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Pediatric intensive care outcomes

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https://www.readbyqxmd.com/read/29161668/patterns-of-c-reactive-protein-ratio-response-to-antibiotics-in-pediatric-sepsis-a-prospective-cohort-study
#1
Vanessa Soares Lanziotti, Pedro Póvoa, Arnaldo Prata-Barbosa, Lucas Berbet Pulcheri, Ligia S C F Rabello, José Roberto Lapa E Silva, Marcio Soares, Jorge I F Salluh
PURPOSE: Evaluate sequential C-reactive protein (CRP) measurements and patterns of CRP-ratio response to antibiotic therapy during first 7days in Pediatric Intensive Care Unit (PICU) of septic children. METHODS: Prospective, cohort study of children (1month-12years) admitted at 3 PICUs, with diagnosis of sepsis with <72h course. CRP-ratio was calculated in relation to D0_CRP value. Children were classified according to an individual pattern of CRP-ratio response: fast - CRP_D4 of therapy was <0...
November 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29151847/pediatric-traumatic-brain-injury-a-5-year-descriptive-study-from-the-national-trauma-center-in-qatar
#2
Ayman El-Menyar, Rafael Consunji, Hassan Al-Thani, Ahammed Mekkodathil, Gaby Jabbour, Khalid A Alyafei
Background: The epidemiologic characteristics and outcomes of pediatric traumatic brain injury (pTBI) have not been adequately documented from the rapidly developing countries in the Arab Middle East. We aimed to describe the hospital-based epidemiologic characteristics, injury mechanisms, clinical presentation, and outcomes of pTBI and analyze key characteristics and determinant of pTBI that could help to make recommendations for policies to improve their care. Methods: We conducted a retrospective observational study in a level 1 trauma center (2010-2014) for all pTBI patients...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/29149961/practice-variation-in-the-immediate-postoperative-care-of-pediatric-kidney-transplantation-a-national-survey
#3
S Abu-Sultaneh, M J Hobson, A C Wilson, W C Goggins, M E Nitu, R Lutfi
INTRODUCTION: Advances in organ allocation, surgical technique, immunosuppression, and long-term follow-up have led to a significant improvement in kidney transplant outcomes. Although there are clear recommendations for several aspects of kidney transplant management, there are no pediatric-specific guidelines for immediate postoperative care. The aim of this survey is to examine practice variations in the immediate postoperative care of pediatric kidney transplant patients. METHODS: We surveyed medical directors of Pediatric Acute Lung Injury and Sepsis Investigators (PALISI)-affiliated pediatric intensive care units regarding center-specific immediate postoperative management of pediatric kidney transplantation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29144275/the-effect-of-level-of-care-on-gastroschisis-outcomes
#4
Jordan C Apfeld, Zachary J Kastenberg, Karl G Sylvester, Henry C Lee
OBJECTIVE: To examine the relationship between level of care in neonatal intensive care units (NICUs) and outcomes for newborns with gastroschisis. STUDY DESIGN: A retrospective cohort study was conducted at 130 California Perinatal Quality Care Collaborative NICUs from 2008 to 2014. All gastroschisis births were examined according to American Academy of Pediatrics NICU level of care at the birth hospital. Multivariate analyses examined odds of mortality, duration of mechanical ventilation, and duration of stay...
November 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29142377/serum-vitamin-d-status-and-outcome-in-critically-ill-children
#5
Nazik Aşılıoğlu, Halit Çiǧdem, Muhammed Sükrü Paksu
Background: Vitamin D is a pleiotropic hormone essential for optimal health. Critical illness in children is a major cause of significant health-care utilization and mortality around the world. The association of Vitamin D deficiency (VDD) in critically ill adults has been well-studied, in comparison, the importance of Vitamin D in pediatric critical illness has been much less studied. Aim and Objectives: This study aimed to assess Vitamin D status and its determinants in patients admitted to a pediatric intensive care unit (PICU) in North of Turkey...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29138363/primary-care-interventions-for-early-childhood-development-a-systematic-review
#6
REVIEW
Elizabeth Peacock-Chambers, Kathryn Ivy, Megan Bair-Merritt
CONTEXT: The pediatric primary care setting offers a platform to promote positive parenting behaviors and the optimal development of young children. Many new interventions have been developed and tested in this setting over the past 2 decades. OBJECTIVE: To summarize the recent published evidence regarding the impact of primary care-based interventions on parenting behaviors and child development outcomes; to provide recommendations for incorporation of effective interventions into pediatric clinics...
November 14, 2017: Pediatrics
https://www.readbyqxmd.com/read/29128553/pediatric-hematopoietic-cell-transplant-patients-who-survive-critical-illness-frequently-have-significant-but-recoverable-decline-in-functional-status
#7
M S Zinter, R Holubkov, M A Steurer, C C Dvorak, C N Duncan, A Sapru, R F Tamburro, P S McQuillen, M M Pollack
BACKGROUND: The number of pediatric hematopoietic cell transplant (HCT) patients who survive pediatric intensive care unit (PICU) admission is increasing, yet little is known about their functional morbidity after PICU discharge. We hypothesized that relative to controls, pediatric HCT patients who survive PICU admission would have greater rates of new functional morbidity at the time of PICU discharge, and only a minority of these patients would return to their functional baseline by the end of the hospitalization...
