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https://www.readbyqxmd.com/read/28922271/the-impact-of-telemedicine-on-pediatric-critical-care-triage
#1
Jillian B Harvey, Brooke E Yeager, Christina Cramer, David Wheeler, S David McSwain
OBJECTIVE: To examine the relationship between pediatric critical care telemedicine consultation to rural emergency departments and triage decisions. We compare the triage location and provider rating of the accuracy of remote assessment for a cohort of patients who receive critical care telemedicine consultations and a similar group of patients receiving telephone consultations. DESIGN: Retrospective evaluation of consultations occurring between April 2012 and March 2016...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922268/early-exercise-in-critically-ill-youth-and-children-a-preliminary-evaluation-the-weecycle-pilot-trial
#2
Karen Choong, Saif Awladthani, Adeeb Khawaji, Heather Clark, Asm Borhan, Ji Cheng, Sam Laskey, Charmaine Neu, Aimee Sarti, Lehana Thabane, Brian W Timmons, Katina Zheng, Samah Al-Harbi
OBJECTIVES: To determine the feasibility of conducting a full trial evaluating the efficacy of early mobilization using in-bed cycling as an adjunct to physiotherapy, on functional outcomes in critically ill children. DESIGN: Single center, pilot, randomized controlled trial. SETTING: Twelve-bed tertiary care, medical-surgical PICU at McMaster Children's Hospital, Hamilton, ON, Canada. PATIENTS: Children 3-17 years old who were limited to bed-rest with an expected PICU stay of at least 48 hours...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#3
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
September 15, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28921175/routine-gastric-residual-volume-measurement-and-energy-target-achievement-in-the-picu-a-comparison-study
#4
Lyvonne N Tume, Anna Bickerdike, Lynne Latten, Simon Davies, Madeleine H Lefèvre, Gaëlle W Nicolas, Frédéric V Valla
Critically ill children frequently fail to achieve adequate energy intake, and some care practices, such as the measurement of gastric residual volume (GRV), may contribute to this problem. We compared outcomes in two similar European Paediatric Intensive Care Units (PICUs): one which routinely measures GRV (PICU-GRV) to one unit that does not (PICU-noGRV). An observational pilot comparison study was undertaken. Eighty-seven children were included in the study, 42 (PICU-GRV) and 45 (PICU-noGRV). There were no significant differences in the percentage of energy targets achieved in the first 4 days of PICU admission although PICU-noGRV showed more consistent delivery of median (and IQR) energy targets and less under and over feeding for PICU-GRV and PICU-noGRV: day 1 37 (14-72) vs 44 (0-100), day 2 97 (53-126) vs 100 (100-100), day 3 84 (45-112) vs 100 (100-100) and day 4 101 (63-124) vs 100 (100-100)...
September 18, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28918409/qualitative-interview-study-of-parents-perspectives-concerns-and-experiences-of-the-management-of-lower-respiratory-tract-infections-in-children-in-primary-care
#5
Amy Halls, Catherine Van't Hoff, Paul Little, Theo Verheij, Geraldine M Leydon
OBJECTIVE: To explore parents' perspectives, concerns and experiences of the management of lower respiratory tract infections (LRTIs) in children in primary care. DESIGN: Qualitative semistructured interview study. SETTING: UK primary care. PARTICIPANTS: 23 parents of children aged 6 months to 10 years presenting with LRTI in primary care. METHOD: Thematic analysis of semistructured interviews (either in person or by telephone) conducted with parents to explore their experiences and views on their children being prescribed antibiotics for LRTI...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28918202/implementation-of-a-risk-stratified-opioid-weaning-protocol-in-a-pediatric-intensive-care-unit
#6
L Nelson Sanchez-Pinto, Lara P Nelson, Phuong Lieu, Joyce Y Koh, John W Rodgers, Krichelle A Larson, Jennifer M Huson, Rambod Amirnovin
PURPOSE: Opioids are important in the care of critically ill children. However, their use is associated with complications including delirium, dependence, withdrawal, and bowel dysfunction. Our aim was to implement a risk-stratified opioid weaning protocol to reduce the duration of opioids without increasing the incidence of withdrawal. METHODS: A pre- and post-interventional prospective study was undertaken in a large children's hospital pediatric ICU where we implemented a risk-stratified opioid weaning protocol...
September 7, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917160/is-magnet%C3%A2-recognition-associated-with-improved-outcomes-among-critically-ill-children-treated-at-freestanding-children-s-hospitals
#7
Mallikarjuna Rettiganti, Kavisha M Shah, Jeffrey M Gossett, Joshua A Daily, Paul M Seib, Punkaj Gupta
PURPOSE: With increasing emphasis on high-quality care, we designed this study to evaluate the relationship between Magnet® recognition and patient outcomes in pediatric critical care. MATERIALS AND METHODS: Post hoc analysis of data from an existing administrative national database. We used inverse probability of treatment weighting and multivariate models to compare outcomes between two study groups after adjusting for confounding variables. RESULTS: A total of 823,634 pediatric patients from 41 centers were included...
