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https://www.readbyqxmd.com/read/28936698/recommendations-for-mechanical-ventilation-of-critically-ill-children-from-the-paediatric-mechanical-ventilation-consensus-conference-pemvecc
#1
Martin C J Kneyber, Daniele de Luca, Edoardo Calderini, Pierre-Henri Jarreau, Etienne Javouhey, Jesus Lopez-Herce, Jürg Hammer, Duncan Macrae, Dick G Markhorst, Alberto Medina, Marti Pons-Odena, Fabrizio Racca, Gerhard Wolf, Paolo Biban, Joe Brierley, Peter C Rimensberger
PURPOSE: Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. METHODS: The European Society for Paediatric and Neonatal Intensive Care initiated a consensus conference of international European experts in paediatric mechanical ventilation to provide recommendations using the Research and Development/University of California, Los Angeles, appropriateness method...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28905374/heat-and-moisture-exchangers-versus-heated-humidifiers-for-mechanically-ventilated-adults-and-children
#2
REVIEW
Donna Gillies, David A Todd, Jann P Foster, Bisanth T Batuwitage
BACKGROUND: Invasive ventilation is used to assist or replace breathing when a person is unable to breathe adequately on their own. Because the upper airway is bypassed during mechanical ventilation, the respiratory system is no longer able to warm and moisten inhaled gases, potentially causing additional breathing problems in people who already require assisted breathing. To prevent these problems, gases are artificially warmed and humidified. There are two main forms of humidification, heat and moisture exchangers (HME) or heated humidifiers (HH)...
September 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28881007/delayed-antibiotic-prescriptions-for-respiratory-infections
#3
REVIEW
Geoffrey Kp Spurling, Chris B Del Mar, Liz Dooley, Ruth Foxlee, Rebecca Farley
BACKGROUND: Concerns exist regarding antibiotic prescribing for respiratory tract infections (RTIs) owing to adverse reactions, cost, and antibacterial resistance. One proposed strategy to reduce antibiotic prescribing is to provide prescriptions, but to advise delay in antibiotic use with the expectation that symptoms will resolve first. This is an update of a Cochrane Review originally published in 2007, and updated in 2010 and 2013. OBJECTIVES: To evaluate the effects on clinical outcomes, antibiotic use, antibiotic resistance, and patient satisfaction of advising a delayed prescription of antibiotics in respiratory tract infections...
September 7, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28879605/in-vitro-evaluation-of-limitations-and-possibilities-for-the-future-use-of-intracorporeal-gas-exchangers-placed-in-the-upper-lobe-position
#4
Erin Schumer, Klaus Höffler, Christian Kuehn, Mark Slaughter, Axel Haverich, Bettina Wiegmann
The lack of donor organs has led to the development of alternative "destination therapies", such as a bio-artificial lung (BA) for end-stage lung disease. Ultimately aiming at a fully implantable BA, general capabilities and limitations of different oxygenators were tested based on the model of BA positioning at the right upper lobe. Three different-sized oxygenators (neonatal, paediatric, and adult) were tested in a mock circulation loop regarding oxygenation and decarboxylation capacities for three respiratory pathologies...
September 6, 2017: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
https://www.readbyqxmd.com/read/28806480/aerosolized-prostacyclins-for-acute-respiratory-distress-syndrome-ards
#5
REVIEW
Arash Afshari, Anders Bastholm Bille, Mikkel Allingstrup
BACKGROUND: Acute respiratory distress syndrome (ARDS) is a critical condition that is associated with high mortality and morbidity. Aerosolized prostacyclin has been used to improve oxygenation despite the limited evidence available so far.This review was originally published in 2010 and updated in 2017. OBJECTIVES: To assess the benefits and harms of aerosolized prostacyclin in adults and children with ARDS. SEARCH METHODS: In this update, we searched CENTRAL (2017, Issue 4); MEDLINE (OvidSP), Embase (OvidSP), ISI BIOSIS Previews, ISI Web of Science, LILACS, CINAHL (EBSCOhost), and three trials registers...
