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Pediatric intensive care outcomes

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28538057/an-airway-risk-assessment-score-for-unplanned-extubation-in-intensive-care-pediatric-patients
#4
Atul Vats, Clara Hopkins, Kelly M Hatfield, Jia Yan, Robert Palmer, Pinar Keskinocak
OBJECTIVE: As a result of a workshop to identify common causes of unplanned extubation, Children's Healthcare of Atlanta developed a scoring tool (Risk Assessment Score) to stratify patients into groups of low, moderate, high, and extreme risk. This tool could be used to institute appropriate monitoring or interventions for patients with high risks of unplanned extubation to enhance safety. The objective of this study is to test the hypothesis that the Risk Assessment Score will correlate with the occurrence rate of unplanned extubation in pediatric patients...
May 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28533916/pediatric-intensive-care-stress-ulcer-prevention-pic-up-a-protocol-for-a-pilot-randomized-trial
#5
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Nikhil Pai, Lehana Thabane, Deborah J Cook
BACKGROUND: Despite sparse pediatric data on effectiveness, the majority of critically ill children receive medications to prevent gastrointestinal (GI) bleeding. Stress ulcer prophylaxis may have unintended consequences-increasing the risk of nosocomial infections-which may be more serious and common than the bleeding which these drugs are prescribed to prevent. Randomized controlled trials (RCTs) in pediatric critical care are exceptionally challenging to complete, thus a rigorous pilot RCT is crucial...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28529914/characteristics-of-postintensive-care-syndrome-in-survivors-of-pediatric-critical-illness-a-systematic-review
#6
Elizabeth A Herrup, Beth Wieczorek, Sapna R Kudchadkar
AIM: To synthesize the available evidence focusing on morbidities in pediatric survivors of critical illness that fall within the defined construct of postintensive care syndrome (PICS) in adults, including physical, neurocognitive and psychological morbidities. METHODS: A comprehensive search was conducted in MEDLINE, EMBASE, the Cochrane Library, PsycINFO, and CINAHL using controlled vocabulary and key word terms to identify studies reporting characteristics of PICS in pediatric intensive care unit (PICU) patients...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28496382/elements-of-family-centered-care-in-the-pediatric-intensive-care-unit-an-integrative-review
#7
Claire A Richards, Helene Starks, M Rebecca O'Connor, Ardith Z Doorenbos
This paper reports result from a systematic search and thematic analysis of qualitative literature to identify key issues related to family-centered care, behaviors, and communication skills that support the parental role and improve patient and family outcomes in the PICU. Five themes were identified: 1) sharing information; 2) hearing parental voices; 3) making decisions for or with parents; 4) negotiating roles; and 5) individualizing communication. These themes highlight several gaps between how parents want to be involved and perceive clinicians engage them in the care of their child...
June 2017: Journal of Hospice and Palliative Nursing: JHPN
https://www.readbyqxmd.com/read/28493595/empathy-in-pediatric-intensive-care-nurses-part-1-behavioral-and-psychological-correlates
#8
Margot Latimer, Philip L Jackson, Fanny Eugène, Emily Macleod, Tara Hatfield, Etienne Vachon-Presseau, Pierre-Emmanuel Michon, Kenneth M Prkachin
AIM: To determine if differences exist between pediatric intensive care nurses and allied health professionals in empathy, secondary trauma, burnout, pain exposure and pain ratings of self and others. Early and late career differences were also examined. BACKGROUND: Nurses are routinely exposed to patient pain expression. This work context may make them vulnerable to adverse outcomes such as desensitization to patient pain or a compromise in personal wellbeing. DESIGN: Cross-sectional study...
May 11, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28492405/a-case-control-analysis-of-postoperative-fluid-balance-and-mortality-after-pediatric-cardiac-surgery
#9
Meth R Delpachitra, Siva P Namachivayam, Johnny Millar, Carmel Delzoppo, Warwick W Butt
OBJECTIVES: A positive fluid balance after cardiac surgery may be associated with poor outcomes; however, previous studies looking at this association have been limited by the number of deaths in the study population. Our primary aim was to determine the relationship between postoperative cumulative fluid balance and mortality in cardiac surgical patients. Secondary aims were to study the association between fluid balance and duration of mechanical ventilation, intensive care and hospital length of stay...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28490231/energy-and-protein-delivery-in-overweight-and-obese-children-in-the-pediatric-intensive-care-unit
#10
Enid E Martinez, Katelyn A Ariagno, Nicole Stenquist, Daniela Anderson, Eliana Muñoz, Nilesh M Mehta
BACKGROUND: Early and optimal energy and protein delivery have been associated with improved clinical outcomes in the pediatric intensive care unit (PICU). Overweight and obese children in the PICU may be at risk for suboptimal macronutrient delivery; we aimed to describe macronutrient delivery in this cohort. METHODS: We performed a retrospective study of PICU patients ages 2-21 years, with body mass index (BMI) ≥85th percentile and >48 hours stay. Nutrition variables were extracted regarding nutrition screening and assessment, energy and protein prescription, and delivery...
