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Critically ill children

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https://www.readbyqxmd.com/read/28720723/profile-and-outcomes-of-critically-ill-children-in-a-lower-middle-income-country
#1
Muhammad Irfan Habib, Khalid Mehmood A Khan
OBJECTIVE: To determine the clinical profile and outcome of critically ill children presenting to a paediatric ED in a lower middle-income country. METHODS: We performed a retrospective analysis of children (<14 years) presenting to the ED of the National Institute of Child Health, Karachi, between January and December 2014 who were assigned to acuity 1 (requiring immediate life-saving interventions) according to the Emergency Severity Index. Data included demographic variables, presenting complaints, interventions and outcomes in the ED...
July 18, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28708688/respiratory-muscle-weakness-and-extubation-failure-in-critically-ill-children
#2
Maroun J Mhanna, Aparna Roy
No abstract text is available yet for this article.
August 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28704229/treatment-of-hyponatremic-encephalopathy-in-the-critically-ill
#3
Steven G Achinger, Juan Carlos Ayus
OBJECTIVES: Hyponatremic encephalopathy, symptomatic cerebral edema due to a low osmolar state, is a medical emergency and often encountered in the ICU setting. This article provides a critical appraisal and review of the literature on identification of high-risk patients and the treatment of this life-threatening disorder. DATA SOURCES, STUDY SELECTION, AND DATA EXTRACTION: Online search of the PubMed database and manual review of articles involving risk factors for hyponatremic encephalopathy and treatment of hyponatremic encephalopathy in critical illness...
July 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28699888/predicting-augmented-renal-clearance-using-estimated-glomerular-filtration-rate-in-critically-ill-children%C3%A2
#4
Bongjin Lee, Jongyoon Kim, June Dong Park, Hyun Mi Kang, Yoon Sook Cho, Kwi Suk Kim
AIMS: Measured glomerular filtration rate (mGFR) is often used to identify augmented renal clearance (ARC). However, in the clinical setting, estimated GFR (eGFR) is obtained more quickly and inexpensively. We aimed to determine whether eGFR can identify ARC by evaluating the correlation between the eGFR and vancomycin trough level (VTL). MATERIALS AND METHODS: We retrospectively reviewed the records of patients aged ≤ 18 years who underwent vancomycin therapeutic drug monitoring at our tertiary hospital from July 2009 to June 2014...
July 12, 2017: Clinical Nephrology
https://www.readbyqxmd.com/read/28697170/critically-ill-children-with-hemophagocytic-lymphohistiocytosis-a-case-series-of-14-patients
#5
Esther Huimin Leow, Shui Yen Soh, Ah Moy Tan, Yee Hui Mok, Mei Yoke Chan, Jan Hau Lee
Children with hemophagocytic lymphohistiocytosis (HLH) are at an increased risk of critical illness. In this study, we described the clinical characteristics of critically ill children with HLH and identify factors associated with poor clinical outcomes. Children who were diagnosed with HLH with emergent admission to Children's Intensive Care Unit (CICU) between January 1, 2000 and October 31, 2015 were included. The primary outcome was CICU mortality. Over the 15-year period, there were 14 critically ill patients with HLH with 23 CICU admissions...
July 10, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28696880/performance-of-pediatric-risk-of-mortality-score-among-critically-ill-children-with-heart-disease
#6
Rebecca A Russell, Mallikarjuna Rettiganti, Nancy Brundage, Howard E Jeffries, Punkaj Gupta
OBJECTIVE: To evaluate the performance of the Pediatric Risk of Mortality 3 (PRISM-3) score in critically ill children with heart disease. METHODS: Patients <18 years of age admitted with cardiac diagnoses (cardiac medical and cardiac surgical) to one of the participating pediatric intensive care units in the Virtual Pediatric Systems, LLC, database were included. Performance of PRISM-3 was evaluated with discrimination and calibration measures among both cardiac surgical and cardiac medical patients...
July 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28692913/particle-and-bioaerosol-characteristics-in-a-paediatric-intensive-care-unit
#7
Congrong He, Ian M Mackay, Kay Ramsay, Zhen Liang, Timothy Kidd, Luke D Knibbs, Graham Johnson, Donna McNeale, Rebecca Stockwell, Mark G Coulthard, Debbie A Long, Tara J Williams, Caroline Duchaine, Natalie Smith, Claire Wainwright, Lidia Morawska
The paediatric intensive care unit (PICU) provides care to critically ill neonates, infants and children. These patients are vulnerable and susceptible to the environment surrounding them, yet there is little information available on indoor air quality and factors affecting it within a PICU. To address this gap in knowledge we conducted continuous indoor and outdoor airborne particle concentration measurements over a two-week period at the Royal Children's Hospital PICU in Brisbane, Australia, and we also collected 82 bioaerosol samples to test for the presence of bacterial and viral pathogens...