July 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28708268/screening-protocols-to-monitor-respiratory-status-in-primary-immunodeficiency-disease-findings-from-a-european-survey-and-subclinical-infection-working-group
#6
S Jolles, S Sánchez-Ramón, I Quinti, P Soler-Palacín, C Agostini, B Florkin, L-J Couderc, N Brodszki, A Jones, H Longhurst, K Warnatz, F Haerynck, A Matucci, E de Vries
Many patients with primary immunodeficiency (PID) who have antibody deficiency develop progressive lung disease due to underlying subclinical infection and inflammation. To understand how these patients are monitored we conducted a retrospective survey based on patient records of 13 PID centres across Europe, regarding the care of 1061 adult and 178 paediatric patients with PID on immunoglobulin (Ig) G replacement. The most common diagnosis was common variable immunodeficiency in adults (75%) and hypogammaglobulinaemia in children (39%)...
July 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28695492/patterns-of-acute-poisoning-with-pesticides-in-the-paediatric-age-group
#7
Kavinda Chandimal Dayasiri, Shaluka F Jayamanne, Chamilka Y Jayasinghe
BACKGROUND: Pesticides are identified as one of the dangerous poisons globally in children and are associated with increased short- and long-term morbidity. Pesticide poisoning is the most common method of self-poisoning among adults in rural Sri Lanka, and the clinical management is associated with significant healthcare costs to the country. There is however little data published on acute pesticide poisoning among children in rural Sri Lanka. The current study aimed to comprehensively evaluate clinical profiles, harmful first aid measures, emergency clinical management, complications and outcomes related to acute pesticide poisoning among children in the rural community of Sri Lanka...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28692675/cardio-haemodynamic-assessment-and-venous-lactate-in-severe-dengue-relationship-with-recurrent-shock-and-respiratory-distress
#8
Sophie Yacoub, Trieu Huynh Trung, Phung Khanh Lam, Vuong Huynh Ngoc Thien, Duong Ha Thi Hai, Tu Qui Phan, Oanh Pham Kieu Nguyet, Nguyen Than Ha Quyen, Cameron Paul Simmons, Christopher Broyd, Gavin Robert Screaton, Bridget Wills
BACKGROUND: Dengue can cause plasma leakage that may lead to dengue shock syndrome (DSS). In approximately 30% of DSS cases, recurrent episodes of shock occur. These patients have a higher risk of fluid overload, respiratory distress and poor outcomes. We investigated the association of echocardiographically-derived cardiac function and intravascular volume parameters plus lactate levels, with the outcomes of recurrent shock and respiratory distress in severe dengue. METHODS/PRINCIPLE FINDINGS: We performed a prospective observational study in Paediatric and adult ICU, at the Hospital for Tropical Diseases (HTD), Ho Chi Minh City, Vietnam...
July 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28687343/the-montreux-definition-of-neonatal-ards-biological-and-clinical-background-behind-the-description-of-a-new-entity
#9
REVIEW
Daniele De Luca, Anton H van Kaam, David G Tingay, Sherry E Courtney, Olivier Danhaive, Virgilio P Carnielli, Luc J Zimmermann, Martin C J Kneyber, Pierre Tissieres, Joe Brierley, Giorgio Conti, Jane J Pillow, Peter C Rimensberger
Acute respiratory distress syndrome (ARDS) is undefined in neonates, despite the long-standing existing formal recognition of ARDS syndrome in later life. We describe the Neonatal ARDS Project: an international, collaborative, multicentre, and multidisciplinary project which aimed to produce an ARDS consensus definition for neonates that is applicable from the perinatal period. The definition was created through discussions between five expert members of the European Society for Paediatric and Neonatal Intensive Care; four experts of the European Society for Paediatric Research; two independent experts from the USA and two from Australia...
August 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28677615/myopathology-of-adult-and-paediatric-mitochondrial-diseases
#10
REVIEW
Rahul Phadke
Mitochondria are dynamic organelles ubiquitously present in nucleated eukaryotic cells, subserving multiple metabolic functions, including cellular ATP generation by oxidative phosphorylation (OXPHOS). The OXPHOS machinery comprises five transmembrane respiratory chain enzyme complexes (RC). Defective OXPHOS gives rise to mitochondrial diseases (mtD). The incredible phenotypic and genetic diversity of mtD can be attributed at least in part to the RC dual genetic control (nuclear DNA (nDNA) and mitochondrial DNA (mtDNA)) and the complex interaction between the two genomes...
