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Pediatric cardiac risk assessment

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https://www.readbyqxmd.com/read/29239978/picu-length-of-stay-factors-associated-with-bed-utilization-and-development-of-a-benchmarking-model
#1
Murray M Pollack, Richard Holubkov, Ron Reeder, J Michael Dean, Kathleen L Meert, Robert A Berg, Christopher J L Newth, John T Berger, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, Tammara L Jenkins, Robert Tamburro
OBJECTIVES: ICU length of stay is an important measure of resource use and economic performance. Our primary aims were to characterize the utilization of PICU beds and to develop a new model for PICU length of stay. DESIGN: Prospective cohort. The main outcomes were factors associated with PICU length of stay and the performance of a regression model for length of stay. SETTING: Eight PICUs. PATIENTS: Randomly selected patients (newborn to 18 yr) from eight PICUs were enrolled from December 4, 2011, to April 7, 2013...
December 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29222881/development-and-validation-of-a-pediatric-nutritional-screening-score-pnss-for-hospitalized-children
#2
Lina Lu, Xiaomeng Mao, Jinye Sheng, Jianhu Huang, Ying Wang, Qingya Tang, Wei Cai
BACKGROUND AND OBJECTIVES: There is no evidence on the most effective nutritional screening tool for hospitalized children. The objective of this study was to develop and validate a pediatric nutritional screening tool to assess undernutrition risk upon hospital admission. METHODS AND STUDY DESIGN: The study had a two-phase prospective observational design. A novel pediatric nutritional screening score (PNSS) was developed and sensitivity, specificity, and reliability were evaluated by comparing with a complete dietetic assessment...
2018: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29218262/neurologic-outcomes-following-care-in-the-pediatric-intensive-care-unit
#3
Sherrill D Caprarola, Sapna R Kudchadkar, Melania M Bembea
Purpose of review: With increasing survival of children requiring admission to pediatric intensive care units (PICU), neurodevelopmental outcomes of these patients are an area of increased attention. Our goal was to systematically review recently published literature on neurologic outcomes of PICU patients. Recent Findings: Decline in neurofunctional status occurs in 3%-20% of children requiring PICU care. This proportion varies based on primary diagnosis and severity of illness, with children admitted for primary neurologic diagnosis, children who suffer cardiac arrest or who require invasive interventions during the PICU admission, having worse outcomes...
September 2017: Current Treatment Options in Pediatrics
https://www.readbyqxmd.com/read/29207322/identification-of-a-vte-rich-population-in-pediatrics-critically-ill-children-with-central-venous-catheters
#4
Minh Tran, Steven L Shein, Xinge Ji, Sanjay P Ahuja
BACKGROUND: The incidence of venous thromboembolism (VTE) is rising among inpatients in US hospitals, especially among kids with central venous catheters (CVCs) in the pediatric intensive care unit (PICU). OBJECTIVES: To identify a sub-group of "VTE-rich" population among PICU children, and to assess the effect of VTE on morbidity and mortality. METHODS: Data was extracted from a multicenter Virtual PICU Database, or VPS, for children with a CVC and presence of a VTE...
