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Pediatric intensive care outcomes

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https://www.readbyqxmd.com/read/28648809/improving-quality-in-measuring-time-to-initiation-of-cpr-during-in-hospital-resuscitation
#1
Ashley Siems, Elyse Tomaino, Anne Watson, Michael C Spaeder, Lillian Su
OBJECTIVE: Time from the onset of "low or no flow" indicators of cardiac failure to initiation of cardiopulmonary resuscitation is an important quality metric thought to improve the likelihood of survival and preservation of end organ function. We hypothesized that delays in initiation of chest compressions were under recognized during in-hospital resuscitation and aimed to develop a system which identifies the actual time of deterioration during cardiac events. METHODS: Retrospective review on prospectively identified resuscitation records and monitor data were compared...
June 22, 2017: Resuscitation
https://www.readbyqxmd.com/read/28644537/psychosocial-demographic-and-illness-related-factors-associated-with-acute-traumatic-stress-responses-in-parents-of-children-with-a-serious-illness-or-injury
#2
Frank Muscara, Maria C McCarthy, Emma J Thompson, Claire-Marie Heaney, Stephen J C Hearps, Meredith Rayner, Kylie Burke, Jan M Nicholson, Vicki A Anderson
This study investigated factors associated with acute stress symptoms in parents of seriously ill children across a range of illnesses and treatment settings within a pediatric hospital setting. It was hypothesized that psychosocial variables would be more strongly associated with acute stress responses than demographic and child illness variables. Participants were 115 mothers and 56 fathers of children treated within the oncology, cardiology, and intensive care departments of a pediatric hospital. Acute stress, psychosocial, demographic, and medical data were collected within the first 4 weeks of the child's hospital admission...
June 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28643749/treatment-of-high-risk-neuroblastoma-national-protocol-results-of-the-turkish-pediatric-oncology-group
#3
Serap Aksoylar, Ali Varan, Canan Vergin, Volkan Hazar, Ferhan Akici, Ayhan Dagdemir, Mustafa Buyukavci, Rejin Kebudi, Nilgun Kurucu, Betul Sevinir, Emel Unal, Sema Vural, Elif Guler, Hilmi Apak, Haldun Oniz, Ceyda Karadeniz, Cengiz Canpolat, Sema Anak, Inci Ilhan, Dilek Ince, Emre Cecen, Nur Olgun
BACKGROUND: The national protocol aimed to improve the outcome of the high risk neuroblastoma patients by high-dose chemotherapy and stem cell rescue with intensive multimodal therapy. MATERIALS AND METHODS: After the 6 induction chemotherapy cycles, patients without disease progression were nonrandomly (by physicians' and/or parent's choices) allocated into two treatment arms, which were designed to continue the conventional chemotherapy (CCT), or myeloablative therapy with autologous stem cell rescue (ASCR)...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28622279/hydrogen-sulphide-in-exhaled-gases-from-ventilated-septic-neonates-and-children-a-preliminary-report
#4
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
#5
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/28612133/brain-specific-serum-biomarkers-predict-neurological-morbidity-in-diagnostically-diverse-pediatric-intensive-care-unit-patients
#6
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/28602381/variability-of-care-in-infants-with-severe-bronchiolitis-less-invasive-respiratory-management-leads-to-similar-outcomes
#7
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/28599026/transition-issues-and-challenges-for-youth-with-autism-spectrum-disorders
#8
Fred R Volkmar, Scott L J Jackson, Logan Hart
Earlier detection and effective, evidence-based practices are gradually improving outcomes for people with autism spectrum disorder (ASD). Although some continue to need intensive support as adults, an increasing number are now going to college, becoming independent, and marrying. With the transition to adulthood, people with ASD will face a number of significant challenges. Health care providers who are knowledgeable about these challenges can help foster better outcomes and support those requiring higher levels of care...
June 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28598947/moral-distress-in-picu-and-neonatal-icu-practitioners-a-cross-sectional-evaluation
#9
Charles Philip Larson, Karen D Dryden-Palmer, Cathy Gibbons, Christopher S Parshuram
OBJECTIVES: To measure the level of moral distress in PICU and neonatal ICU health practitioners, and to describe the relationship of moral distress with demographic factors, burnout, and uncertainty. DESIGN: Cross-sectional survey. SETTING: A large pediatric tertiary care center. SUBJECTS: Neonatal ICU and PICU health practitioners with at least 3 months of ICU experience. INTERVENTIONS: A 41-item questionnaire examining moral distress, burnout, and uncertainty...
