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Pediatric intensive care outcomes

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https://www.readbyqxmd.com/read/28335672/effect-of-severe-vitamin-d-deficiency-at-admission-on-shock-reversal-in-children-with-septic-shock
#1
Jhuma Sankar, Javed Ismail, Rashmi Das, Nishanth Dev, Anubhuti Chitkara, M Jeeva Sankar
OBJECTIVES: To evaluate the association of severe vitamin D deficiency with clinically important outcomes in children with septic shock. METHODS: We enrolled children ≤17 years with septic shock prospectively over a period of 6 months. We estimated 25-hydroxyvitamin D [25 (OH) D] levels at admission and 72 hours. Severe deficiency was defined as serum 25 (OH) <10 ng/mL. We performed univariate and multivariate analysis to evaluate association with clinically important outcomes...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#2
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28328654/outcomes-for-children-receiving-noninvasive-ventilation-as-the-first-line-mode-of-mechanical-ventilation-at-intensive-care-admission-a-propensity-score-matched-cohort-study
#3
Jenny V Morris, Padmanabhan Ramnarayan, Roger C Parslow, Sarah J Fleming
OBJECTIVES: To compare outcomes of children receiving noninvasive ventilation with those receiving invasive ventilation as first-line mode of mechanical ventilation following unplanned intensive care admission. DESIGN: Propensity score-matched cohort study analyzing data prospectively collected by the Pediatric Intensive Care Audit Network over 8 years (2007-2014). SETTING: Thirty-one PICUs in the United Kingdom and Ireland; twenty-one of whom submitted Pediatric Critical Care Minimum Dataset data for the entire study period...
March 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#4
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28321802/sepsis-risk-factors-in-infants-with-congenital-diaphragmatic-hernia
#5
Michaël Levy, Nolwenn Le Sache, Mostafa Mokhtari, Guy Fagherazzi, Gaelle Cuzon, Benjamin Bueno, Virginie Fouquet, Alexandra Benachi, Sergio Eleni Dit Trolli, Pierre Tissieres
BACKGROUND: Congenital diaphragmatic hernia (CDH) is a rare congenital anomaly and remains among the most challenging ICU-managed disease. Beside severe pulmonary hypertension, lung hypoplasia and major abdominal surgery, infective complications remain major determinants of outcome. However, the specific incidence of sepsis as well as associated risk factors is unknown. METHODS: This prospective, 4-year observational study took place in the pediatric intensive care and neonatal medicine department of the Paris South University Hospitals (Le Kremlin-Bicêtre, France), CDH national referral center and involved 62 neonates with CDH...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28321321/associations-between-fluid-balance-and-outcomes-in-critically-ill-children-a-protocol-for-a-systematic-review-and-meta-analysis
#6
Rashid Alobaidi, Catherine Morgan, Rajit K Basu, Erin Stenson, Robin Featherstone, Sumit R Majumdar, Sean M Bagshaw
BACKGROUND: Fluid therapy is a mainstay during the resuscitation of critically ill children. After initial stabilization, excessive fluid accumulation may lead to complications of fluid overload, which has been independently associated with increased risk for mortality and major morbidity in critically ill children. OBJECTIVES: Perform an evidence synthesis to describe the methods used to measure fluid balance, define fluid overload, and evaluate the association between fluid balance and outcomes in critically ill children...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28319507/recombinant-factor-viia-is-associated-with-increased-thrombotic-complications-in-pediatric-cardiac-surgery-patients
#7
Laura Downey, Morgan L Brown, David Faraoni, David Zurakowski, James A DiNardo
BACKGROUND: Recombinant factor VIIa (rFVIIa) is routinely used as an off-label hemostatic agent in children undergoing cardiac surgery. Despite evidence that rFVIIa use is associated with an increased incidence of thrombotic complications in adult cardiac surgery, the safety of rFVIIa as a rescue hemostatic agent in the pediatric cardiac surgical population is less definitively delineated. In this retrospective study, we used propensity score matching to compare the incidence of thrombotic complications between children treated with rFVIIa and their matched controls...
March 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28306345/a-retrospective-study-on-non-drug-related-poisoning-in-the-community-among-children-from-south-india
#8
Debasis Das Adhikari, Saibal Das, Blessed Winston A, Kaysina Vazhudhi, Aniket Kumar, Margaret Shanthi Fx, Indira Agarwal
OBJECTIVES: This retrospective study was performed to determine the incidence, demographic distribution, types and outcomes across various non-drug related poisonings among children attending a tertiary care center in south India. METHODS: All children from 0-16 years who presented to the Paediatric Emergency Department, Christian Medical College, Vellore with non-drug related poisoning from October 2004 to September 2013 were included. RESULTS: Out of the total 997 cases of poisoning, 629 (63...
