebsiella pneumoniae isolates from children hospitalized over 10 months in an intensive care unit in a children's teaching hospital in Poland were analyzed. All of the isolates belonged to a single pulsotype and sequence type (ST) 11, and produced the KPC-2 carbapenemase and extended-spectrum β-lactamase (ESBL) CTX-M-15. They were resistant to a variety of antimicrobials, and their β-lactam resistance patterns were typical for KPC producers. This is one of few cases of identification of KPC (or carbapenemase)-producing K...
September 27, 2017: Polish Journal of Microbiology
https://www.readbyqxmd.com/read/29318344/severe-casualties-from-bastille-day-attack-in-nice-france
#12
Federico Solla, Joseph Carboni, Arnaud Fernandez, Audrey Dupont, Nathalie Chivoret, Gilles Brézac, Virginie Rampal, Jean Bréaud
PURPOSE: To describe the most severe casualties from the July 14th, 2016 terror attack in Nice that were treated at the Lenval University Children's Hospital (LUCH) of Nice (France). METHODS: Retrospective study about casualties treated at LUCH from Bastille Day Attack with injuries resulting in the need for surgery, resuscitation, or death. The type of lesions and surgery, duration of hospitalizations, complications, psychological status, and outcome at discharge were collected...
January 9, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29316006/extubation-in-the-operating-room-after-pediatric-liver-transplant-a-retrospective-cohort-study
#13
Harshad G Gurnaney, Scott D Cook-Sather, Abraham Shaked, Kim M Olthoff, Elizabeth B Rand, Arul M Lingappan, Mohamed A Rehman
BACKGROUND: Early extubation immediately following liver transplantation is increasingly common in adult practice. Some pediatric institutions have begun to adopt this strategy. Careful patient selection is essential in minimizing risk. METHODS: This retrospective cohort study evaluated infants and children who underwent liver transplantation between July 2011 and December 2014. Our primary objective was to determine early extubation rate. Secondary objectives were to identify clinical factors associated with successful early extubation compared with delayed extubation and to examine significant postoperative complications, intensive care unit length of stay, and hospital length of stay...
January 8, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29315204/moral-distress-model-reconstructed-using-grounded-theory
#14
Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu
BACKGROUND: The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. PURPOSE: The aim of this study was to reconstruct the model of moral distress using the grounded theory. METHODS: Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29315137/reducing-ischemic-injury-from-indwelling-peripheral-arterial-catheters-in-a-pediatric-cardiac-icu-a-quality-improvement-initiative
#15
Adam C Adler, Stephanie Helman, Cynthia Field, Judith J Stellar, Lauren A Brown, Nicole Omensetter, Andrew T Costarino, Mahsun Yuerek, Karen S Bender
OBJECTIVES: To reduce the number of ischemic arterial catheter injuries in children with congenital or acquired heart disease. DESIGN: This is a quality improvement study with pre- and postintervention groups. SETTING: University-affiliated pediatric cardiac center in a quaternary care freestanding children's hospital. PATIENTS: All patients with an indwelling peripheral arterial catheter placed in the Children's Hospital of Philadelphia Cardiac Center associated with an admission to the Cardiac Intensive Cardiac Unit from January 2015 to July 2017 are included...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29315136/renal-replacement-therapy-in-the-critically-ill-child
#16
Claire A Westrope, Sarah Fleming, Melpo Kapetanstrataki, Roger C Parslow, Kevin P Morris
OBJECTIVES: Although renal replacement therapy is widely used in critically ill children, there have been few comprehensive population-based studies of its use. This article describes renal replacement therapy use, and associated outcomes, in critically ill children across the United Kingdom in the largest cohort study of this patient group. DESIGN: A retrospective observational study using prospectively collected data. SETTING: Data from the Pediatric Intensive Care Audit Network database which collects data on all children admitted to U...
January 8, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29313710/long-term-outcomes-after-protocolized-sedation-vs-usual-care-in-ventilated-pediatric-patients
#17
R Scott Watson, Lisa A Asaro, James H Hertzog, Lauren R Sorce, Alicia G Kachmar, Leslie A Dervan, Derek C Angus, David Wypij, Martha A Q Curley
RATIONALE: Whether a nurse-implemented goal-directed sedation protocol resulting in more awake yet calm intubated children affects post-discharge functional status, health-related quality of life, or risk for post-traumatic stress disorder is unknown. OBJECTIVES: To compare post-discharge outcomes in children with acute respiratory failure cluster randomized to a sedation protocol or usual care. METHODS: A stratified random sample of 1360 patients from 31 centers in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial was assessed by mail, electronically, and/or telephone six months after intensive care unit discharge...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29310361/severe-pertussis-infection-a-clinicopathological-study
#18
Fernando Palvo, Alexandre Todorovic Fabro, Maria Célia Cervi, Davi Casale Aragon, Fernando Silva Ramalho, Ana Paula de Carvalho Panzeri Carlotti
We aimed to investigate the clinicopathological features of pertussis in children admitted to a tertiary-care university hospital in Brazil.This was a retrospective cohort study of all pediatric hospital admissions with pertussis from January 1, 2008 to December 31, 2014. We also reported the autopsy findings in children who died.Fifty-five patients admitted to the hospital over the study period had laboratorial confirmation of Bordetella pertussis infection, 17 (30.9%) needed pediatric intensive care unit (PICU) admission and 6 (10...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29302715/remote-ischemic-preconditioning-has-a-cardioprotective-effect-in-children-in-the-early-postoperative-phase-a-meta-analysis-of-randomized-controlled-trials
#19
Wen Tan, Chaoji Zhang, Jianzhou Liu, Xiaofeng Li, Yuzhi Chen, Qi Miao
In this updated meta-analysis, we assessed the cardioprotective effect of remote ischemic preconditioning (RIPC) in pediatric patients undergoing congenital heart surgery. A total of 9 randomized controlled trials (RCTs) involving 793 pediatric patients under 18 years old were identified. RIPC obviously reduced the release of troponin I at 6 h after surgery [standard mean difference (SMD) -0.59, 95% confidence interval (CI) -1.14 to -0.04; p = 0.03], mitigated the inotropic scores within 4-6 h (SMD -0...
January 4, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29302123/bloodless-repair-for-a-3-6-kilogram-transposition-of-the-great-arteries-with-jehovah-s-witness-faith
#20
Jeffery L Burnside, Todd M Ratliff, Ashley B Hodge, Daniel Gomez, Mark Galantowicz, Aymen Naguib
Achieving pediatric cardiac surgery using cardiopulmonary bypass (CPB) without allogeneic blood transfusion is challenging. There are many clinical and economic factors that point to the importance of avoiding blood transfusions. In some instances, honoring patients or parents beliefs may be the reason for avoiding blood transfusions. For example, patients or parents of the Jehovah's Witness faith refuse blood transfusion based on their religious beliefs. Over the last decade, our institution has seen a steady increase in our pediatric Jehovah's Witness patient population...
December 2017: Journal of Extra-corporeal Technology
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