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https://www.readbyqxmd.com/read/28328243/factors-associated-with-bleeding-and-thrombosis-in-children-receiving-extracorporeal-membrane-oxygenation-ecmo
#1
Heidi J Dalton, Ron Reeder, Pamela Garcia-Filion, Richard Holubkov, Robert A Berg, Athena Zuppa, Frank W Moler, Thomas Shanley, Murray M Pollack, Christopher Newth, John Berger, David Wessel, Joseph Carcillo, Michael Bell, Sabrina Heidemann, Kathleen L Meert, Richard Harrison, Allan Doctor, Robert F Tamburro, J Michael Dean, Tammara Jenkins, Carol Nicholson
RATIONALE: Extracorporeal membrane oxygenation (ECMO) is employed for respiratory and cardiac failure in children but is complicated by bleeding and thrombosis. OBJECTIVES: (1) Measure the incidence of bleeding (blood loss requiring transfusion or intracranial hemorrhage) and thrombosis during ECMO support; (2) identify factors associated with these complications; and (3) determine the impact of these complications on patient outcome. METHODS: Prospective, observational cohort study in pediatric, cardiac, and neonatal intensive care units in eight hospitals from December 2012 to September 2014...
March 22, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28326208/a-child-as-a-donor-for-hematopoietic-stem-cell-transplantation-bioethical-justification-a-case-study-on-sickle-cell-disease
#2
Andrea Z Pereira, Ricardo Hellman, Nelson Hamerschlak, Andrea Kondo, Polianna Mara Rodrigues de Souza, Wilson Leite Pedreira, Luiz Fernando Alves Lima Mantovani, Eduardo Juan Troster, Henrique Grunspun, Marco Aurélio Scarpinella Bueno
Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28302286/viscoelastic-hemostatic-assays-in-the-management-of-the-pediatric-trauma-patient
#3
Christine M Leeper, Barbara A Gaines
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28298664/the-impact-of-roller-pump-vs-centrifugal-pump-on-homologous-blood-transfusion-in-pediatric-cardiac-surgery
#4
Bharat Datt, Moui B Nguyen, Gary Plancher, Mark Ruzmetov, Michael O'Brien, Alicia Kube, Hamish M Munro, Kamal K Pourmoghadam, William M DeCampli
Centrifugal pumps are considered to be less destructive to blood elements (1) when compared to roller pumps. However, their large prime volumes render them unsuitable as arterial pumps in heart lung machine (HLM) circuitry for children. In November of 2014, the circuit at Arnold Palmer Hospital, a Biomedicus BP-50 with kinetic assist venous drainage (KAVD) and 1/4″ tubing was converted to a roller pump in the arterial position with gravity drainage. Vacuum-assisted venous drainage (VAVD) was mounted on the HLM as a backup, but not used...
March 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28296163/long-term-safety-and-efficacy-of-deferasirox-in-young-pediatric-patients-with-transfusional-hemosiderosis-results-from-a-5-year-observational-study-entrust
#5
Elliott Vichinsky, Amal El-Beshlawy, Azzam Al Zoebie, Annie Kamdem, Suzanne Koussa, Thirachit Chotsampancharoen, Andreas Bruederle, Geralyn Gilotti, Jackie Han, Mohsen Elalfy
BACKGROUND: Children with red blood cell disorders may receive regular transfusions from an early age and consequently accumulate iron. Adequate iron chelation therapy can prevent organ damage and delayed growth/development. Deferasirox is indicated for treatment of pediatric patients with chronic iron overload due to transfusional hemosiderosis; however, fewer than 10% of patients in the registration studies were aged 2 to less than 6 years. PROCEDURE: Deferasirox, a once-daily oral iron chelator, was evaluated in young pediatric patients with transfusional hemosiderosis during the observational 5-year ENTRUST study...
