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pediatric hemodynamic monitoring

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https://www.readbyqxmd.com/read/27923692/a-hemodynamic-directed-approach-to-pediatric-cardiopulmonary-resuscitation-hd-cpr-improves-survival
#1
Ryan W Morgan, Todd J Kilbaugh, Wesley Shoap, George Bratinov, Yuxi Lin, Ting-Chang Hsieh, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
AIM: Most pediatric in-hospital cardiac arrests (IHCAs) occur in ICUs where invasive hemodynamic monitoring is frequently available. Titrating cardiopulmonary resuscitation (CPR) to the hemodynamic response of the individual improves survival in preclinical models of adult cardiac arrest. The objective of this study was to determine if titrating CPR to systolic blood pressure (SBP) and coronary perfusion pressure (CoPP) in a pediatric porcine model of asphyxia-associated ventricular fibrillation (VF) IHCA would improve survival as compared to traditional CPR...
December 3, 2016: Resuscitation
https://www.readbyqxmd.com/read/27909839/biventricular-support-using-a-centrifugal-pump-in-a-6%C3%A2-year-old-with-fulminant-myocarditis
#2
Hiromu Kehara, Tamaki Takano, Takamitsu Terasaki, Kenji Okada
We experienced a case of ventricular assist with both a pulsatile-flow and a continuous-flow pump in a pediatric patient, and herein report the clinical course and characteristics of the pumps. A 6-year-old female was diagnosed with fulminant myocarditis and transferred to our hospital for mechanical support. After 12 days of extracorporeal membrane oxygenation, we implanted a left ventricular assist device (LVAD) and a right ventricular assist device (RVAD) using centrifugal Gyro pumps with a membrane oxygenator in a paracorporeal fashion...
December 1, 2016: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/27886191/hemodynamic-and-metabolic-effects-of-a-new-pediatric-dobutamine-formulation-in-hypoxic-newborn-pigs
#3
Victoria E Mielgo, Adolf Valls-I-Soler, Juan M Lopez de Heredia, Heike Rabe, Carmen Rey-Santano
BACKGROUND: The aim of our study was to measure drug-related changes in hemodynamics and oxygen metabolism in response to different doses of an age-appropriate dobutamine formulation in hypoxic pigs. A secondary aim was to validate superior vena cava flow (SVCF) as a marker of cardiac index (CI) for subsequent clinical trials of this formulation in humans. METHODS: Newborn pigs (n=18) were exposed to 2h-hypoxia (10-15% oxygen) followed by reoxygenation (21-30% oxygen 4h)...
November 25, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27870825/evaluation-of-pediatric-liver-transplantation-related-artery-complications-using-intra-operative-multi-parameter-ultrasonography
#4
Xiuyun Ren, Junhui Guan, Nong Gao, Hong Niu, Jie Tang
BACKGROUND This article discusses the value of using multi-parameter evaluation of intra-operative ultrasonography in evaluating pediatric liver transplantation-related arterial complications. MATERIAL AND METHODS Sixty-eight children receiving a liver transplant underwent intraoperative ultrasonography for monitoring of artery hemodynamics. The ultrasonic measurement parameters included the diameters of the hepatic artery (HA) of the donor and anastomotic stoma, peak systolic velocity (PSV), resistance index (RI), acceleration time (SAT), and blood flow volume...
November 21, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27862035/does-an-open-recirculation-line-affect-the-flow-rate-and-pressure-in-a-neonatal-extracorporeal-life-support-circuit-with-a-centrifugal-or-roller-pump
#5
Shigang Wang, Shannon B Spencer, Karl Woitas, Kristen Glass, Allen R Kunselman, Akif Ündar
The objective of this study is to evaluate the impact of an open or closed recirculation line on flow rate, circuit pressure, and hemodynamic energy transmission in simulated neonatal extracorporeal life support (ECLS) systems. The two neonatal ECLS circuits consisted of a Maquet HL20 roller pump (RP group) or a RotaFlow centrifugal pump (CP group), Quadrox-iD Pediatric oxygenator, and Biomedicus arterial and venous cannulae (8 Fr and 10 Fr) primed with lactated Ringer's solution and packed red blood cells (hematocrit 35%)...
November 15, 2016: Artificial Organs
https://www.readbyqxmd.com/read/27849656/the-use-of-nesiritide-in-children-with-congenital-heart-disease
#6
Ronald A Bronicki, Michele Domico, Paul A Checchia, Curtis E Kennedy, Ayse Akcan-Arikan
OBJECTIVE: We evaluated the use of nesiritide in children with critical congenital heart disease, pulmonary congestion, and inadequate urine output despite conventional diuretic therapy. DESIGN: We conducted a retrospective analysis of 26 consecutive patients, comprising 37 infusions occurring during separate hospitalizations. Hemodynamic variables, urine output, and serum creatinine levels were monitored prior to and throughout the duration of therapy with nesiritide...