July 7, 2017: Environment International
https://www.readbyqxmd.com/read/28691958/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#8
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between two organizations, American Society of Parenteral and Enteral Nutrition and the Society of Critical Care Medicine, to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric (> 1 mo and < 18 yr) critically ill patient expected to require a length of stay greater than 2 or 3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2,032 citations were scanned for relevance...
July 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28691631/web-review-risky-business
#9
(no author information available yet)
Risky Business In the early 2000s, a quality improvement project brought together a group of healthcare professionals with experts from the world of motor racing. They compared handovers of critically ill infants and children from operating theatre to intensive care team after complex heart surgery with the processes of a Formula 1 pitstop.
July 10, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/28689669/low-serum-selenium-is-associated-with-the-severity-of-organ-failure-in-critically-ill-children
#10
M Broman, Mattias Lindfors, Åke Norberg, Christina Hebert, Olav Rooyackers, Jan Wernerman, Urban Fläring
BACKGROUND & AIMS: Low concentration of serum selenium is associated with the inflammatory response and multiple organ failure in adult ICU-patients. Critically ill children are less well characterized. In this study, serum selenium concentration and its possible relation to multiple organ failure as well as glutathione status was investigated in pediatric intensive care (PICU) patients. METHODS: A prospective consecutive cohort of critically ill children (n = 100) admitted to the PICU of a tertiary university hospital, and in addition an age stratified reference group of healthy children (n = 60) were studied...
June 21, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28688239/successful-treatment-of-toxic-epidermal-necrolysis-using-plasmapheresis-a-prospective-observational-study
#11
Feng Han, Jingjing Zhang, Qi Guo, Yanjing Feng, Ya Gao, Litao Guo, Yanli Hou, Jingang An, Xiaopeng Wang, Bin Yan, Yan Zheng, Jingchun Song, Manxiang Li, Gang Wang
Toxic epidermal necrolysis (TEN) is a rare, severe, life-threatening skin disease and it requires urgent critical care, including admission to the intensive care unit (ICU). It is characterized by fatal sequelae and high mortality. Currently, insufficient evidence exists to support the use of any systemic adjuvant therapy, such as cyclophosphamide, intravenous immunoglobulin (IVIg), or corticosteroids. However, plasmapheresis has been increasingly valued by clinicians due to its significant efficacy and little adverse side effects...
July 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28688136/ultrasound-versus-traditional-palpation-to-guide-radial-artery-cannulation-in-critically-ill-children-a-randomized-trial
#12
Nattachai Anantasit, Pimporn Cheeptinnakorntaworn, Anant Khositseth, Rojjanee Lertbunrian, Marut Chantra
OBJECTIVES: To identify success rates for radial artery cannulation in a pediatric critical care unit using either palpation or ultrasound guidance to cannulate the radial artery. METHODS: A prospective randomized comparative study of critically ill children who required invasive monitoring in a tertiary referral center was conducted. All patients were randomized by a stratified block of 4 to either ultrasound-guided or traditional palpation radial artery cannulation...
July 8, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28686844/guidelines-for-the-provision-and-assessment-of-nutrition-support-therapy-in-the-pediatric-critically-ill-patient-society-of-critical-care-medicine-and-american-society-for-parenteral-and-enteral-nutrition
#13
Nilesh M Mehta, Heather E Skillman, Sharon Y Irving, Jorge A Coss-Bu, Sarah Vermilyea, Elizabeth Anne Farrington, Liam McKeever, Amber M Hall, Praveen S Goday, Carol Braunschweig
This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and <18 years) expected to require a length of stay >2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance...
May 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28686328/genetically-contextual-effects-of-smoking-on-genome-wide-dna-methylation
#14
Meeshanthini V Dogan, Steven R H Beach, Robert A Philibert
Smoking is the leading cause of death in the United States. It exerts its effects by increasing susceptibility to a variety of complex disorders among those who smoke, and if pregnant, to their unborn children. In prior efforts to understand the epigenetic mechanisms through which this increased vulnerability is conveyed, a number of investigators have conducted genome wide methylation analyses. Unfortunately, secondary to methodological limitations, these studies were unable to examine methylation in gene regions with significant amounts of genetic variation...