September 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28917005/outcome-of-pediatric-acute-kidney-injury-a-multicenter-prospective-cohort-study
#8
Jameela A Kari, Khalid A Alhasan, Mohamed A Shalaby, Norah Khathlan, Osama Y Safdar, Suleman A Al Rezgan, Sherif El Desoky, Amr S Albanna
BACKGROUND: Acute kidney injury (AKI) is a common problem encountered in critically ill children with an increasing incidence and evolving epidemiology. AKI carries a serious morbidity and mortality in patients requiring admission to a pediatric intensive care unit (PICU). METHODS: We undertook a prospective cohort study of PICU admissions at three tertiary care hospitals in the Kingdom of Saudi Arabia over 2 years. The Kidney Disease Improving Global Outcomes (KDIGO) definition was used to diagnose AKI...
September 15, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28911284/effect-of-nicotine-replacement-therapy-on-mortality-delirium-and-duration-of-therapy-in-critically-ill-smokers-a-systematic-review-and-meta-analysis
#9
K T Ng, M Gillies, D M Griffith
Nicotine replacement therapy is widely used in critically ill smokers and its effect on delirium, mortality and duration of intensive care unit (ICU) admission is unknown. The aims of this review were to determine whether the management of nicotine withdrawal with nicotine replacement therapy reduces delirium, mortality or length of stay in critically ill smokers in ICU. The primary outcome was incidence of author-defined ICU delirium. Secondary outcomes were ICU or hospital mortality, ICU-free days at day 28, and ICU or hospital length of stay...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28906422/increased-risk-of-acute-kidney-injury-in-critically-ill-children-treated-with-vancomycin-and-piperacillin-tazobactam
#10
Maya R Holsen, Calvin J Meaney, Amanda B Hassinger, Nicholas M Fusco
OBJECTIVES: Compare the rates of acute kidney injury in critically ill children treated with vancomycin and piperacillin-tazobactam versus vancomycin and ceftriaxone. DESIGN: Retrospective cohort study. SETTING: A large tertiary care children's hospital in an urban setting. PATIENTS: Children greater than or equal to 2 months old admitted to the PICU who received greater than or equal to 48 consecutive hours of vancomycin and piperacillin-tazobactam or vancomycin and ceftriaxone...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906421/the-relationship-between-remoteness-and-outcomes-in-critically-ill-children
#11
Megan Sample, Anand Acharya, Katharine O'Hearn, Shane Livingstone, Kusum Menon
OBJECTIVE: A significant number of children live in remote geographic areas without direct access to tertiary care PICU. Our objective was to explore the relationship between remoteness and outcomes of critically ill children in Canada. DESIGN: Retrospective cohort study of patients admitted to the PICU from February 1, 2015, to January 31, 2016. SETTING: Pediatric tertiary care PICU in Canada. PATIENTS: All children admitted to PICU during the study period...
September 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28906047/a-systematic-review-to-explore-influences-on-parental-attitudes-towards-antibiotic-prescribing-in-children
#12
REVIEW
Helen Bosley, Catherine Henshall, Jane V Appleton, Debra Jackson
AIM: To understand the factors influencing parental attitudes towards antibiotic prescribing. BACKGROUND: Overuse of antibiotics and inappropriate prescribing has resulted in rapid development of antimicrobial resistance (AMR), and is significant global threat to patient safety. In Primary Care settings, substantial numbers of antibiotics are prescribed for young children, despite viral nature of illness for which antibiotics are ineffective. Parents, play a vital role in decision making regarding accessing healthcare services and requesting treatment for their children...
September 14, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28894313/need-for-a-randomized-controlled-trial-of-stress-ulcer-prophylaxis-in-critically-ill-children-a-canadian-survey
#13
Mark Duffett, Karen Choong, Jennifer Foster, Elaine Gilfoyle, Jacques Lacroix, Deborah J Cook
BACKGROUND: Stress ulcer prophylaxis is commonly used in pediatric critical care, to prevent upper gastrointestinal bleeding. The most frequently used agents are histamine-2 receptor antagonists (H2RAs) and proton pump inhibitors (PPIs). The risk-benefit ratio for stress ulcer prophylaxis is uncertain, because data from randomized clinical trials (RCTs) on the effectiveness and harms of prophylaxis in children are limited. OBJECTIVE: To describe the views of Canadian pediatric intensivists about a future RCT of stress ulcer prophylaxis...