June 8, 2017: Pediatric Critical Care Medicine
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
#10
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/28591056/epidemiology-and-clinical-analysis-of-critical-patients-with-child-maltreatment-admitted-to-the-intensive-care-units
#11
En-Pei Lee, Shao-Hsuan Hsia, Jing-Long Huang, Jainn-Jim Lin, Oi-Wa Chan, Chia-Ying Lin, Kuang-Lin Lin, Yu-Ching Chang, I-Jun Chou, Fu-Song Lo, Jung Lee, Yi-Chen Hsin, Pei-Chun Chan, Mei-Hua Hu, Cheng-Hsun Chiu, Han-Ping Wu
Children with abuse who are admitted to the intensive care unit (ICU) may have high mortality and morbidity and commonly require critical care immediately. It is important to understand the epidemiology and clinical characteristics of these critical cases of child maltreatment.We retrospectively evaluated the data for 355 children with maltreatments admitted to the ICU between 2001 and 2015. Clinical factors were analyzed and compared between the abuse and the neglect groups, including age, gender, season of admission, identifying settings, injury severity score (ISS), etiologies, length of stay (LOS) in the ICU, clinical outcomes, and mortality...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28590996/helicopter-transport-from-the-scene-of-injury-are-there-improved-outcomes-for-pediatric-trauma-patients
#12
Sandra M Farach, Nebbie E Walford, Lindsey Bendure, Ernest K Amankwah, Paul D Danielson, Nicole M Chandler
BACKGROUND: There is conflicting data to support the routine use of helicopter transport (HT) for the transfer of trauma patients. The purpose of this study was to evaluate outcomes for trauma patients transported via helicopter from the scene of injury to a regional pediatric trauma center. METHODS: The institutional trauma registry was queried for trauma patients presenting from January 2000 through March 2012. Of 9119 patients, 1709 patients who presented from the scene were selected for further evaluation...
June 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28586613/hyperlactetemia-and-its-trends-in-critically-ill-children-admitted-in-pediatric-intensive-care-unit-of-a-developing-country
#13
Qalab Abbas, Muhammad Tariq Jamil, Leena Jafri, Anwar Ul Haque, Vivek Khetpal
OBJECTIVE: There is increasing evidence that in setting of critical ailments clinical signs lag biomarkers like Lactate and hyperlactetemia can be the only marker for this disorder. This study was conducted to describe the incidence of hyperlactatemia in critically ill children and its association with outcome. METHODS: Retrospective review of medical records of all children who had their lactic acid (LA) levels measured during their admission in PICU from January 2014 to December 2015 was done...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28582303/tranexamic-acid-reduces-blood-loss-in-craniosynostosis-surgery
#14
Nicole M Kurnik, Lacey R Pflibsen, Ruth E Bristol, Davinder J Singh
METHODS: The authors retrospectively reviewed 79 patients with craniosynostosis who underwent either bifrontal or biparietal-occipital calvarial vault remodeling before institution of tranexamic acid (TXA) administration (non-TXA group) and 35 patients after institution of TXA administration (TXA group). The patients were analyzed in 2 groups: all open calvarial vault remodeling patients (anterior and posterior) as a whole, and anterior vaults only as a subset analysis. Primary outcomes accessed were: total intraoperative blood transfused, postoperative blood transfused, and estimated blood loss (EBL)...
June 2, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28578358/incidence-and-outcome-of-acute-kidney-injury-by-the-prifle-criteria-for-children-receiving-extracorporeal-membrane-oxygenation-after-heart-surgery
#15
Raja Abou Elella, Eiad Habib, Pavla Mokrusova, Princy Joseph, Hani Aldalaty, Mamdouh Al Ahmadi, Zohair Al Halees
BACKGROUND: Acute kidney injury (AKI) is common in patients treated with extracorporeal membrane oxygenation (ECMO). The RIFLE criteria demonstrate clinical relevance for diagnosing AKI and classifying its severity. OBJECTIVES: To systematically define the incidence, clinical course and outcome of AKI using the pediatric pRIFLE criteria. DESIGN: Retrospective, medical records review. SETTINGS: Pediatric cardiac surgical intensive care units at a tertiary care hospital in Riyadh...
