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Pediatric impedance

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https://www.readbyqxmd.com/read/28808763/characteristics-of-gastroesophageal-reflux-in-pediatric-patients-with-neurological-impairment
#1
Hisayoshi Kawahara, Yuko Tazuke, Hideki Soh, Noriaki Usui, Hiroomi Okuyama
PURPOSE: To clarify the characteristics of gastroesophageal reflux (GER) in pediatric patients with neurological impairment (NI). METHODS: Twenty-six patients with NI, 1-17-year-old, fed via a nasogastric tube were categorized based on the absence (group I) or presence (group II) of abnormal GER, defined with multichannel intraluminal impedance-pH monitoring as %time with an esophageal pH <4.0 being ≥5.0% or number of liquid/mixed bolus reflux events(RE) >70 in 24 h...
August 14, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28759491/the-evaluation-of-a-noninvasive-respiratory-volume-monitor-in-pediatric-patients-undergoing-general-anesthesia
#2
Andrea D Gomez-Morad, Joseph P Cravero, Brian C Harvey, Rachel Bernier, Erin Halpin, Brian Walsh, Viviane G Nasr
BACKGROUND: Pediatric patients following surgery are at risk for respiratory compromise such as hypoventilation and hypoxemia depending on their age, comorbidities, and type of surgery. Quantitative measurement of ventilation in nonintubated infants/children is a difficult and inexact undertaking. Current respiratory assessment in nonintubated patients relies on oximetry data, respiratory rate (RR) monitors, and subjective clinical assessment, but there is no objective measure of respiratory parameters that could be utilized to predict early respiratory compromise...
July 27, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28730574/mechanical-ventilation-guided-by-electrical-impedance-tomography-in-pediatric-acute-respiratory-distress-syndrome
#3
Jeffrey Dmytrowich, Tanya Holt, Karen Schmid, Gregory Hansen
Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to assess regional tidal volumes in real time at the bedside. Here we report the utilization of thoracic electrical impedance tomography to guide daily PEEP settings and recruitment maneuvers in a child with pARDS...
July 20, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28711175/the-prevalence-of-rome-iv-nonerosive-esophageal-phenotypes-in-children
#4
Lisa B Mahoney, Samuel Nurko, Rachel Rosen
OBJECTIVES: To assess the prevalence of Rome IV nonerosive esophageal phenotypes in children using multichannel intraluminal impedance testing and to describe the rates of proton pump inhibitor (PPI) responsiveness and the frequency of microscopic esophagitis in these patients. STUDY DESIGN: We conducted a retrospective review of all children ≥5 years of age who underwent esophagogastroduodenoscopy and multichannel intraluminal impedance testing off PPI therapy for evaluation of typical gastroesophageal reflux symptoms...
July 12, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28696319/combined-epigenetic-and-differentiation-based-treatment-inhibits-neuroblastoma-tumor-growth-and-links-hif2%C3%AE-to-tumor-suppression
#5
Isabelle Westerlund, Yao Shi, Konstantinos Toskas, Stuart M Fell, Shuijie Li, Olga Surova, Erik Södersten, Per Kogner, Ulrika Nyman, Susanne Schlisio, Johan Holmberg
Neuroblastoma is a pediatric cancer characterized by variable outcomes ranging from spontaneous regression to life-threatening progression. High-risk neuroblastoma patients receive myeloablative chemotherapy with hematopoietic stem-cell transplant followed by adjuvant retinoid differentiation treatment. However, the overall survival remains low; hence, there is an urgent need for alternative therapeutic approaches. One feature of high-risk neuroblastoma is the high level of DNA methylation of putative tumor suppressors...
July 25, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28604757/time-to-lung-aeration-during-a-sustained-inflation-at-birth-is-influenced-by-gestation-in-lambs
#6
Karen E McCall, Andreas D Waldmann, Prue Pereira-Fantini, Regina Oakley, M Miedema, Elizabeth J Perkins, Peter G Davis, Peter A Dargaville, Stephan H Böhm, Raffaele Dellacà, Magdy Sourial, Emanuela Zannin, Anushi Rajapaksa, Andre Tan, Andy Adler, Inéz Frerichs, David G Tingay
BACKGROUND: Current sustained lung inflation (SI) approaches use uniform pressures and durations. We hypothesised that gestational age related mechanical and developmental differences would affect the time required to achieve optimal lung aeration, and resultant lung volumes, during SI delivery at birth in lambs. METHODS: 49 lambs, in five cohorts between 118d and 139d gestation (term 142d), received a standardised 40 cmH2O SI, delivered until 10 s after lung volume stability (optimal aeration) was visualised on real-time electrical impedance tomography (EIT), or to a maximum duration of 180 s...
June 12, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28604515/novel-pressure-impedance-parameters-for-evaluating-esophageal-function-in-pediatric-achalasia
#7
Maartje M J Singendonk, Taher I Omari, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, Rachel Rosen, Samuel Nurko
OBJECTIVE: In achalasia, absent peristalsis and reduced esophagogastric junction (EGJ) relaxation and compliance underlie dysphagia symptoms. Novel high-resolution impedance manometry (HRIM) variables, i.e. bolus presence time (BPT) and trans-EGJ-bolus flow time (BFT) have been developed to estimate the duration of EGJ opening and trans-EGJ bolus flow. The aim of this study was to evaluate esophageal motor function and bolus flow in children diagnosed with achalasia using these variables...