July 4, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28623011/-recommendations-for-the-use-of-rapid-diagnosis-techniques-in-respiratory-infections-in-primary-care
#11
Carles Llor, Miriam Alkorta Gurrutxaga, Josep de la Flor I Bru, Sílvia Bernárdez Carracedo, José Luis Cañada Merino, Mario Bárcena Caamaño, Carmen Serrano Martino, Josep Maria Cots Yago
Respiratory tract infections rank first as causes of adult and paediatric infectious morbidity in primary care in Spain. These infections are usually self-limiting and are mainly caused by viruses. However, a high percentage of unnecessary antibiotic prescription is reported. Point-of-care tests are biomedical tests, which can be used near the patient, without interference of a laboratory. The use of these tests, many of which have been recently developed, is rapidly increasing in general practice. Notwithstanding, we must mull over whether they always contribute to an effective and high-quality diagnostic process by primary care clinicians...
August 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28604599/nutritional-challenges-in-duchenne-muscular-dystrophy
#12
REVIEW
Simona Salera, Francesca Menni, Maurizio Moggio, Sophie Guez, Monica Sciacco, Susanna Esposito
Neuromuscular diseases (NMDs) represent a heterogeneous group of acquired or inherited conditions. Nutritional complications are frequent in NMDs, but they are sometimes underestimated. With the prolongation of survival in patients with NMDs, there are several nutritional aspects that are important to consider, including the deleterious effects of overnutrition on glucose metabolism, mobility, and respiratory and cardiologic functions; the impact of hyponutrition on muscle and ventilatory function; constipation and other gastrointestinal complications; chewing/swallowing difficulties with an increased risk of aspiration that predisposes to infectious diseases and respiratory complications; as well as osteoporosis with an associated increased risk of fractures...
June 10, 2017: Nutrients
https://www.readbyqxmd.com/read/28601216/usefulness-of-ct-value-in-acute-respiratory-infections-caused-by-respiratory-syncytial-virus-a-and-b-and-influenza-virus-a-h1n1-pdm09-a-h3n2-and-b
#13
Jordi Reina, Carmen Morales, María Busquets, Cristina Norte
INTRODUCTION: Acute respiratory infections of viral cause are very frequent entities. The difficulty in evaluating the detection of a virus in these entities could be solved by determining the viral load. METHODS: A prospective study on the mean Ct value (cycle threshold value) detected against RSV-A, RSV-B and influenza A (H1N1)pdm09, A (H3N2) and B viruses in patients of different origin and age was performed. Detection was performed using a commercial molecular amplification (RT-PCR) technique...
June 7, 2017: Enfermedades Infecciosas y Microbiología Clínica
https://www.readbyqxmd.com/read/28546471/automated-quality-control-of-forced-oscillation-measurements-respiratory-artifact-detection-with-advanced-feature-extraction
#14
Thuy T Pham, Philip H W Leong, Paul David Robinson, Thomas Gutzler, Adelle S Jee, Gregory G King, Cindy Thamrin
The forced oscillation technique (FOT) can provide unique and clinically relevant lung function information with little cooperation with subjects. However, FOT has higher variability than spirometry, possibly because strategies for quality control and reducing artifacts in FOT measurements have yet to be standardized or validated. Many quality control procedures either rely on simple statistical filters or subjective evaluation by a human operator. In this study, we propose an automated artifact removal approach based on the resistance against flow profile, applied to complete breaths...
May 25, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28523136/phenotypic-presentation-of-chronic-cough-in-children
#15
EDITORIAL
Ahmad Kantar
Chronic cough in children is increasingly defined as a cough that lasts more than four weeks. It is recognized as a different entity than cough in adults. As a result, the diagnostic approach and management of chronic cough in children are no longer extrapolated from adult guidelines. These differences are attributed to the various characteristics of the respiratory tract, immunological system and nervous system in children. Specific paediatric guidelines and algorithms for chronic cough are now widely applied...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28522352/immune-plasma-for-the-treatment-of-severe-influenza-an-open-label-multicentre-phase-2-randomised-study
#16
John H Beigel, Pablo Tebas, Marie-Carmelle Elie-Turenne, Ednan Bajwa, Todd E Bell, Charles B Cairns, Shmuel Shoham, Jaime G Deville, Eric Feucht, Judith Feinberg, Thomas Luke, Kanakatte Raviprakash, Janine Danko, Dorothy O'Neil, Julia A Metcalf, Karen King, Timothy H Burgess, Evgenia Aga, H Clifford Lane, Michael D Hughes, Richard T Davey
BACKGROUND: Influenza causes substantial morbidity and mortality despite available treatments. Anecdotal reports suggest that plasma with high antibody titres to influenza might be of benefit in the treatment of severe influenza. METHODS: In this randomised, open-label, multicentre, phase 2 trial, 29 academic medical centres in the USA assessed the safety and efficacy of anti-influenza plasma with haemagglutination inhibition antibody titres of 1:80 or more to the infecting strain...