May 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/28574294/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#16
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28556917/decreased-relapsed-rate-and-treatment-related-mortality-contribute-to-improved-outcomes-for-pediatric-acute-myeloid-leukemia-in-successive-clinical-trials
#17
Thomas B Alexander, Lei Wang, Hiroto Inaba, Brandon M Triplett, Stanley Pounds, Raul C Ribeiro, Ching-Hon Pui, Jeffrey E Rubnitz
BACKGROUND: Outcomes for children with acute myeloid leukemia (AML) have improved over the past 20 years even though the medications used for induction therapy have not changed. METHODS: This study analyzed data from patients with AML who were enrolled in successive protocols (AML97 and AML02) to determine the contributors to the improved outcomes of the latter clinical trial. RESULTS: There were significant improvements in 5-year overall survival (48...
May 30, 2017: Cancer
https://www.readbyqxmd.com/read/28549578/pediatric-out-of-hospital-cardiac-arrest-caused-by-left-coronary-artery-agenesis-with-primary-shockable-rhythm-a-brief-report
#18
Moritz Weigeldt, Sabine Lahmann, Konstantin Krieger, Sebastian Buttenberg, Volker Stephan, Brigitte Stiller, Dirk Stengel
BACKGROUND: To illustrate a rare cause of out-of-hospital cardiac arrest in children, its differential diagnoses, emergency and subsequent treatment at various steps in the rescue chain, and potential outcomes. CASE PRESENTATION: A 4-year-old boy with unknown agenesis of the left coronary ostium sustained out-of-hospital cardiac arrest. Bystander cardio-pulmonary resuscitation was initiated and defibrillation was performed via an automated external defibrillator (AED) shortly after paramedics arrived at the scene, restoring sinus rhythm and spontaneous circulation...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28540196/significance-of-platelet-count-in-children-admitted-with-bronchiolitis
#19
Amar Al Shibli, Najla Alkuwaiti, May Hamie, Dima Abukhater, Muhammad B Noureddin, Abdulla Amri, Salwa Al Kaabi, Aysha Al Kaabi, Mariam Harbi, Hassib Narchi
AIM: To determine the true prevalence of thrombocytosis in children less than 2 years of age with bronchiolitis, its association with risk factors, disease severity and thromboembolic complications. METHODS: A retrospective observational medical chart review of 305 infants aged two years or less hospitalized for bronchiolitis. Clinical outcomes included disease severity, duration of hospital stay, admission to pediatric intensive care unit, or death. They also included complications of thrombocytosis, including thromboembolic complications such as cerebrovascular accident, acute coronary syndrome, deep venous thrombosis, pulmonary embolus, mesenteric thrombosis and arterial thrombosis and also hemorrhagic complications such as bleeding (spontaneous hemorrhage in the skin, mucous membranes, gastrointestinal, respiratory, or genitourinary tracts)...
May 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28539208/birth-weight-length-and-head-circumference-progression-and-impact-over-the-outcome-of-patients-with-congenital-heart-disease
#20
Daniélle Bernardi Silveira, Ernani Bohrer da Rosa, Jamile Dutra Correia, Patrícia Trevisan, Marilu Fiegenbaum, Ceres Andréia Oliveira, Carolina Geitens Grapiglia, Mauricio Rouvel Nunes, Rosana Cardoso Manique Rosa, Tatiana Diehl Zen, Paulo Ricardo Gazzola Zen, Rafael Fabiano Machado Rosa
BACKGROUND: There are few studies assessing the birth measures of patients with congenital heart disease (CHD). Our aim to evaluate their progression and impact over the outcome. METHODS: The cases consisted of patients with CHD during their first hospitalization in a reference cardiac and pediatric intensive care unit (ICU) from Southern Brazil. Controls were composed of patients with no clinical evidence of CHD hospitalized soon after cases. The cases underwent high-resolution karyotype and fluorescence in situ hybridization (FISH) for 22q11 microdeletion...
May 18, 2017: International Journal of Cardiology
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