March 10, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28292647/transfusion-transmitted-infections-in-frequently-transfused-thalassemic-children-living-in-fayoum-governorate-egypt-current-prevalence-and-risk-factors
#6
Zeze Th Atwa, Wafaa Y Abdel Wahed
Regular blood transfusion therapy remains the primary treatment in thalassemia major (TM). Transfusion-transmitted infections (TTIs) and iron overload are considered to be the major drawbacks of this therapy. This cross-sectional study aimed to update the prevalence of the hepatitis C virus (HCV) antibody, PCR-confirmed HCV, hepatitis B surface antigen (HBsAg), and human immunodeficiency virus (HIV) antibody among TM children. Clinical and epidemiological factors that can affect HCV infection prevalence rate were studied...
March 11, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28285862/comparing-the-effectiveness-of-vapocoolant-spray-and-lidocaine-procaine-cream-in-reducing-pain-of-intravenous-cannulation-a-randomized-clinical-trial
#7
Asghar Dalvandi, Hadi Ranjbar, Maryam Hatamizadeh, Abolfazl Rahgoi, Colleen Bernstein
INTRODUCTION: Venous cannulation is the most common procedure in emergency departments. The aim of this study was to compare the effectiveness of vapocoolant spray and EMLA cream in reduction of pain during venous cannulation in 6-12years old children. METHODS: The study was a randomized clinical trial with a crossover design. It took place between June and December 2015 at Ali-Asghar hospital in Tehran, Iran. 40 Thalassemic children who need regular blood transfusions were randomly assigned in two groups...
February 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28281428/a-review-of-blood-transfusions-in-a-trauma-unit-for-young-children
#8
M Salverda, N Ketharanathan, M Van Dijk, E Beltchev, H Buys, A Numanoglu, A B Van As
BACKGROUND: Trauma is the leading cause of mortality and morbidity worldwide. Blood transfusions play an incremental role in the acute phase, yet practice varies owing to variations in transfusion thresholds and concerns about potential complications, especially in children. OBJECTIVES: To evaluate protocol adherence to blood transfusion thresholds in paediatric trauma patients and determine the degree of blood product wastage, as defined by discarded units. METHODS: A retrospective, descriptive study of trauma patients (age 0 - 13 years) who received a blood transfusion in the trauma unit at Red Cross War Memorial Children's Hospital, Cape Town, South Africa, over a 5...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28279156/premature-atherosclerosis-in-children-with-beta-thalassemia-major-new-diagnostic-marker
#9
Laila M Sherief, Osama Dawood, Adel Ali, Hanan S Sherbiny, Naglaa M Kamal, Mohamed Elshanshory, Osama Abd Alazez, Mohamed Abd Alhady, Mohamed Nour, Wesam A Mokhtar
BACKGROUND: Early vascular alteration, atherosclerosis and coronary artery disease have emerged as important cardiovascular complications among beta-thalassemia major (B-TM) patients. The aims of the current study were to assess the prevalence of premature atherosclerosis among our B-TM patients, and to investigate the diagnostic value of serum Osteoprotegerin assay as an early biomarker for atherosclerosis. METHODS: This cross-sectional study was conducted at Hematology unit - Pediatric Department, Zagazig University Children Hospital- Egypt in the period from March 2014 to March 2015...
March 9, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28263168/red-blood-cell-components-time-to-revisit-the-sources-of-variability
#10
REVIEW
Rosemary L Sparrow
Quality and safety of red blood cell (RBC) components is managed by screening of donors and strict regulatory controls of blood collection, processing and storage procedures. Despite these efforts, variations in RBC component quality exist as exemplified by the wide range in storage-induced haemolysis. This article provides a brief overview of the variables that contribute or potentially contribute to the quality of stored RBC components, including blood collection, processing, and donor-related variables. Particular focus is made on donor health and lifestyle factors that are not specifically screened and may impact on the physicobiochemical properties of RBCs and their storability...