June 9, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28602463/air-displacement-plethysmography-versus-bioelectrical-impedance-to-determine-body-composition-in-pediatric-hemodialysis-patients
#8
Molly Wong Vega, Poyyapakkam R Srivaths
OBJECTIVE: Protein energy wasting is difficult to assess in pediatric hemodialysis (HD) populations because of fluid shifts. Body composition (BC) analysis aids in monitoring nutrition therapy's effects on fat and lean mass. Air displacement plethysmography (ADP) is a "practical" gold standard for fat mass (FM) measurements. We aim to compare BC measures in a pediatric HD population via anthropometry, ADP, and bioelectrical impedance (BIA). DESIGN: The study was prospective cohort study and the setting was 1 pediatric HD unit in Houston, Texas...
June 8, 2017: Journal of Renal Nutrition
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#9
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28553990/investigating-the-effects-of-cerebrospinal-fluid-removal-on-cerebral-blood-flow-and-oxidative-metabolism-in-infants-with-post-hemorrhagic-ventricular-dilatation
#10
Peter J McLachlan, Jessica Kishimoto, Mamadou Diop, Daniel Milej, David S C Lee, Sandrine de Ribaupierre, Keith St Lawrence
BackgroundPost-hemorrhagic ventricular dilatation (PHVD) is predictive of mortality and morbidity among very-low-birth-weight preterm infants. Impaired cerebral blood flow (CBF) due to elevated intracranial pressure (ICP) is believed to be a contributing factor.MethodsA hyperspectral near-infrared spectroscopy (NIRS) method of measuring CBF and the cerebral metabolic rate of oxygen (CMRO2) was used to investigate perfusion and metabolism changes in patients receiving a ventricular tap (VT) based on clinical management...
June 14, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28546376/noninvasive-monitoring-of-oxygen-and-ventilation
#11
Craig D Smallwood, Brian K Walsh
Noninvasive monitoring of oxygenation and ventilation is an essential part of pediatric respiratory care. Carbon dioxide, gas exchange monitoring, transcutaneous monitoring, near-infrared spectroscopy, pulse oximetry, and electrical impedance tomography are examined. Although some of these technologies have been utilized for decades, incorporation into mechanical ventilators and recently developed methods may provide important clinical insights in a broader patient range. Less mature technologies (electrical impedance tomography and near-infrared spectroscopy) have been of particular interest, since they offer easy bedside application and potential for improved care of children with respiratory failure and other disorders...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28542196/using-relative-handgrip-strength-to-identify-children-at-risk-of-sarcopenic-obesity
#12
Michal Steffl, Jan Chrudimsky, James J Tufano
Identifying children at risk of developing childhood sarcopenic obesity often requires specialized equipment and costly testing procedures, so cheaper and quicker methods would be advantageous, especially in field-based settings. The purpose of this study was to determine the relationships between the muscle-to-fat ratio (MFR) and relative handgrip strength, and to determine the ability of handgrip strength relative to body mass index (grip-to-BMI) to identify children who are at risk of developing sarcopenic obesity...
2017: PloS One
https://www.readbyqxmd.com/read/28509684/histone-complexed-dna-fragments-levels-are-associated-with-coagulopathy-endothelial-cell-damage-and-increased-mortality-after-severe-pediatric-trauma
#13
Robert T Russell, Sarah C Christiaans, Tate Nice, Morgan Banks, Vincent Mortellaro, Charity Morgan, Amy Duhachek-Stapelman, Steven J Lisco, Jeffrey D Kerby, Brant M Wagener, Mike K Chen, Jean-François Pittet
BACKGROUND: The release of damage-associated molecular pattern molecules (DAMPs) in the extracellular space secondary to injury has been shown to cause systemic activation of the coagulation system and endothelial cell damage. We hypothesized that pediatric trauma patients with increased levels of histone-complexed DNA fragments (hcDNA) would have evidence of coagulopathy and endothelial damage that would be associated with poor outcomes. METHODS: We conducted a prospective observational study of 149 pediatric trauma patients and 62 control patients at two level 1 pediatric trauma centers from 2013-2016...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28505989/pediatric-robotic-rehabilitation-current-knowledge-and-future-trends-in-treating-children-with-sensorimotor-impairments
#14
Konstantinos P Michmizos, Hermano Igo Krebs
BACKGROUND: Robot-aided sensorimotor therapy imposes highly repetitive tasks that can translate to substantial improvement when patients remain cognitively engaged into the clinical procedure, a goal that most children find hard to pursue. Knowing that the child's brain is much more plastic than an adult's, it is reasonable to expect that the clinical gains observed in the adult population during the last two decades would be followed up by even greater gains in children. Nonetheless, and despite the multitude of adult studies, in children we are just getting started: There is scarcity of pediatric robotic rehabilitation devices that are currently available and the number of clinical studies that employ them is also very limited...
