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Ventilator strategies in Children

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https://www.readbyqxmd.com/read/27871584/a-comparison-of-3-ventilation-strategies-in-children-younger-than-1-year-using-a-proseal-laryngeal-mask-airway-a-randomized-controlled-trial
#1
T Wesley Templeton, Lauren K Hoke, Leah B Templeton, Douglas G Ririe, Danielle M Rose, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in patients younger than 1 year with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Tertiary care pediatric hospital. PATIENTS: Thirty-nine American Society Anesthesiologists classifications 1 to 2, pediatric patients younger than 1 year...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27854381/interventions-for-children-with-ear-discharge-occurring-at-least-two-weeks-following-grommet-ventilation-tube-insertion
#2
REVIEW
Roderick P Venekamp, Faisal Javed, Thijs Ma van Dongen, Angus Waddell, Anne Gm Schilder
BACKGROUND: Ear discharge (otorrhoea) is common in children with grommets (ventilation/tympanostomy tubes); the proportion of children developing discharge ranges from 25% to 75%. The most common treatment strategies include oral broad-spectrum antibiotics, antibiotic eardrops or those containing a combination of antibiotic(s) and a corticosteroid, and initial observation. Important drivers for one strategy over the other are concerns over the side effects of oral antibiotics and the potential ototoxicity of antibiotic eardrops...
November 17, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27790606/nutrition-a-primary-therapy-in-pediatric-acute-respiratory-distress-syndrome
#3
REVIEW
Bryan Wilson, Katri Typpo
Appropriate nutrition is an essential component of intensive care management of children with acute respiratory distress syndrome (ARDS) and is linked to patient outcomes. One out of every two children in the pediatric intensive care unit (PICU) will develop malnutrition or have worsening of baseline malnutrition and present with specific micronutrient deficiencies. Early and adequate enteral nutrition (EN) is associated with improved 60-day survival after pediatric critical illness, and, yet, despite early EN guidelines, critically ill children receive on average only 55% of goal calories by PICU day 10...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27787571/-anesthesia-for-medical-students-a-brief-guide-to-practical-anesthesia-in-adults-with-a-web-based-video-illustration
#4
S Mathis, O Schlafer, J Abram, J Kreutziger, P Paal, V Wenzel
In Germany, Austria and Switzerland, anesthesiologists are the second largest group of physicians in hospitals, but this does not correspond to the amount of anesthesiology teaching that medical students receive in medical schools. Accordingly, the chances of medical students recognizing anesthesiology as a promising personal professional career are smaller than in other disciplines with large teaching components. Subsequent difficulties to recruit anesthesiology residents are likely, although many reasons support anesthesiology as a professional career...
October 27, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27734109/conservative-fluid-management-or-deresuscitation-for-patients-with-sepsis-or-acute-respiratory-distress-syndrome-following-the-resuscitation-phase-of-critical-illness-a-systematic-review-and-meta-analysis
#5
Jonathan A Silversides, Emmet Major, Andrew J Ferguson, Emma E Mann, Daniel F McAuley, John C Marshall, Bronagh Blackwood, Eddy Fan
BACKGROUND: It is unknown whether a conservative approach to fluid administration or deresuscitation (active removal of fluid using diuretics or renal replacement therapy) is beneficial following haemodynamic stabilisation of critically ill patients. PURPOSE: To evaluate the efficacy and safety of conservative or deresuscitative fluid strategies in adults and children with acute respiratory distress syndrome (ARDS), sepsis or systemic inflammatory response syndrome (SIRS) in the post-resuscitation phase of critical illness...
October 12, 2016: Intensive Care Medicine
https://www.readbyqxmd.com/read/27716596/assessment-of-mastoid-function-with-magnetic-resonance-imaging-after-canal-wall-up-cholesteatoma-surgery
#6
William J Parkes, Sharon L Cushing, Blake C Papsin, Susan I Blaser, Adrian L James
OBJECTIVE: To use magnetic resonance imaging (MRI) to assess the extent of mastoid opacification after canal wall up (CWU) cholesteatoma surgery. MATERIALS AND METHODS: Thirty-five children in whom post-operative MRI had been obtained after CWU surgery. Cholesteatoma confined to the meso- and/or epi-tympanum was removed using a transcanal approach (n=18). More extensive disease required a combined approach tympanomastoidectomy (CAT, n=17). Mastoid opacification was assessed in both ears by a neuroradiologist blind to surgical details using an ordinal scale from 0 (no opacification) to 6 (completely opacified)...