June 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28512388/insufficient-humidification-of-respiratory-gases-in-patients-who-are-undergoing-therapeutic-hypothermia-at-a-paediatric-and-adult-intensive-care-unit
#17
Yukari Tanaka, Sachiko Iwata, Masahiro Kinoshita, Kennosuke Tsuda, Shoichiro Tanaka, Naoko Hara, Ryota Shindou, Eimei Harada, Ryouji Kijima, Osamu Yamaga, Hitoe Ohkuma, Kazuo Ushijima, Teruo Sakamoto, Yushiro Yamashita, Osuke Iwata
For cooled newborn infants, humidifier settings for normothermic condition provide excessive gas humidity because absolute humidity at saturation is temperature-dependent. To assess humidification of respiratory gases in patients who underwent moderate therapeutic hypothermia at a paediatric/adult intensive care unit, 6 patients were studied over 9 times. Three humidifier settings, 37-default (chamber-outlet, 37°C; Y-piece, 40°C), 33.5-theoretical (chamber-outlet, 33.5°C; Y-piece, 36.5°C), and 33.5-adjusted (optimised setting to achieve saturated vapour at 33...
2017: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/28484313/management-of-cardiac-involvement-in-muscular-dystrophies-paediatric-versus-adult-forms
#18
REVIEW
Alberto Palladino, Paola D'Ambrosio, Andrea Antonio Papa, Roberta Petillo, Chiara Orsini, Marianna Scutifero, Gerardo Nigro, Luisa Politano
Muscular dystrophies are a group of genetic disorders characterized by muscle degeneration and consequent substitution by fat and fibrous tissue. Cardiac involvement is an almost constant feature in a great part of these diseases, as both primary myocardial involvement and secondary involvement due to respiratory insufficiency, pulmonary hypertension or reduced mobility. Primary myocardial involvement usually begins more precociously compared to the secondary involvement. In fact the first signs of cardiomyopathy can be observed in the first decade of life in muscular dystrophies with childhood onset and later in adult form of muscular dystrophies as myotonic dystrophy type 1...
December 2016: Acta Myologica: Myopathies and Cardiomyopathies: Official Journal of the Mediterranean Society of Myology
https://www.readbyqxmd.com/read/28462830/a-systematic-review-of-the-impact-of-nurse-initiated-medications-in-the-emergency-department
#19
REVIEW
C J Cabilan, Mary Boyde
BACKGROUND: Nurse-initiated medications are one of the most important strategies used to facilitate timely care for people who present to Emergency Departments (EDs). The purpose of this paper was to systematically review the evidence of nurse-initiated medications to guide future practice and research. METHODS: A systematic review of the literature was conducted to locate published studies and Grey literature. All studies were assessed independently by two independent reviewers for relevance using titles and abstracts, eligibility dictated by the inclusion criteria, and methodological quality...
May 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28249938/remifentanil-for-procedural-sedation-a-systematic-review-of-the-literature
#20
Magdalena Kisilewicz, Hans Rosenberg, Christian Vaillancourt
OBJECTIVE: We sought to determine the performance characteristics of remifentanil as an agent of procedural sedation and analgesia (PSA) for adult and paediatric patients undergoing procedures similar to those executed in the ED. METHODS: We systematically reviewed electronically published literature, grey literature, conference proceedings and trial registries from 1946 to 2015. Outcome measures included PSA effectiveness, recovery time, patient safety and resource management...
May 2017: Emergency Medicine Journal: EMJ
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