July 2017: Canadian Journal of Hospital Pharmacy
https://www.readbyqxmd.com/read/28867295/asthma-outcomes-and-management-during-pregnancy
#14
REVIEW
Catherine A Bonham, Karen C Patterson, Mary E Strek
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. We review recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active asthma management during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting...
August 31, 2017: Chest
https://www.readbyqxmd.com/read/28866320/differences-in-perioperative-femoral-and-radial-arterial-blood-pressure-in-neonates-and-infants-undergoing-pediatric-cardiac-surgery-requiring-cardiopulmonary-bypass
#15
Hwa Jin Cho, Sang Hoon Lee, In Seok Jeong, Nam Sik Yoon, Jae Sook Ma, Byoung Hee Ahn
OBJECTIVE: Several reports claim that blood pressure (BP) in the radial artery may underestimate the accurate BP in critically ill patients. Here, the authors evaluated differences in mean blood pressure (MBP) between the radial and femoral artery during pediatric cardiac surgery to determine the effectiveness of femoral arterial BP monitoring. METHOD: The medical records of children under 1 year of age who underwent open-heart surgery between 2007 and 2013 were retrospectively reviewed...
August 30, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28861270/phosphate-disturbance-in-critically-ill-children-incidence-associated-risk-factors-and-clinical-outcomes
#16
Ahmed Nabih El Shazly, Doaa Refaey Soliman, Effat Hussien Assar, Eman Gamal Behiry, Ibrahim Abd El Naby Gad Ahmed
BACKGROUND: Hypophosphatemia is one of the common disorders that develop in critically ill patients. It has potential complications and is often unrecognized in those patients. OBJECTIVE: Determining the incidence of hypophosphatemia in critically ill children, its association with clinical outcomes and the possible risk factors. METHODS: 50 patients were enrolled in the study. Levels of serum phosphate were measured on day 1 and day 7 of PICU (Pediatric intensive care unit) stay...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28860332/negative-pressure-ventilation-in-pediatric-acute-respiratory-failure
#17
Amanda B Hassinger, Ryan K Breuer, Kirsten Nutty, Chang-Xing Ma, Omar S Al Ibrahim
BACKGROUND: The objective of this work was to describe the use of negative-pressure ventilation (NPV) in a heterogeneous critically ill, pediatric population. METHODS: A retrospective chart review was conducted of all patients admitted to a pediatric ICU with acute respiratory failure supported with NPV from January 1, 2012 to May 15, 2015. RESULTS: Two hundred thirty-three subjects at a median age of 15.5 months were supported with NPV for various etiologies, most commonly bronchiolitis (70%)...
August 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28857062/online-media-coverage-of-air-pollution-risks-and-current-policies-in-india-a-content-analysis
#18
Nandita Murukutla, Nalin S Negi, Pallavi Puri, Sandra Mullin, Lesley Onyon
Background Air pollution is of particular concern in India, which contains 11 of the 20 most polluted cities in the world. Media coverage of air pollution issues plays an important role in influencing public opinion and increasing citizen demand for action on clean air policy. Hence, this study was designed to assess news coverage of air pollution in India and its implications for policy advancement. Methods Articles published online between 1 January 2014 and 31 October 2015 that discussed air pollution in India were systematically content analysed...
September 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28845042/factors-determining-parents-decisions-to-bring-their-children-to-the-pediatric-emergency-department-for-a-minor-illness
#19
Sigita Burokienė, Juozas Raistenskis, Emilija Burokaitė, Rimantė Čerkauskienė, Vytautas Usonis
BACKGROUND The number of children visiting Emergency Departments (EDs) is increasing in Lithuania; therefore, the aim of this study was to determine the factors influencing the parental decision to bring their child to the ED for a minor illness that could be managed in a primary healthcare setting, and to compare parents' and medical professionals' attitudes toward a child's health status and need for urgent care. MATERIAL AND METHODS A prospective observational study was performed at the tertiary-level teaching Children's Hospital in Vilnius...
August 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28843537/sophia-observation-withdrawal-symptoms-paediatric-delirium-scale-a-tool-for-early-screening-of-delirium-in-the-picu
#20
Erwin Ista, Harma Te Beest, Joost van Rosmalen, Matthijs de Hoog, Dick Tibboel, Babette van Beusekom, Monique van Dijk
BACKGROUND: Delirium in critically ill children is a severe neuropsychiatric disorder which has gained increased attention from clinicians. Early identification of delirium is essential for successful management. The Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) scale was developed to detect Paediatric Delirium (PD) at an early stage. OBJECTIVE: The aim of this study was to determine the measurement properties of the PD component of the SOS-PD scale in critically ill children...
August 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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