July 7, 2017: American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics
https://www.readbyqxmd.com/read/28672402/testing-for-respiratory-viruses-in-children-to-swab-or-not-to-swab
#15
Peter J Gill, Susan E Richardson, Olivia Ostrow, Jeremy N Friedman
Importance: While most viral respiratory tract infections can be diagnosed clinically, clinicians frequently order tests to identify the specific offending virus. While there has been tremendous growth in the variety, availability, and sophistication of the types of respiratory viral tests, there may have been less critical thought and discussion among frontline clinicians about the clinical utility and specific indications for testing. We summarize the rationale historically used to support respiratory virus testing in children, with a review of the supporting evidence...
July 3, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28671859/being-underweight-is-an-independent-risk-factor-for-poor-outcomes-among-acutely-critically-ill-children
#16
Ming-Yin Chen, Yao-Jong Yang
BACKGROUND: Malnutrition is associated with impaired immune function; thus, nutrition status assessment is crucial in critical care medicine. We aimed to investigate the impact of being underweight or overweight on major sequelae and mortality among healthy children with an intensive care unit admission. METHODS: In this retrospective study, 282 patients aged 1 month to 18 years were enrolled on intensive care unit admission between 2011 and 2012. Children were excluded if they had underlying chronic diseases and were transferred to other hospitals or discharged against medical advice...
July 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28671616/incidence-of-ventilator-associated-pneumonia-in-critically-ill-children-undergoing-mechanical-ventilation-in-pediatric-intensive-care-unit
#17
Ali Amanati, Abdollah Karimi, Alireza Fahimzad, Ahmad Reza Shamshiri, Fatemeh Fallah, Alireza Mahdavi, Mahshid Talebian
BACKGROUND: Among hospital-acquired infections (HAIs) in children, ventilator-associated pneumonia (VAP) is the most common after blood stream infection (BSI). VAP can prolong length of ventilation and hospitalization, increase mortality rate, and directly change a patient's outcome in Pediatric Intensive Care Units (PICU). OBJECTIVES: The research on VAP in children is limited, especially in Iran; therefore, the identification of VAP incidence and mortality rate will be important for both clinical and epidemiological implications...
July 3, 2017: Children
https://www.readbyqxmd.com/read/28668918/pediatric-skin-failure
#18
Katie E Cohen, Matthew C Scanlon, Amin Bemanian, Christine A Schindler
BACKGROUND: The phenomenon of skin failure as distinct from pressure ulcers has been documented in the adult literature. However, in the pediatric population, skin injury continues to be grouped indiscriminately as various types of pressure ulcers. OBJECTIVE: To identify and describe the phenomenon of skin failure in critically ill children. METHODS: Retrospective chart review of 19 patients who had serious skin injuries develop. Organ dysfunction scores, medications, pressure ulcer prevention techniques used, and laboratory values in the 7 days leading up to the development of a skin lesion were evaluated...
July 2017: American Journal of Critical Care: An Official Publication, American Association of Critical-Care Nurses
https://www.readbyqxmd.com/read/28661973/determinants-of-antibiotic-tailoring-in-pediatric-intensive-care-a-national-survey
#19
Patricia S Fontela, Caroline Quach, Mohammad E Karim, Douglas F Willson, Elaine Gilfoyle, James Dayre McNally, Milagros Gonzales, Jesse Papenburg, Steven Reynolds, Jacques Lacroix
OBJECTIVES: To describe the criteria that currently guide empiric antibiotic treatment in children admitted to Canadian PICUs. DESIGN: Cross-sectional survey. SETTING: Canadian PICUs. SUBJECTS: Pediatric intensivists and pediatric infectious diseases specialists. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We used focus groups and literature review to design the survey questions and its four clinical scenarios (sepsis, pneumonia, meningitis, and intra-abdominal infections)...
June 28, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28661307/policy-approaches-to-improving-housing-and-health
#20
William C Tilburg
Safe and healthy housing conditions are critical to improving population health, particularly for the most vulnerable - young children, senior citizens, and individuals with chronic illnesses and disabilities - who spend more time at home and are more susceptible to illness and injury. Across the country, millions of Americans are exposed to lead, radon, asbestos, volatile organic compounds, pests, mold, carbon monoxide, and tobacco smoke in the home, affecting the air they breathe and the water they drink...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
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