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Pediatric sepsis shock

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https://www.readbyqxmd.com/read/28072671/evaluation-of-the-association-of-early-elevated-lactate-with-outcomes-in-children-with-severe-sepsis-or-septic-shock
#1
Noelle Gorgis, Jeannette M Asselin, Cynthia Fontana, R Scott Heidersbach, Heidi R Flori, Shan L Ward
OBJECTIVE: The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis. METHODS: This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#2
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
January 9, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28063688/crystalloid-fluid-choice-and-clinical-outcomes-in-pediatric-sepsis-a-matched-retrospective-cohort-study
#3
Scott L Weiss, Luke Keele, Fran Balamuth, Neika Vendetti, Rachael Ross, Julie C Fitzgerald, Jeffrey S Gerber
OBJECTIVE: To test the hypothesis that resuscitation with balanced fluids (lactated Ringer [LR]) is associated with improved outcomes compared with normal saline (NS) in pediatric sepsis. STUDY DESIGN: We performed matched analyses using data from 12 529 patients <18 years of age with severe sepsis/septic shock at 382 US hospitals between 2000 and 2013 to compare outcomes with vs without LR as part of initial resuscitation. Patients receiving LR were matched 1:1 to patients receiving only NS (NS group), including separate matches for any (LR-any group) or exclusive (LR-only group) LR use...
January 4, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#4
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27986330/making-the-quick-diagnosis-a-case-of-neonatal-shock
#5
Mike Gardiner, Timothy K Ruttan, Andrew J Kienstra, Matthew Wilkinson
BACKGROUND: The work-up and initial management of a critically ill neonate is challenging and anxiety provoking for the Emergency Physician. While sepsis and critical congenital heart disease represent a large proportion of neonates presenting to the Emergency Department (ED) in shock, there are several additional etiologies to consider. Underlying metabolic, endocrinologic, gastrointestinal, neurologic, and traumatic disorders must be considered in a critically ill infant. Several potential etiologies will present with nonspecific and overlapping signs and symptoms, and the diagnosis often is not evident at the time of ED assessment...
December 13, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27956337/-postsurgical-morbidity-in-pediatric-patients-undergoing-surgery-for-congenital-heart-disease-in-umae-from-yucatan
#6
Addy Castillo-Espínola, Ana Velázquez-Ibarra, Aurea Zetina-Solórzano, Patricia Bolado-García, Gonzalo Gamboa-López
OBJECTIVE: To describe the clinical course of pediatric patients undergoing surgery for congenital heart disease in UMAE from Yucatan. METHODS: Descriptive survey records of pediatric patients congenital heart undergoing surgery for congenital heart disease from November, 1st 2011 to November, 30st 2013. RESULTS: The most frequent heart diseases were the persistence ductus arteriosus (37.6%) and transposition of great vessels. The intensive care stay was 3days (median)...
December 9, 2016: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/27942705/association-of-a-clinical-practice-guideline-with-blood-culture-use-in-critically-ill-children
#7
Charlotte Z Woods-Hill, James Fackler, Kristen Nelson McMillan, Judith Ascenzi, Diego A Martinez, Matthew F Toerper, Annie Voskertchian, Elizabeth Colantuoni, Sybil Ann Klaus, Scott Levin, Aaron M Milstone
Importance: Sepsis and septic shock are common and, at times, fatal in pediatrics. Blood cultures are often obtained when clinicians suspect sepsis, yet are low-yield with a false-positive rate up to 50%. Objectives: To determine whether a novel, 2-part, clinical practice guideline could decrease the rates of total blood cultures and cultures collected from central venous catheters in critically ill children and to examine the effect of the guideline on patient outcomes...
December 12, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27851097/1461-the-pediatric-provider-experience-with-sepsis-and-septic-shock-press-study
#8
Ryan Breuer, Amanda Hassinger
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27851007/1371-using-lactate-and-blood-pressure-to-classify-shock-in-pediatric-sepsis-an-ehr-based-approach
#9
Halden Scott, Lina Brou, Sara Deakyne, Lalit Bajaj
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850969/1333-pediatric-sepsis-and-septic-shock-risk-factors-and-comorbid-conditions
#10
Andrew Prout, Victor Talisa, Florian Mayr, Sachin Yende
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#11
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27822386/correlation-between-arterial-lactate-and-central-venous-lactate-in-children-with-sepsis
#12
Jaime Fernández Sarmiento, Paula Araque, María Yepes, Hernando Mulett, Ximena Tovar, Fabio Rodriguez
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital...
2016: Critical Care Research and Practice
https://www.readbyqxmd.com/read/27761292/pediatric-fulminant-leptospirosis-complicated-by-pericardial-tamponade-macrophage-activation-syndrome-and-sclerosing-cholangitis
#13
Osman Yeşilbaş, Hasan Serdar Kıhtır, Hamdi Murat Yıldırım, Nevin Hatipoğlu, Esra Şevketoğlu
BACKGROUND: Leptospirosis is a zoonotic infectious disease caused by pathogenic spirochetes of the genus Leptospira. Although it is usually asymptomatic and self-limited, severe potentially fatal illness accompanied by multi-organ failure may occur. CASE REPORT: Here we report an unusual case of severe leptospirosis successfully treated with continuous venovenous hemofiltration (CVVHF) and therapeutic plasma exchange (TPE). The patient presented with pericardial tamponade, renal failure and macrophage activation syndrome, and later suffered prolonged jaundice and sclerosing cholangitis during hospitalization in the pediatric intensive care unit (PICU)...