October 1, 2016: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28486647/clinical-and-economic-long-term-treatment-outcome-of-children-and-adolescents-with-disabling-chronic-pain
#11
Boris Zernikow, Ann-Kristin Ruhe, Lorin Stahlschmidt, Pia Schmidt, Tobias Staratzke, Michael Frosch, Julia Wager
Objective.:  Disabling pediatric chronic pain is accompanied by a significant burden to those affected and by high societal costs. Furthermore, it bears the risk of aggravation into adulthood. Studies have shown intensive interdisciplinary pain treatment to result in short-term positive effects on pain-related and psychological outcomes. In this study, we aimed to prove the stability of the long-term effects of intensive interdisciplinary pain treatment four years after treatment. Methods...
May 9, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28483249/effect-of-gentamicin-and-levels-of-ambient-sound-on-hearing-screening-outcomes-in-the-neonatal-intensive-care-unit-a-pilot-study
#12
Angela C Garinis, Selena Liao, Campbell P Cross, Johnathan Galati, Jessica L Middaugh, Jess C Mace, Anna-Marie Wood, Lindsey McEvoy, Lauren Moneta, Troy Lubianski, Noe Coopersmith, Nicholas Vigo, Christopher Hart, Artur Riddle, Olivia Ettinger, Casey Nold, Heather Durham, Carol MacArthur, Cynthia McEvoy, Peter S Steyger
OBJECTIVE: Hearing loss rates in infants admitted to neonatal intensive care units (NICU) run at 2-15%, compared to 0.3% in full-term births. The etiology of this difference remains poorly understood. We examined whether the level of ambient sound and/or cumulative gentamicin (an aminoglycoside) exposure affect NICU hearing screening results, as either exposure can cause acquired, permanent hearing loss. We hypothesized that higher levels of ambient sound in the NICU, and/or gentamicin dosing, increase the risk of referral on the distortion product otoacoustic emission (DPOAE) assessments and/or automated auditory brainstem response (AABR) screens...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28483222/endoscopic-management-of-bilateral-vocal-fold-paralysis-in-newborns-and-infants
#13
Sahba Sedaghat, Mario Tapia, Felipe Fredes, Pablo Rojas
INTRODUCTION: Bilateral vocal cord paralysis in adducted position (BVCPAd) is a severe cause of airway obstruction and usually debuts with stridor and airway distress necessitating immediate intervention. Tracheostomy has long been the gold standard for treating this condition, but has significant associated morbidity and mortality in pediatric patients. New conservative procedures have emerged to treat this condition thus avoiding tracheostomy, like endoscopic anterior and posterior cricoid split (EAPCS)...
June 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28469535/association-between-deep-sedation-from-continuous-intravenous-sedatives-and-extubation-failures-in-mechanically-ventilated-patients-in-the-pediatric-intensive-care-unit
#14
Jennifer M Schultheis, Travis S Heath, David A Turner
OBJECTIVE: The primary objective of this study was to determine whether an association exists between deep sedation from continuous infusion sedatives and extubation failures in mechanically ventilated children. Secondary outcomes evaluated risk factors associated with deep sedation. METHODS: This was a retrospective cohort study conducted between January 1, 2009, and October 31, 2012, in the pediatric intensive care unit (PICU) at Duke Children's Hospital. Patients were included in the study if they had been admitted to the PICU, had been mechanically ventilated for ≥48 hours, and had received at least one continuous infusion benzodiazepine and/or opioid infusion for ≥24 hours...
March 2017: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/28461547/use-of-electromagnetic-device-to-insert-postpyloric-feeding-tubes-in-a-pediatric-intensive-care-unit
#15
Ann-Marie Brown, Christine Perebzak, Colleen Handwork, M David Gothard, Kristine Nagy
BACKGROUND: The preferred route for providing nutrition in the pediatric intensive care unit is enteral. Placement of postpyloric feeding tubes using an electromagnetic-tipped stylet that emits a signal detected by a device held over the patient's abdomen is effective in adult intensive care units, but has not been well studied in pediatric units. OBJECTIVES: To determine the effectiveness of the electromagnetic device in reducing the numbers of radiation exposures, intrahospital transports, tubes used, and tube placement attempts in the pediatric intensive care unit...