November 15, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27833479/efficacy-of-dexmedetomidine-as-an-adjuvant-to-ropivacaine-in-pediatric-caudal-epidural-block
#7
Manoj Kamal, Sadik Mohammed, Saroj Meena, Geeta Singariya, Rakesh Kumar, Dilip Singh Chauhan
CONTEXT: Caudal analgesia is a reliable and an easy method to provide intraoperative and postoperative analgesia for infraumbilical surgeries in pediatric population but with the disadvantage of short duration of action after single injection. Many additives were used in combination with local anesthetics in the caudal block to prolong the postoperative analgesia. AIM: We compared the analgesic effects and side effects of dexmedetomidine added to ropivacaine in pediatric patients undergoing lower abdominal surgeries...
October 2016: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/27829710/early-norepinephrine-decreases-fluid-and-ventilatory-requirements-in-pediatric-vasodilatory-septic-shock
#8
Suchitra Ranjit, Rajeswari Natraj, Sathish Kumar Kandath, Niranjan Kissoon, Balasubramaniam Ramakrishnan, Paul E Marik
AIMS: We previously reported that vasodilatation was common in pediatric septic shock, regardless of whether they were warm or cold, providing a rationale for early norepinephrine (NE) to increase venous return (VR) and arterial tone. Our primary aim was to evaluate the effect of smaller fluid bolus plus early-NE versus the American College of Critical Care Medicine (ACCM) approach to more liberal fluid boluses and vasoactive-inotropic agents on fluid balance, shock resolution, ventilator support and mortality in children with septic shock...
October 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/27800660/treatment-of-severe-adult-traumatic-brain-injury-using-bone-marrow-mononuclear-cells
#9
Charles S Cox, Robert A Hetz, George P Liao, Benjamin M Aertker, Linda Ewing-Cobbs, Jenifer Juranek, Sean I Savitz, Margaret L Jackson, Anna M Romanowska-Pawliczek, Fabio Triolo, Pramod K Dash, Claudia Pedroza, Dean A Lee, Laura Worth, Imoigele P Aisiku, Huimahn A Choi, John B Holcomb, Ryan S Kitagawa
BACKGROUND: Numerous pre-clinical studies using bone marrow derived cells for the treatment of traumatic brain injury and stroke have demonstrated efficacy in terms of blood-brain barrier preservation, neurogenesis, and other functional outcomes. Phase 1 clinical trials using bone marrow mononuclear cells infused intravenously in children with severe TBI demonstrated safety and potentially a CNS structural preservation treatment effect. This study sought to confirm the safety, logistic feasibility, and potential treatment effect size of structural preservation/inflammatory biomarker mitigation in adults to guide Phase 2 clinical trial design...
November 1, 2016: Stem Cells
https://www.readbyqxmd.com/read/27794361/the-vulnerable-microcirculation-in-the-critically-ill-pediatric-patient
#10
REVIEW
J W Kuiper, D Tibboel, C Ince
In neonates, cardiovascular system development does not stop after the transition from intra-uterine to extra-uterine life and is not limited to the macrocirculation. The microcirculation (MC), which is essential for oxygen, nutrient, and drug delivery to tissues and cells, also develops. Developmental changes in the microcirculatory structure continue to occur during the initial weeks of life in healthy neonates. The physiologic hallmarks of neonates and developing children make them particularly vulnerable during critical illness; however, the cardiovascular monitoring possibilities are limited compared with critically ill adult patients...
October 30, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27755489/the-use-of-epinephrine-in-caudal-anesthesia-increases-stroke-volume-and-cardiac-output-in-children
#11
Chang Amber Liu, Jinghu Sui, Charles J Coté, Thomas A Anderson
BACKGROUND AND OBJECTIVES: Caudal anesthesia is a common and effective regional anesthesia technique in pediatric patients. The addition of epinephrine to local anesthetics in caudal anesthesia is a frequent practice; however, changes in hemodynamic and cardiac parameters produced by epinephrine in caudal anesthesia are not well studied. Using data collected with the ICON noninvasive cardiac output monitor, we examined the hemodynamic changes associated with the administration of epinephrine containing local anesthetics during caudal anesthesia in children...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27687464/effects-of-music-on-sedation-depth-and-sedative-use-during-pediatric-dental-procedures
#12
Ozlem Ozkalayci, Coskun Araz, Sevi Burcak Cehreli, Resmiye Ebru Tirali, Zeynep Kayhan
STUDY OBJECTIVE: The study aimed to investigate the effects of listening to music or providing sound isolation on the depth of sedation and need for sedatives in pediatric dental patients. DESIGN: Prospective, randomized, and controlled study. SETTING: Tertiary, university hospital. PATIENTS: In total, 180 pediatric patients, American Society of Anesthesiologists physical status I and II, who were scheduled for dental procedures of tooth extraction, filling, amputation, and root treatment...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27651032/intravenous-infiltration-risk-by-catheter-dwell-time-among-hospitalized-children
#13
Ihn Sook Jeong, Gey Rok Jeon, Man Seop Lee, Bum Joo Shin, Yong-Jin Kim, Soon Mi Park, Sookyung Hyun
: This study was aimed to examine the cumulative risk for infiltration over IV catheter dwell time by general or catheterization-specific characteristics of pediatric patients with IV therapy. DESIGN AND METHODS: This secondary data analysis was done with the data of 1596 children who received peripheral IV therapy at least once during their hospital stay between August 1st and October 30th, 2011 and in June, 2013 in an academic medical center, Yangsan, Republic of Korea...