November 8, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29126550/trends-in-pediatric-adjusted-shock-index-predict-morbidity-and-mortality-in-children-with-severe-blunt-injuries
#8
Robert J Vandewalle, Julia K Peceny, Scott C Dolejs, Jodi L Raymond, Thomas M Rouse
PURPOSE: The utility of measuring the pediatric adjusted shock index (SIPA) at admission for predicting severity of blunt injury in pediatric patients has been previously reported. However, the utility of following SIPA after admission is not well described. METHODS: The trauma registry from a level-one pediatric trauma center was queried from January 1, 2010 to December 31, 2015. Patients were included if they were between 4 and 16years old at the time of admission, sustained a blunt injury with an Injury Severity Score≥15, and were admitted less than 12h after their injury (n=286)...
October 14, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29124404/pediatric-patients-receiving-naloxone-within-48%C3%A2-h-of-anesthesia-a-case-control-study
#9
Vinay K Donempudi, Juraj Sprung, Toby N Weingarten
PURPOSE: Excessive narcotization in pediatric surgical patients has not been well characterized. This report describes the use of postoperative naloxone in pediatric patients. METHODS: Pediatric surgical patients from January 1, 2010, through June 30, 2016, who underwent general anesthesia and received naloxone within 48 h postoperatively were identified and matched 1:1 with controls by age, sex, and procedure. Cases and controls underwent retrospective chart review...
November 9, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/29121791/unexpected-survivors-children-with-life-limiting-conditions-of-uncertain-prognosis
#10
Savithri Nageswaran, Anna Hurst, Andrea Radulovic
OBJECTIVE: Prognostication of survival is difficult in children with life-limiting illnesses because of the rarity of these conditions and technological advances improving survival. The objective of this article is to describe the characteristics of children with life-limiting illnesses who survived longer than the expectations of health-care providers. STUDY DESIGN: This is a retrospective cohort study conducted in a tertiary-care children's hospital in North Carolina...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29117819/role-of-ultrasound-in-confirmation-of-endotracheal-tube-in-neonates-a-review
#11
Deepak Sharma, Seyyed Ahmad Tabatabaii, Nazanin Farahbakhsh
Tracheal intubation is a commonly done procedure in neonatal intensive care unit and delivery room during resuscitation. The confirmation of endotracheal tube (ETT) position should be done quickly as tube malposition is associated with various serious adverse outcomes like hypoxemia, right upper lobe collapse, atelectasis, air leak syndromes and esophageal intubation. ETT position can be confirmed by various methods like clinical sign, chest radiography, capnography, external digital tracheal palpation, ultrasonography (USG), respiratory function monitor, video-laryngoscope and fiberoptic devices...
November 8, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29113508/outcomes-of-children-with-critical-bronchiolitis-living-in-poor-communities
#12
Katherine N Slain, Steven L Shein, Anne G Stormorken, Meredith C G Broberg, Alexandre T Rotta
There are established associations between adverse health outcomes and poverty, but little is known regarding these associations in critically ill children. We hypothesized that living in poorer communities would be associated with unfavorable outcomes in children with critical bronchiolitis. This retrospective study included children with bronchiolitis admitted to a pediatric intensive care unit (PICU) over a 2-year period. Median household income was estimated from patient ZIP codes and 2014 US Census Bureau data...
November 1, 2017: Clinical Pediatrics
https://www.readbyqxmd.com/read/29108845/validation-of-the-age-adjusted-shock-index-using-pediatric-trauma-quality-improvement-program-data
#13
Andrew Nordin, Alan Coleman, Junxin Shi, Krista Wheeler, Henry Xiang, Shannon Acker, Denis Bensard, Brian Kenney
PURPOSE: In adults, shock index (SI; heart rate/systolic blood pressure) >0.9 predicts injury severity and trauma outcomes. However, age-adjusted shock index (SIPA) out-performs SI in blunt trauma patients 4-16years old. We sought to confirm these findings and expand this tool to include penetrating trauma and children aged 1-4years. METHODS: We developed cutoff values for patients 1-3years old using age-based vital signs and queried the 2014 Pediatric Trauma Quality Improvement Program (TQIP) database for patients aged 1-16years sustaining blunt or penetrating trauma...
October 12, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29105103/development-of-a-pediatric-cardiac-mechanical-support-program
#14
Abhishek Kashyap, Joseph W Turek, Samantha J Wagner, Laura Felderman, Elizabeth A Jaggers, Peter J Gruber, R Erik Edens
The development of a pediatric cardiac support program is a complex, multidisciplinary project. This study describes the University of Iowa Congenital Heart Program's experience from its inception to the present. In, we examine those specific factors that have led to substantial improvements in the program, additionally identifying where further gains can be made. We retrospectively reviewed all pediatric patients who received mechanical cardiac support at the University of Iowa from the inception of the program in 1991...