March 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28297684/physical-and-occupational-therapy-utilization-in-a-pediatric-intensive-care-unit
#9
Liang R Cui, Megan LaPorte, Matthew Civitello, Meg Stanger, Maxine Orringer, Frank Casey, Bradley A Kuch, Sue R Beers, Cynthia A Valenta, Patrick M Kochanek, Amy J Houtrow, Ericka L Fink
PURPOSE: To characterize the use of physical therapy (PT) and occupational therapy (OT) consultation in our pediatric intensive care unit (PICU). MATERIALS AND METHODS: We studied children aged 1week-18years admitted to a tertiary care PICU for ≥3days. Patient characteristics, details of PT and OT sessions and adverse events were collected. A multivariable logistic regression was performed to determine factors associated with receipt of PT and OT consultation with propensity analysis followed by a regression for factors associated with outcome...
March 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28292873/variation-in-inpatient-croup-management-and-outcomes
#10
Amy Tyler, Lisa McLeod, Brenda Beaty, Elizabeth Juarez-Colunga, Meghan Birkholz, Daniel Hyman, Allison Kempe, James Todd, Amanda F Dempsey
BACKGROUND AND OBJECTIVES: Croup is a clinical diagnosis, and the available evidence suggests that, except in rare cases, ancillary testing, such as radiologic imaging, is not helpful. Given the paucity of inpatient-specific evidence for croup care, we hypothesized that there would be marked variability in the use of not routinely indicated resources (NRIRs). Our primary study objective was to describe the variation and predictors of variation in the use of NRIRs. METHODS: This was a retrospective cohort study that used the Pediatric Health Information System database of generally healthy inpatients with croup aged 6 months to 15 years who were admitted between January 1, 2012 and September 30, 2014...
March 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/28289613/effect-of-perioperative-management-on-outcome-of-patients-after-craniosynostosis-surgery
#11
Abdoljalil Kalantar Hormozi, Nastaran Mahdavi, Mohammad Mehdi Foroozanfar, Seyed Sajad Razavi, Razavi Mohajerani, Ahmad Eghbali, Amir Ali Mafi, Haleh Hashemzadeh, Alireza Mahdavi
BACKGROUND: Craniosynostosis results from premature closure of one or more cranial sutures, leading to deformed calvaria and craniofacial skeleton at birth. Postoperative complications and outcome in intensive care unit (ICU) is related to surgical method and perioperative management. This study determined the perioperative risk factors, which affect outcome of patients after craniosynostosis surgery. METHODS: In a retrospective study, 178 patients with craniosynostosis who underwent primary cranial reconstruction were included...
January 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/28288150/-unknown-title
#12
Janneke Dekker, Stuart B Hooper, Jeroen J van Vonderen, Ruben Sgm Witlox, Enrico Lopriore, Arjan B Te Pas
BACKGROUND: Caffeine promotes spontaneous breathing by antagonizing adenosine. We assessed the direct effect of caffeine on respiratory effort in preterm infants at birth. METHODS: Thirty infants of 24-30 weeks of gestation were randomized for receiving caffeine directly after birth in the delivery room (caffeine DR-group) or later in the neonatal intensive care unit (control-group). Primary outcome was respiratory effort, expressed as minute volume, tidal volumes, respiratory rate, rate of rise to maximum tidal volume and recruitment breaths at 7-9 minutes after birth...
March 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28274812/pediatric-cardiac-arrest-due-to-drowning-and-other-respiratory-etiologies-neurobehavioral-outcomes-in-initially-comatose-children
#13
Beth S Slomine, Vinay M Nadkarni, James R Christensen, Faye S Silverstein, Russell Telford, Alexis Topjian, Joshua D Koch, Jill Sweney, Ericka L Fink, Mudit Mathur, Richard Holubkov, J Michael Dean, Frank W Moler
AIM: To describe the 1-year neurobehavioral outcome of survivors of cardiac arrest secondary to drowning, compared with other respiratory etiologies, in children enrolled in the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital (THAPCA-OH) trial. METHODS: Exploratory analysis of survivors (ages 1-18 years) who received chest compressions for ≥2min, were comatose, and required mechanical ventilation after return of circulation (ROC). Participants recruited from 27 pediatric intensive care units in North America received targeted temperature management [therapeutic hypothermia (33°C) or therapeutic normothermia (36...