September 17, 2016: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/27631447/-control-of-hemodynamic-and-cerebral-perfusion-in-children-which-monitoring-should-be-used
#14
Claudia Höhne
Options for hemodynamic and cerebral perfusion monitoring in pediatric anesthesia are limited, but it should be used to reduce the potential damage due to hypotension and reduced cerebral perfusion. Non-invasive blood pressure measurement should be used in all cases of pediatric anesthesia and near-infrared spectroscopy for risk pediatric patients. In former times measurement of non-invasive blood pressure had no priority, this is not state of the art based on current data.
September 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27613151/treatment-for-unstable-slipped-capital-femoral-epiphysis-current-status-and-future-challenge-in-japan
#15
Takuya Otani, Tohru Futami, Atsushi Kita, Toshio Kitano, Takashi Saisu, Shinichi Satsuma, Yasuhiko Kawaguchi
BACKGROUND: Treatment for unstable slipped capital femoral epiphysis (SCFE) is challenging and controversial. For many years, the debate centered around closed treatments and especially the pros and cons of manual reduction and its concrete procedure. However, recent studies reported on open treatments such as open reduction through an anterior approach and modified Dunn procedure. Being in a period of such transition, we investigated the current status and future challenge of treatment for unstable SCFE...
September 6, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27603562/near-infrared-spectroscopy-for-detection-of-a-significant-patent-ductus-arteriosus
#16
Valerie Y Chock, Laura A Rose, Jeanet V Mante, Rajesh Punn
BACKGROUND: Near-infrared spectroscopy (NIRS) may assist with characterization of a hemodynamically significant patent ductus arteriosus (hsPDA) by measuring cerebral and renal saturation (Csat and Rsat) levels. We hypothesized that Csat and Rsat in preterm infants with an hsPDA would be decreased compared to those with no PDA or non-significant PDA. METHODS: This non a-priori designed study retrospectively investigated clinical and ECHO characteristics of preterm infants <29 weeks gestation who underwent routine NIRS monitoring...
September 7, 2016: Pediatric Research
https://www.readbyqxmd.com/read/27599454/cardiac-catheterization-in-children-with-pulmonary-arterial-hypertension
#17
Hiroyuki Matsuura
Cardiac catheterization of childhood pulmonary arterial hypertension (PAH) plays a pivotal role in assessing the severity of the disease as well as its prognosis, selection of the most adequate pulmonary vasodilators, and evaluation of effectiveness. However, sudden deterioration of cardiovascular hemodynamics can be easily induced by pain, a patient's agitation, catheter manipulation, and by vasodilator provocation tests; these could trigger a pulmonary hypertension crisis, vagotony, respiratory distress, and hemoptysis resulting in critical complications, including death...
September 7, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27591466/intraoperative-goal-directed-hemodynamic-therapy-in-noncardiac-surgery-a-systematic-review-and-meta-analysis
#18
Javier Ripollés, Angel Espinosa, Eugenio Martínez-Hurtado, Alfredo Abad-Gurumeta, Rubén Casans-Francés, Cristina Fernández-Pérez, Francisco López-Timoneda, José María Calvo-Vecino
BACKGROUND: The goal directed hemodynamic therapy is an approach focused on the use of cardiac output and related parameters as end-points for fluids and drugs to optimize tissue perfusion and oxygen delivery. Primary aim: To determine the effects of intraoperative goal directed hemodynamic therapy on postoperative complications rates. METHODS: A meta-analysis was carried out of the effects of goal directed hemodynamic therapy in adult noncardiac surgery on postoperative complications and mortality using Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology...
September 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27559005/pediatric-patient-blood-management-programs-not-just-transfusing-little-adults
#19
REVIEW
Ruchika Goel, Melissa M Cushing, Aaron A R Tobian
Red blood cell transfusions are a common life-saving intervention for neonates and children with anemia, but transfusion decisions, indications, and doses in neonates and children are different from those of adults. Patient blood management (PBM) programs are designed to assist clinicians with appropriately transfusing patients. Although PBM programs are well recognized and appreciated in the adult setting, they are quite far from standard of care in the pediatric patient population. Adult PBM standards cannot be uniformly applied to children, and there currently is significant variation in transfusion practices...
October 2016: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/27553912/faster-rate-of-blood-volume-change-in-pediatric-hemodialysis-patients-impairs-cardiac-index
#20
Jessica J Geer, Shweta Shah, Eric Williams, Ayse Akcan Arikan, Poyyapakkam Srivaths
BACKGROUND: Intradialytic hypotension and myocardial stunning are proposed as contributing to the pathogenesis of increased cardiovascular disease burden and death in patients receiving maintenance hemodialysis (HD). Noninvasive cardiac output measurements provide a dynamic, real-time assessment of hemodynamic parameters. We investigated intradialytic changes in hemodynamic parameters in pediatric outpatients receiving chronic HD and determined patient and treatment risk factors associated with such intradialytic changes...
August 23, 2016: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
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