May 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28461212/risk-factors-and-outcomes-related-to-pediatric-intensive-care-unit-admission-after-hematopoietic-stem-cell-transplantation-a-single-centre-experience
#16
Marta Pillon, Angela Amigoni, Annaelena Contin, Manuela Cattelan, Elisa Carraro, Emiliana Campagnano, Manuela Tumino, Elisabetta Calore, Antonio Marzollo, Chiara Mainardi, Maria Paola Boaro, Marta Nizzero, Andrea Pettenazzo, Giuseppe Basso, Chiara Messina
To describe incidence, causes and outcomes related to pediatric intensive care unit (PICU) admission for patients undergoing hematopoietic stem cell transplantation (HSCT). To investigate risk factors predisposing to PICU admission and prognostic factors in terms of patient survival. From October 1998 to April 2015, 496 children and young adults (0-23 years) underwent transplantation in the HSCT Unit. Among them, 70 (14.1%) were admitted to PICU. The 3-year cumulative incidence of PICU admission was 14.3%. The main causes of PICU admission were: respiratory failure (36%), multiple organ failure (16%) and septic shock (13%)...
April 28, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28460703/putting-the-family-back-in-the-center-a-teach-back-protocol-to-improve-communication-during-rounds-in-a-pediatric-intensive-care-unit
#17
REVIEW
Terri L Bogue, Lynn Mohr
Patient- and family-centered care is endorsed by leading health care organizations. To incorporate the family in interdisciplinary rounds in the pediatric intensive care unit, it is necessary to prepare the family to be an integral member of the child's health care team. When the family is part of the health care team, interdisciplinary rounds ensure that the family understands the process of interdisciplinary rounds and that it is an integral part of the discussion. An evidence-based protocol to provide understanding and support to families related to interdisciplinary rounds has significant impact on satisfaction, trust, and patient outcomes...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460702/unbundling-the-bundles-using-apparent-and-systemic-cause-analysis-to-prevent-health-care-associated-infection-in-pediatric-intensive-care-units
#18
REVIEW
Terri L Bogue, Robert L Bogue
Today's health care environment emphasizes patient outcomes, although financial incentives and penalties have placed a high priority on elimination of health care-associated infections (HAIs). The use of standardized care bundles is evidence-based; however, implementation of these bundles has not proven effective in eliminating HAIs. Actively learning from HAI events through the use of apparent and systemic cause analysis identifies new barriers to success and opportunities for improvement in further reducing HAIs...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460699/case-study-of-high-dose-ketamine-for-treatment-of-complex-regional-pain-syndrome-in-the-pediatric-intensive-care-unit
#19
REVIEW
Tracy Ann Pasek, Kelli Crowley, Catherine Campese, Rachel Lauer, Charles Yang
Complex regional pain syndrome (CRPS) is a life-altering and debilitating chronic pain condition. The authors are presenting a case study of a female who received high-dose ketamine for the management of her CRPS. The innovative treatment lies not only within the pharmacologic management of her pain, but also in the fact that she was the first patient to be admitted to our pediatric intensive care unit solely for pain control. The primary component of the pharmacotherapy treatment strategy plan was escalating-dose ketamine infusion via patient-controlled-analgesia approved by the pharmacy and therapeutics committee guided therapy for this patient...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28460120/post-neonatal-tetanus-in-a-picu-of-a-developing-economy-intensive-care-needs-outcome-and-predictors-of-mortality
#20
Suresh Kumar Angurana, Muralidharan Jayashree, Arun Bansal, Sunit Singhi, Karthi Nallasamy
Objectives: To evaluate pediatric intensive care unit (PICU) needs, outcome and predictors of mortality in post-neonatal tetanus. Materials and methods: Review of 30 consecutive post-neonatal tetanus cases aged 1 months to 12 years admitted to a PICU in north India over a period of 10 years (January 2006 to December 2015). Results: Chronic suppurative otitis media was the commonest portal of entry. All received tetanus toxoid, human tetanus immunoglobulin (HTIG) and appropriate antibiotics; 7 (23...
April 27, 2017: Journal of Tropical Pediatrics
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