November 22, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29167745/the-use-of-smartphones-to-influence-lifestyle-changes-in-overweight-and-obese-youth-with-congenital-heart-disease-a-single-arm-study-pilot-and-feasibility-study-protocol-smart-heart-trial
#5
Meghan Rombeek, Stefanie De Jesus, Luis Altamirano-Diaz, Eva Welisch, Harry Prapavessis, Jamie A Seabrook, Kambiz Norozi
Background: Both obesity and congenital heart disease (CHD) are risk factors for the long-term cardiovascular health of children and adolescents. The addition of smart mobile technology to conventional lifestyle counseling for weight management offers great potential to appeal to technologically literate youth and can address a large geographical area with minimal burden to participants. This pilot study seeks to examine the influence of a 1-year lifestyle intervention on nutrition and physical activity-related health outcomes in overweight or obese children and adolescents with CHD...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29135751/perceptions-experiences-and-preferences-of-patients-receiving-a-clinician-s-touch-during-intimate-care-and-procedures-a-qualitative-systematic-review
#6
Chad O'Lynn, Adam Cooper, Lisa Blackwell
BACKGROUND: Clinical practice frequently involves the practitioner touching patients' bodies in areas that are highly personal. If inappropriately performed, such intimate touch may result in much anxiety, confusion and misinterpretation. Examination of evidence is necessary to guide practice in this area to mitigate risks and foster optimal clinician-patient relations and care. OBJECTIVES: The objective of this qualitative systematic review was to identify and synthesize findings on the perceptions, experiences and preferences of patients receiving a clinician's touch during intimate care and procedures INCLUSION CRITERIA TYPES OF PARTICIPANTS: The current review considered studies that included patients who had received a clinician's touch during intimate care and procedures...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29132262/diastolic-dysfunction-is-common-in-survivors-of-pediatric-differentiated-thyroid-carcinoma
#7
Mariëlle Sanne Klein Hesselink, Gianni Bocca, Yoran M Hummel, Adrienne H Brouwers, Johannes G M Burgerhof, Eveline W C M van Dam, Jourik A Gietema, Bas Havekes, Marry M van den Heuvel-Eibrink, Eleonora P M Corssmit, Leontien Kremer, Romana Netea-Maier, Helena J H van der Pal, Robin Peeters, John Th M Plukker, Cécile M Ronckers, Hanneke M van Santen, Peter van der Meer, Thera P Links, Wim J E Tissing
INTRODUCTION: Whether pediatric patients with differentiated thyroid carcinoma (DTC) are at risk of developing treatment-related adverse effects on cardiac function is unknown. We therefore studied in long-term survivors of pediatric DTC the prevalence of cardiac dysfunction and atrial fibrillation (AF) in relation to treatment variables, and the association between cardiac dysfunction and plasma biomarkers. PATIENTS AND METHODS: In this nationwide prospective multicenter study, cardiac assessments were performed in 66 adult survivors of pediatric DTC (age at diagnosis ≤18 years and follow-up ≥5 years after diagnosis) treated in The Netherlands between 1970 and 2009...
November 13, 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/29082218/evaluation-of-radiation-exposure-pattern-and-radiation-absorbed-dose-resulting-from-occupational-exposure-of-anesthesiologists-to-ionizing-radiation
#8
B Maghsoudi, S M J Mortazavi, S Khademi, P Vatankhah
INTRODUCTION: Little information is available concerning the radiation exposure of anesthesiologists, and no such data have previously been collected in Iran. This prospective study was performed to determine the amount of radiation exposure of anesthesiologists for the purpose of assessing whether or not dangerous levels of radiation exposures were being reached, and to identify factors that correlate with excessive risk. PARTICIPANTS AND METHODS: The radiation exposure of all anesthesiology residents and the attending of Shiraz University of Medical Sciences during a 3-month period (from June to August 2016) was measured using a film badge with monthly readings...
September 2017: Journal of Biomedical Physics & Engineering
https://www.readbyqxmd.com/read/29076929/delirium-in-the-pediatric-cardiac-extracorporeal-membrane-oxygenation-patient-population-a-case-series
#9
Anita K Patel, Katherine V Biagas, Eunice C Clark, Chani Traube
OBJECTIVE: To determine the prevalence of delirium in children who require extracorporeal membrane oxygenation. DESIGN: Prospective observational longitudinal cohort study. SETTING: Urban academic cardiothoracic ICU. PATIENTS: All consecutive admissions to the cardiothoracic ICU who required venoarterial extracorporeal membrane oxygenation support. INTERVENTIONS: Daily delirium screening with the Cornell Assessment for Pediatric Delirium...
October 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29053178/utility-of-genetics-for-risk-stratification-in-pediatric-hypertrophic-cardiomyopathy
#10
J Mathew, L Zahavich, M Lafreniere-Roula, J Wilson, K George, L Benson, S Bowdin, S Mital
Children with hypertrophic cardiomyopathy (HCM) experience sudden cardiac death (SCD) and other life-threatening events. We assessed if affected gene and variant burden predict outcomes. Patients <18 years old with primary HCM with a pathogenic variant or variant of uncertain significance in cardiomyopathy genes were included. Association of gene and variant number and type with freedom from major adverse cardiac events (MACE) i.e. ICD insertion, myectomy, aborted SCD, transplantation or death, was assessed by Cox regression...