March 2017: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/28260433/effect-of-graft-weight-to-recipient-body-weight-ratio-on-hemodynamic-and-metabolic-parameters-in-pediatric-liver-transplant-a-retrospective-analysis
#11
Zeynep Ersoy, Serife Kaplan, Aycan Ozdemirkan, Adnan Torgay, Gulnaz Arslan, Arash Pirat, Mehmet Haberal
OBJECTIVES: To analyze how graft-weight-to-bodyweight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters. MATERIALS AND METHODS: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio ≤ 4% (normal for size). Data included demographics, preoperative laboratory findings, intraoperative metabolic and hemodynamic parameters, and intensive care follow-up parameters...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28250985/factors-associated-with-growth-retardation-in-children-suffering-from-sickle-cell-anemia-first-report-from-central-africa
#12
Aimé Lukusa Kazadi, René Makuala Ngiyulu, Jean Lambert Gini-Ehungu, Jean Marie Mbuyi-Muamba, Michel Ntetani Aloni
Background. The aim of this study was to investigate and determine the risk factors associated with poor growth among SCA children. Methods. A cross-sectional study was conducted in Kinshasa, the capital's country. The nutritional status was assessed using the Z scores of the anthropometric indices. Results. We gathered data on the 256 patients, 138 females (53.9%), who entered the study. The mean age at presentation was 8.4 ± 4.9 years of age. Underweight, stunting, and wasting were found, respectively, in 47...
2017: Anemia
https://www.readbyqxmd.com/read/28248835/specific-etiologies-associated-with-the-multiple-organ-dysfunction-syndrome-in-children-part-2
#13
Jeffrey S Upperman, John C Bucuvalas, Felicia N Williams, Bruce A Cairns, Charles S Cox, Allan Doctor, Robert F Tamburro
OBJECTIVE: To describe a number of conditions and therapies associated with multiple organ dysfunction syndrome presented as part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Multiple Organ Dysfunction Workshop (March 26-27, 2015). In addition, the relationship between burn injuries and multiple organ dysfunction syndrome is also included although it was not discussed at the workshop. DATA SOURCES: Literature review, research data, and expert opinion...
March 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28241909/reducing-unnecessary-postoperative-complete-blood-count-testing-in-the-pediatric-intensive-care-unit
#14
Maya Dewan, Jorge Galvez, Tracey Polsky, Genna Kreher, Blair Kraus, Luis Ahumada, John Mccloskey, Heather Wolfe
CONTEXT: Complete blood count (CBC) testing commonly occurs to determine the need for blood transfusions after surgical procedures. Many clinicians believe postoperative CBCs are "routine." OBJECTIVE: To decrease unnecessary routine CBC testing in a low-risk cohort of postoperative patients in the pediatric intensive care unit (PICU) at The Children's Hospital of Philadelphia by 50% in 6 months. DESIGN: Quality-improvement study. Data from our institution regarding frequency of ordering laboratory studies and transfusion requirements were collected for prior quality-improvement work demonstrating the safety and feasibility of avoiding routine postoperative CBCs in this cohort...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28241813/anaemia-in-hospitalised-preschool-children-from-a-rural-area-in-mozambique-a-case-control-study-in-search-for-aetiological-agents
#15
Cinta Moraleda, Ruth Aguilar, Llorenç Quintó, Tacilta Nhampossa, Montserrat Renom, Augusto Nhabomba, Sozinho Acácio, John J Aponte, Delino Nhalungo, Ariel H Achtman, Louis Schofield, Helder Martins, Eusebio Macete, Pedro L Alonso, Clara Menéndez
BACKGROUND: Young children bear the world's highest prevalence of anaemia, the majority of which is of multifactorial aetiology, which in turn hampers its successful prevention. Even moderate degrees of anaemia are associated with increased mortality and morbidity. Despite this evidence, there is a lack of effective preventive programs and absence of consensus in the safety of iron supplementation in malaria areas, which reflects the poor understanding of the contribution of different aetiologies to anaemia...