November 3, 2017: Artificial Organs
https://www.readbyqxmd.com/read/29104480/heart-failure-and-mortality-of-adult-survivors-from-acute-myocarditis-requiring-intensive-care-treatment-a-nationwide-cohort-study
#15
Jung-Jung Chang, Ming-Shyan Lin, Tien-Hsing Chen, Dong-Yi Chen, Shao-Wei Chen, Jen-Te Hsu, Po-Chang Wang, Yu-Sheng Lin
Background The correlation between severity and long-term outcomes of pediatric myocarditis have been reported, however this correlation in adults has rarely been studied. Materials and Methods This nationwide population-based cohort study used data from the National Health Insurance Research Database in Taiwan. Patients aged < 75 and > 18 years admitted to an intensive care unit due to acute myocarditis were enrolled and divided into three groups according to mechanical circulatory support (MCS) after excluding major comorbidities...
2017: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/29097134/clinical-course-and-long-term-outcome-in-children-with-alteration-of-consciousness-underwent-continuous-eeg-monitoring-a-prospective-observational-study-in-thailand
#16
Thitiporn Fangsaad, Siriluk Assawabumrungkul, Anannit Visudtibhan
The study aims to explore the clinical course and long-term outcome in children with altered consciousness who underwent cEEG monitoring. A prospective observational study was conducted in neonatal and pediatric intensive care units from 1 September 2014 through 31 March 2017. Standard 10-20 cEEG monitoring was applied. Twenty children were included in this study. Their ages ranged from 1 day to 142.7 months (median age 40.6 months). Continuous EEG was commenced from 5 h to 5 days after the onset of alteration of consciousness (median 40...
October 30, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29092664/the-perspective-of-the-intensivist-on-inotropes-and-postoperative-care-following-pediatric-heart-surgery-an-international-survey-and-systematic-review-of-the-literature
#17
Peter P Roeleveld, J C A de Klerk
INTRODUCTION: Inotropes are frequently being used in children undergoing heart surgery to prevent or treat low cardiac output syndrome (LCOS). There is only limited evidence that inotropes actually positively influence postoperative outcome. Our aim was to describe the current international practice variation in the use of inotropes following congenital heart surgery. METHODS: We developed an online survey regarding the postoperative use of inotropes. We sent an invitation to all 197 registered members of the Pediatric Cardiac Intensive Care Society (PCICS) to participate in the survey...
January 1, 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29067568/anemia-at-pediatric-intensive-care-unit-discharge-prevalence-and-risk-markers
#18
Pierre Demaret, Oliver Karam, Marisa Tucci, Jacques Lacroix, Hélène Behal, Alain Duhamel, Frédéric Lebrun, André Mulder, Stéphane Leteurtre
BACKGROUND: Anemia is prevalent at pediatric intensive care unit (PICU) admission and incident during PICU stay, but little is known about anemia at PICU discharge . Anemia after critical illness is an important issue because it could impact post-PICU outcome. We aimed to estimate the prevalence of anemia at PICU discharge and to determine its risk markers. METHODS: This is an ancillary study of a prospective observational study on transfusion practices conducted in the PICU of a tertiary care children's hospital...
October 24, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29055711/comparison-of-del-nido-and-st-thomas-cardioplegia-solutions-in-pediatric-patients-a-prospective-randomized-clinical-trial
#19
Sachin Talwar, Amolkumar Bhoje, Vishnubhatla Sreenivas, Neeti Makhija, Sudheer Aarav, Shiv Kumar Choudhary, Balram Airan
We conducted a prospective randomized trial to compare del Nido (DN) cardioplegia with conventional cold blood cardioplegia (St Thomas [STH]) in pediatric patients. We randomized 100 pediatric patients aged ≤12 years undergoing elective repair of ventricular septal defects and tetralogy of Fallot to the DN and the STH groups. In the DN group, a 20 mL/kg single dose was administered. In the STH group, a 30 mL/kg dose was administered, followed by repeated doses at 25- to 30-minute intervals. The primary outcome was cardiac index that was measured 4 times intra- and postoperatively...
September 1, 2017: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29049043/challenges-of-healthcare-administration-optimizing-quality-and-value-at-an-affordable-cost-in-pediatric-cardiology
#20
Mitchell I Cohen, Patricio A Frias
PURPOSE OF REVIEW: The purpose of this review is to explore the paradigm shift in healthcare delivery that will need to take place over the next few years away from an emphasis on supply-driven health care to better quality transparent-driven health care whose focus is on the consumer's best interest. RECENT FINDINGS: The current healthcare system is fragmented and costs continue to rise. The best way to contain costs is to improve quality to the consumer, the patient...
October 18, 2017: Current Opinion in Cardiology
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