March 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28274664/psychological-outcomes-in-parents-of-critically-ill-hospitalized-children
#14
Robyn Stremler, Summer Haddad, Eleanor Pullenayegum, Christopher Parshuram
Parents of children in pediatric intensive care units (PICUs) are subjected to significant psychological stress. The purpose of this study was to determine the prevalence of, and factors associated with anxiety, depressive symptoms and decisional conflict in parents of children hospitalized in the PICU. The study employed a descriptive, cross-sectional design to investigate the psychological status of 118 parents of 91 children (74 mothers and 44 fathers) admitted to the PICU, using measures of anxiety (STAI), depression (CES-D), and decisional conflict (DCS)...
March 5, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28267086/should-we-pay-attention-to-the-delay-before-admission-to-a-pediatric-intensive-care-unit-for-children-with-cancer-impact-on-1-month-mortality-a-report-from-the-french-children-s-oncology-study-group-goce
#15
Jeanne-L Fausser, Aude Tavenard, Fanny Rialland, Philippe Le Moine, Odile Minckes, Anne Jourdain, Olivier Tirel, Isabelle Pellier, Virginie Gandemer
Acute complications requiring admission to pediatric intensive care unit (PICU) are frequent for children with cancer. Our objective was to determine early prognostic factors of mortality in a cohort of children with cancer hospitalized in PICU for acute complications and particularly to assess whether the delay before admission to a PICU is an early predictor of mortality. We conduct a retrospective multicenter analysis. All patients transferred in PICU for acute complications between January 2002 and December 2012 were included...
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28264082/effects-of-advice-to-drink-8-cups-of-water-per-day-in-adolescents-with-overweight-or-obesity-a-randomized-clinical-trial
#16
Julia M W Wong, Cara B Ebbeling, Lisa Robinson, Henry A Feldman, David S Ludwig
Importance: Health care professionals commonly recommend increased water consumption, typically to 8 cups per day, as part of a weight-reducing diet. However, this recommendation is based on limited evidence and virtually no experimental data from the pediatric population. Objective: To compare 2 standardized weight-loss diets among adolescents with overweight or obesity, either with or without additional advice and behavioral support to increase habitual water intake to 8 cups per day...
March 6, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28263440/a-decade-of-pediatric-tracheostomies-indications-outcomes-and-long-term-prognosis
#17
Mona L McPherson, Lara Shekerdemian, Michelle Goldsworthy, Charles G Minard, Cynthia S Nelson, Fernando Stein, Jeanine M Graf
OBJECTIVE: To define the mortality and long-term outcomes of children undergoing tracheostomy. DESIGN: Retrospective chart and Texas Department of Health Bureau of Vital Statistics review of patients admitted to a Pediatric Intensive Care Unit who underwent a tracheostomy between 2001 and 2011. Mortality and decannulation rates were compared based on tracheostomy indication and age. SUBJECTS: A total of 426 patients admitted to a Pediatric Intensive Care Unit in a large tertiary children's hospital...
March 6, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28260481/incidence-and-patient-outcomes-in-renal-replacement-therapy-after-orthotopic-liver-transplant
#18
Asude Ayhan, Zeynep Ersoy, Aydin Ulas, Pinar Zeyneloglu, Arash Pirat, Mehmet Haberal
OBJECTIVES: Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes. MATERIALS AND METHODS: We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28260348/current-views-of-pediatric-intensive-care-unit-picu
#19
Conghai Fan, Boxiang Qi, Chao Chen
International best practice endorses the use of standardized approaches in the management of pediatric patients in the Pediatric Intensive Care Unit (PICU). There is increasing awareness of the risk of prolonged duration of mechanical ventilation as a consequence of morphine use leading to ventilator associated pneumonia (VAP), extended PICU and hospital length of stay and increased morbidity and mortality. Accordingly a fundamental outcome measure of this study was to determine whether raising awareness of these issues and the introduction of analgesia and sedation guidelines led to a reduction in the amount of analgesics and sedatives administered to PICU patients, while not exposing them to pain and distress...
March 3, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28254390/fluid-overload-and-outcomes-in-critically-ill-children-a-single-center-prospective-cohort-study
#20
Franco Diaz, Mark Benfield, LaTanya Brown, Leslie Hayes
OBJECTIVE: To prospectively evaluate the association between fluid overload (FO) and clinical outcomes, mortality, mechanical ventilation (MV), and duration and length of stay in a pediatric intensive care unit (PICU). METHODS: Over a 12-month period, patients who were on MV for >24h or vasoactive support were prospectively included. Demographic and clinical data were recorded. Daily FO was calculated as [(fluid in-fluid out)/admission weight]×100%. Multivariate stepwise logistic regression analysis was used to determine predictors of survival...
February 16, 2017: Journal of Critical Care
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