February 28, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28240466/liberal-transfusion-strategies-still-the-trend-in-burn-surgery
#16
N L Allorto, M D T Smith, D L Clarke
OBJECTIVE: Blood is a limited resource in middle-income countries such as South Africa. Transfusion is associated with complications and expense. We aimed to understand our transfusion practices in burn surgery as well as ascertain the opinion of a broader group of surgeons and anaesthetists regarding transfusion triggers in order to understand the rationale and bias that drives current transfusion practice in our setting. METHOD: Firstly, we investigated the current blood practices at our regional burn service through an audit of perioperative notes for all patients receiving packed cell transfusions in a 24-month period...
September 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28238822/does-receiving-a-blood-transfusion-predict-for-length-of-stay-in-children-undergoing-cranial-vault-remodeling-for-craniosynostosis-outcomes-using-the-pediatric-national-surgical-quality-improvement-program-dataset
#17
Michael R Markiewicz, Tord Alden, Mohmed Vasim Momin, Alexis B Olsson, Ray J Jurado, Fizan Abdullah, Michael Miloro
PURPOSE: Recent interventions have aimed at reducing the need for blood transfusions in the perioperative period in patients with craniosynostosis undergoing cranial vault remodeling. However, little is known regarding whether the receipt of a blood transfusion influences the length of hospital stay. The purpose of this study was to assess whether the receipt of a blood transfusion in patients undergoing cranial vault remodeling is associated with an increased length of stay. MATERIALS AND METHODS: To address the research purposes, we designed a retrospective cohort study using the 2014 Pediatric National Surgical Quality Improvement Program (NSQIP Peds) dataset...
February 3, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28221267/health-related-quality-of-life-and-its-predictors-among-transfusion-dependent-thalassemia-patients
#18
Gulen Tuysuz, Funda Tayfun
PURPOSE: With regular blood transfusions and modern medical management strategies, transfusion-dependent thalassemia (TDT) patients are currently living into adulthood, but they still suffer from the chronicity of the disease and its complications. This study was aimed to assess the health-related quality of life (HRQoL) scores in pediatric TDT patients compared with healthy controls. PATIENTS AND METHODS: The PedsQL 4.0 Generic Core Scales were administered to 80 pediatric TDT patients (aged 5 to 18 y, child self-report) and their parents (parent-proxy report), as well as age-matched and sex-matched healthy controls (80 participants and their parents)...
February 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28221264/efficacy-and-safety-of-combined-oral-chelation-with-deferiprone-and-deferasirox-in-children-with-%C3%AE-thalassemia-major-an-experience-from-north-india
#19
Nupur Parakh, Jagdish Chandra, Sunita Sharma, Bhavna Dhingra, Rajesh Jain, DeoNath Mahto
OBJECTIVE: A combination of desferrioxamine with either deferiprone (DFP) or deferasirox (DFX) for patients with β-thalassemia major who do not achieve negative iron balance with monotherapy has been studied widely. However, poor compliance resulting from the need for parentral administration of desferrioxamine and its cost necessicitates combining 2 oral chelators. METHODS: A prospective study was conducted in patients with transfusion-dependent β-thalassemia major in a tertiary care center over 2 years...
April 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28211198/safety-of-antifibrinolytics-in-cranial-vault-reconstructive-surgery-a-report-from-the-pediatric-craniofacial-collaborative-group
#20
Susan M Goobie, Franklyn P Cladis, Chris D Glover, Henry Huang, Srijaya K Reddy, Allison M Fernandez, David Zurakowski, Paul A Stricker
BACKGROUND: Antifibrinolytic therapy significantly decreases blood loss and transfusion in pediatric cranial vault reconstructive surgery; however, concern regarding the side effects profile limits clinical use. AIMS: The aim was to utilize the Pediatric Craniofacial Surgery Perioperative Registry database to identify the safety profile of antifibrinolytic therapy for cranial vault reconstructive surgery by reporting the incidence of adverse events as they relate to exposure to tranexamic acid and aminocaproic acid compared to no exposure to antifibrinolytics...
March 2017: Paediatric Anaesthesia
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