2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28490158/endoscopic-endonasal-approach-for-suprasellar-lesions-in-children-complications-and-prevention
#15
REVIEW
Yong Hwy Kim, Kyu-Chang Wang, Ji Hoon Phi, Seung-Ki Kim
The endoscopic endonasal approach (EEA) has been popularized in adults and has been applied to an expanding range of surgical modules and indications in this population. However, its clinical application in pediatric neurosurgery has been impeded by the differences in anatomical features and the relatively low incidence of diseases to which it is applicable. In this review article, we mainly discuss the surgical indications, feasibility, and complications of EEA for suprasellar lesions in children based on a review of the literature, focusing especially on the age-related anatomical features of the nasal cavity, various pathologic entities, and the impact of EEA on long-term craniofacial growth...
May 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28464558/prescribing-for-children-with-rheumatologic-disease-perceived-treatment-approaches-between-pediatric-and-adult-rheumatologists
#16
Heather Van Mater, Stephen J Balevic, Gary L Freed, Sarah J Clark
OBJECTIVE: To compare practice patterns and prescribing differences for juvenile idiopathic arthritis (JIA) between adult and pediatric rheumatologists, the perceived educational needs, and factors that enhance or impede co-management. METHODS: Two parallel, cross sectional surveys focusing on JIA were administered in 2009 to a random sample of 193 pediatric rheumatologists (PR) and 500 adult rheumatologists (AR) using the American College of Rheumatology membership file...
May 2, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28448390/comparison-of-postoperative-respiratory-monitoring-by-acoustic-and-transthoracic-impedance-technologies-in-pediatric-patients-at-risk-of-respiratory-depression
#17
MULTICENTER STUDY
Mario Patino, Megan Kalin, Allison Griffin, Abu Minhajuddin, Lili Ding, Timothy Williams, Stacey Ishman, Mohamed Mahmoud, C Dean Kurth, Peter Szmuk
BACKGROUND: In children, postoperative respiratory rate (RR) monitoring by transthoracic impedance (TI), capnography, and manual counting has limitations. The rainbow acoustic monitor (RAM) measures continuous RR noninvasively by a different methodology. Our primary aim was to compare the degree of agreement and accuracy of RR measurements as determined by RAM and TI to that of manual counting. Secondary aims include tolerance and analysis of alarm events. METHODS: Sixty-two children (2-16 years old) were admitted after tonsillectomy or receiving postoperative patient/parental-controlled analgesia...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28415959/the-practices-and-meanings-of-care-for-nurses-working-on-a-pediatric-bone-marrow-transplant-unit
#18
Caroline F Morrison, Edith J Morris
Bone marrow transplant (BMT) units are stressful work environments with high staff burnout, anxiety, and turnover. A qualitative study was undertaken to better understand care for nurses within the context of their clinical practice on a pediatric BMT unit. Understanding care practices for BMT nurses will allow us to design interventions and provide appropriate support for this subspecialty of nurses. Focus groups were held with 24 nurses as key participants, and 2 focus groups with general participants: unit management (N = 2) and caregivers of inpatients (N = 7)...
May 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28398650/white-paper-on-the-study-of-birth-defects
#19
Mustafa K Khokha, Laura E Mitchell, John B Wallingford
Birth defects are the leading cause of infant death in the United States and among the top causes of pediatric death and hospitalization. Despite the devastating impact of birth defects, we understand little of their etiology impeding progress towards treatment and prevention. Moreover, while surgical interventions have improved survival for many children to beyond their first year, our inability to accurately predict, diagnose and treat the common sequelae of birth defects leaves the economic, social and public health burden of birth defects unacceptably high...
January 30, 2017: Birth defects research
https://www.readbyqxmd.com/read/28297072/operational-failures-detected-by-frontline-acute-care-nurses
#20
Kathleen R Stevens, Eileen P Engh, Heather Tubbs-Cooley, Deborah Marks Conley, Tammy Cupit, Ellen D'Errico, Pam DiNapoli, Joleen Lynn Fischer, Ruth Freed, Anne Marie Kotzer, Carolyn L Lindgren, Marie Ann Marino, Lisa Mestas, Jessica Perdue, Rebekah Powers, Patricia Radovich, Karen Rice, Linda P Riley, Peri Rosenfeld, Linda Roussel, Nancy A Ryan-Wenger, Linda Searle-Leach, Nicole M Shonka, Vicki L Smith, Laura Sweatt, Mary Townsend-Gervis, Ellen Wathen, Janice S Withycombe
Frontline nurses encounter operational failures (OFs), or breakdowns in system processes, that hinder care, erode quality, and threaten patient safety. Previous research has relied on external observers to identify OFs; nurses have been passive participants in the identification of system failures that impede their ability to deliver safe and effective care. To better understand frontline nurses' direct experiences with OFs in hospitals, we conducted a multi-site study within a national research network to describe the rate and categories of OFs detected by nurses as they provided direct patient care...
June 2017: Research in Nursing & Health
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