October 20, 2017: Clinical Genetics
https://www.readbyqxmd.com/read/29024698/pediatric-clif-sofa-score-is-the-best-predictor-of-28-day-mortality-in-children-with-decompensated-chronic-liver-disease
#11
Rishi Bolia, Anshu Srivastava, Surender Kumar Yachha, Ujjal Poddar
BACKGROUND & AIMS: Early identification of children with decompensated chronic liver disease (DCLD) at risk of short-term mortality helps improve outcome. We aimed to evaluate the predictors of outcome and role of Child-Pugh, pediatric end-stage liver disease (PELD) and pediatric chronic liver failure sequential organ failure assessment (pCLIF-SOFA) score for prognosticating 28-day mortality in children with DCLD. METHODS: DCLD children were prospectively evaluated with a clinico-laboratory proforma and followed for 28 days to determine outcome...
October 10, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28968807/chymase-is-a-predictive-biomarker-of-dengue-hemorrhagic-fever-in-pediatric-and-adult-patients
#12
Hasitha Tissera, Abhay P S Rathore, Wei Yee Leong, Brian L Pike, Tyler E Warkentien, Farouk S Farouk, Ayesa Syenina, Eng Eong Ooi, Duane J Gubler, Annelies Wilder-Smith, Ashley L St John
Background: Most dengue patients experience mild disease, dengue fever (DF), while few develop life-threatening severe disease, or dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). No laboratory tests predict DHF/DSS. We evaluated whether serum chymase can predict DHF/DSS in adult and pediatric patients and the influence of pre-existing conditions (PECs) on chymase levels. Methods: Serum chymase levels were measured in patients presenting with undifferentiated fever to hospitals in Colombo District, Sri Lanka...
August 25, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28922191/acr-spr-str-practice-parameter-for-the-performance-of-cardiac-positron-emission-tomography-computed-tomography-pet-ct-imaging
#13
Rathan M Subramaniam, Warren R Janowitz, Geoffrey B Johnson, Martin A Lodge, Marguerite T Parisi, Mark R Ferguson, Jeffrey C Hellinger, Gregory W Gladish, Narainder K Gupta
This clinical practice parameter has been developed collaboratively by the American College of Radiology (ACR), the Society for Pediatric Radiology (SPR), and the Society of Thoracic Radiology (STR). This document is intended to act as a guide for physicians performing and interpreting positron emission tomography-computed tomography (PET/CT) of cardiac diseases in adults and children. The primary value of cardiac PET/CT imaging include evaluation of perfusion, function, viability, inflammation, anatomy, and risk stratification for cardiac-related events such as myocardial infarction and death...
September 15, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28894592/changes-in-delta-adc-reflect-intracranial-pressure-changes-in-craniosynostosis
#14
Yuko Takahashi, Masaaki Hori, Kazuaki Shimoji, Masakazu Miyajima, Osamu Akiyama, Hajime Arai, Shigeki Aoki
BACKGROUND: In patients with craniosynostosis, intracranial pressure (ICP) has been reported to increase even in the absence of overt symptoms. The early and non-invasive detection of intracranial hypertension is important for reducing the risk of abnormal brain development in pediatric patients. PURPOSE: To assess whether the apparent diffusion coefficient (ADC) of white matter during the cardiac cycle (ΔADC) would change after surgery to relieve ICP in children with craniosynostosis...
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28874164/radiation-free-cmr-diagnostic-heart-catheterization-in-children
#15
Kanishka Ratnayaka, Joshua P Kanter, Anthony Z Faranesh, Elena K Grant, Laura J Olivieri, Russell R Cross, Ileen F Cronin, Karin S Hamann, Adrienne E Campbell-Washburn, Kendall J O'Brien, Toby Rogers, Michael S Hansen, Robert J Lederman
BACKGROUND: Children with heart disease may require repeated X-Ray cardiac catheterization procedures, are more radiosensitive, and more likely to survive to experience oncologic risks of medical radiation. Cardiovascular magnetic resonance (CMR) is radiation-free and offers information about structure, function, and perfusion but not hemodynamics. We intend to perform complete radiation-free diagnostic right heart catheterization entirely using CMR fluoroscopy guidance in an unselected cohort of pediatric patients; we report the feasibility and safety...