September 2016: Balkan Medical Journal
https://www.readbyqxmd.com/read/27749512/2016-update-for-the-rogers-textbook-of-pediatric-intensive-care-recognition-and-initial-management-of-shock
#14
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed (www.ncbi.nlm.nih.gov/pubmed) was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27712962/risk-factors-for-candidemia-mortality-in-hospitalized-children
#15
Fabio Araujo Motta, Libera Maria Dalla-Costa, Marisol Dominguez Muro, Mariana Nadal Cardoso, Gledson Luiz Picharski, Gregory Jaeger, Marion Burger
OBJECTIVE: To evaluate risk factors associated with death due to bloodstream infection caused by Candida spp. in pediatric patients and evaluate the resistance to the main anti-fungal used in clinical practice. METHODS: This is a cross-sectional, observational, analytical study with retrospective collection that included 65 hospitalized pediatric patients with bloodstream infection by Candida spp. A univariate analysis was performed to estimate the association between the characteristics of the candidemia patients and death...
October 3, 2016: Jornal de Pediatria
https://www.readbyqxmd.com/read/27635771/olfactomedin-4-is-a-candidate-marker-for-a-pathogenic-neutrophil-subset-in-septic-shock
#16
Matthew N Alder, Amy M Opoka, Patrick Lahni, David A Hildeman, Hector R Wong
OBJECTIVES: Heterogeneity in sepsis-related pathobiology presents a significant challenge. Resolving this heterogeneity presents an opportunity to understand pathobiology and improve patient care. Olfactomedin-4 is a neutrophil subset marker and may contribute to sepsis heterogeneity. Our objective was to evaluate the expression of olfactomedin-4 and characterize neutrophil heterogeneity in children with septic shock. DESIGN: Single-center, prospective cohort, as well as secondary analysis of existing transcriptomic and proteomic databases...
September 15, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27631709/automated-detection-of-sepsis-using-electronic-medical-record-data-a-systematic-review
#17
Laurel A Despins
Severe sepsis and septic shock are global issues with high mortality rates. Early recognition and intervention are essential to optimize patient outcomes. Automated detection using electronic medical record (EMR) data can assist this process. This review describes automated sepsis detection using EMR data. PubMed retrieved publications between January 1, 2005 and January 31, 2015. Thirteen studies met study criteria: described an automated detection approach with the potential to detect sepsis or sepsis-related deterioration in real or near-real time; focused on emergency department and hospitalized neonatal, pediatric, or adult patients; and provided performance measures or results indicating the impact of automated sepsis detection...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27604184/high-reliability-pediatric-septic-shock-quality-improvement-initiative-and-decreasing-mortality
#18
Roni D Lane, Tomohiko Funai, Ron Reeder, Gitte Y Larsen
BACKGROUND AND OBJECTIVE: Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition and timely treatment of patients with septic shock in a pediatric emergency department (PED). Our primary aim was to describe the longitudinal effectiveness of the program, iterative changes in clinical practice, and associated outcomes. METHODS: We implemented multiple interventions during our QI initiative (February 2007 to December 2014)...
October 2016: Pediatrics
https://www.readbyqxmd.com/read/27598288/-toxocarosis-and-acalculous-acute-cholecystitis-consequence-or-coincidence
#19
REVIEW
Alexis Strickler, Natalia Vásquez, Leonardo Maggi, Juvenal Hernández, Ximena Hidalgo
Human toxocarosis is a chronic larval parasitosis listed as one of the five most important neglected diseases by the CDC. The larvae can spread systemically and migrate to different tissues including liver and gallbladder. Acalculous acute cholecystitis (AAC) is a rare disease in children. The diagnosis is based on clinical parameters and imaging criteria. It has been reported in relation to sepsis, shock, trauma, burns, severe systemic diseases, congenital anomalies, infections and also in healthy children...
June 2016: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
https://www.readbyqxmd.com/read/27566963/reduction-in-procalcitonin-level-and-outcome-in-critically-ill-children-with-severe-sepsis-septic-shock-a-pilot-study
#20
Banani Poddar, Mohan Gurjar, Sushma Singh, Amita Aggarwal, Arvind Baronia
PURPOSE: To investigate if reduction in procalcitonin (PCT) provides useful information about 28-day mortality in children with severe sepsis or septic shock. MATERIALS AND METHODS: Design: Prospective observational study. SETTING: Mixed adult-pediatric intensive care unit in a teaching hospital. SUBJECTS: Children up to 18 years of age admitted with severe sepsis or septic shock between March 2011 and June 2013. Procalcitonin measured using electrochemiluminescence immunoassay on the day of admission with sepsis (D0) and 72-96 hours later (D4)...
December 2016: Journal of Critical Care
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