September 6, 2017: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/28874075/congenital-heart-disease-a-primer-for-the-pediatric-neuropsychologist
#16
Adam R Cassidy, Dawn Ilardi, Susan R Bowen, Lyla E Hampton, Kimberley P Heinrich, Michelle M Loman, Jacqueline H Sanz, Kelly R Wolfe
Congenital heart disease (CHD) affects millions of people worldwide, including over one million children in the United States. Approximately 25% of children born with CHD require intensive surgical intervention within the first year of life. Despite improved rates of survival into adulthood - rates that exceed 90% in the modern era - children and adolescents with CHD remain at risk for neurological injury and a range of neurobehavioral and psychosocial challenges that pose a threat to quality of life across the lifespan...
September 6, 2017: Child Neuropsychology: a Journal on Normal and Abnormal Development in Childhood and Adolescence
https://www.readbyqxmd.com/read/28830854/a-mobile-device-app-to-reduce-medication-errors-and-time-to-drug-delivery-during-pediatric-cardiopulmonary-resuscitation-study-protocol-of-a-multicenter-randomized-controlled-crossover-trial
#17
Johan N Siebert, Frederic Ehrler, Christian Lovis, Christophe Combescure, Kevin Haddad, Alain Gervaix, Sergio Manzano
BACKGROUND: During pediatric cardiopulmonary resuscitation (CPR), vasoactive drug preparation for continuous infusions is complex and time-consuming. The need for individual specific weight-based drug dose calculation and preparation places children at higher risk than adults for medication errors. Following an evidence-based and ergonomic driven approach, we developed a mobile device app called Pediatric Accurate Medication in Emergency Situations (PedAMINES), intended to guide caregivers step-by-step from preparation to delivery of drugs requiring continuous infusion...
August 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28818338/spinal-anesthesia-for-pediatric-urological-surgery-reducing-the-theoretic-neurotoxic-effects-of-general-anesthesia
#18
Emmett E Whitaker, Brianne Z Wiemann, Daniel G DaJusta, Seth A Alpert, Christina B Ching, Daryl J McLeod, Joseph D Tobias, Venkata R Jayanthi
BACKGROUND: Spinal anesthesia (SA) is an effective technique that has been used in children for years. With growing concern with regard to the risks of general anesthesia (GA), we developed a SA program to provide an alternative option. We present our initial experience with this program. OBJECTIVE: To implement a SA program at a large tertiary care pediatric center and assess the safety and efficacy of the technique as an alternative to GA for urologic surgery...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28795324/the-fgf23-klotho-axis-and-cardiac-tissue-doppler-imaging-in-pediatric-chronic-kidney-disease-a-prospective-cohort-study
#19
Ylva Tranæus Lindblad, Hannes Olauson, Georgios Vavilis, Ulf Hammar, Maria Herthelius, Jonas Axelsson, Peter Bárány
BACKGROUND: Chronic kidney disease-associated mineral bone disorder (CKD-MBD) is common in pediatric kidney disease patients and a risk factor for future cardiovascular disease (CVD). Fibroblast growth factor-23 (FGF23) and Klotho are novel key players in CKD-MBD, and has been suggested to be involved in the development of CVD. METHODS: This prospective cohort study included 74 pediatric patients; 31 with CKD (age range 0.8-18.8 years, glomerular filtration rate (GFR) range 9-68 mL/min/1...
August 9, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28762646/predicting-unplanned-readmissions-to-a-pediatric-cardiac-intensive-care-unit-using-predischarge-pediatric-early-warning-scores
#20
Ashley R Kroeger, Jacqueline Morrison, Andrew H Smith
OBJECTIVE: Unplanned readmission to the pediatric cardiac intensive care unit (CICU) is associated with significant morbidity and mortality. The Pediatric Early Warning Score (PEWS) predicts ward patients at risk for decompensation but has not been previously reported to identify at-risk patients with cardiac disease prior to ward transfer. This study aimed to determine whether PEWS prior to transfer may serve as a predictor of unplanned readmission to the CICU. DESIGN: All patients discharged from a tertiary children's hospital CICU from September 2012 through August 2015 were included for analysis...
August 1, 2017: Congenital Heart Disease
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