August 2016: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/27687391/comparing-3-ventilation-modalities-by-measuring-several-respiratory-parameters-using-the-proseal-laryngeal-mask-airway-in-children
#7
T Wesley Templeton, Lauren K Hoke, Jill Yaung, Carol A Aschenbrenner, Danielle M Rose, Leah B Templeton, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Pediatric hospital of a tertiary care academic medical center. PATIENTS: Thirty-three, American Society of Anesthesiologists classification 1-2, pediatric patients (12 months to 5 years)...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27679965/pediatric-out-of-hospital-cardiac-arrest-characteristics-and-their-association-with-survival-and-neurobehavioral-outcome
#8
Kathleen L Meert, Russell Telford, Richard Holubkov, Beth S Slomine, James R Christensen, J Michael Dean, Frank W Moler
OBJECTIVE: To investigate relationships between cardiac arrest characteristics and survival and neurobehavioral outcome among children recruited to the Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial. DESIGN: Secondary analysis of Therapeutic Hypothermia after Pediatric Cardiac Arrest Out-of-Hospital trial data. SETTING: Thirty-six PICUs in the United States and Canada. PATIENTS: All children (n = 295) had chest compressions for greater than or equal to 2 minutes, were comatose, and required mechanical ventilation after return of circulation...
September 27, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27606309/sedation-in-critically-ill-children-with-respiratory-failure
#9
REVIEW
Nienke J Vet, Niina Kleiber, Erwin Ista, Matthijs de Hoog, Saskia N de Wildt
This article discusses the rationale of sedation in respiratory failure, sedation goals, how to assess the need for sedation as well as effectiveness of interventions in critically ill children, with validated observational sedation scales. The drugs and non-pharmacological approaches used for optimal sedation in ventilated children are reviewed, and specifically the rationale for drug selection, including short- and long-term efficacy and safety aspects of the selected drugs. The specific pharmacokinetic and pharmacodynamic aspects of sedative drugs in the critically ill child and consequences for dosing are presented...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27590561/asplenic-patients-and-invasive-pneumococcal-disease-how-bad-is-it-these-days
#10
Thomas J Marrie, Gregory J Tyrrell, Sumit R Majumdar, Dean T Eurich
OBJECTIVES: Most are aware of pneumococcal infection as a complication of splenectomy and the increased risk of severe invasive pneumococcal disease (IPD) in asplenic patients. However little is known of the current status of this entity in a population with an active pneumococcal conjugate vaccine program for children. METHODS: All IPD cases reported from 2000 to 2014 in Northern Alberta, Canada were collected prospectively. Socio-demographic variables, clinical characteristics, and IPD-related outcomes were compared between patients with and without a spleen using the Student t-test, Chi-square test, or Fisher's exact test, as appropriate...
August 30, 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27589216/congestive-heart-failure-in-children-with-pneumonia-and-respiratory-failure
#11
Kachaporn Nimdet, Win Techakehakij
BACKGROUND: Congestive heart failure (CHF) is one of the most common cardiac complications of pneumonia in adulthood that leads to increased risk of morbidity and mortality. However, little is known of CHF and pneumonia in children. This study aims to explore the characteristics and factors associated with the presence of CHF in under-5 children with pneumonia and respiratory failure. METHODS: A retrospective cohort was conducted in hospitalized patients aged 2-59 months with community-acquired pneumonia and respiratory failure from June 2011 to June 2014 at Suratthani Hospital, Thailand...
September 2, 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/27513687/poor-adherence-to-lung-protective-mechanical-ventilation-in-pediatric-acute-respiratory-distress-syndrome
#12
Shan L Ward, Carson M Quinn, Stacey L Valentine, Anil Sapru, Martha A Q Curley, Douglas F Willson, Kathleen D Liu, Michael A Matthay, Heidi R Flori
OBJECTIVES: To determine the frequency of low-tidal volume ventilation in pediatric acute respiratory distress syndrome and assess if any demographic or clinical factors improve low-tidal volume ventilation adherence. DESIGN: Descriptive post hoc analysis of four multicenter pediatric acute respiratory distress syndrome studies. SETTING: Twenty-six academic PICU. PATIENTS: Three hundred fifteen pediatric acute respiratory distress syndrome patients...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27486733/metapneumovirus-infections-and-respiratory-complications
#13
Susanna Esposito, Maria Vincenza Mastrolia
Acute respiratory tract infections (ARTIs) are the most common illnesses experienced by people of all ages worldwide. In 2001, a new respiratory pathogen called human metapneumovirus (hMPV) was identified in respiratory secretions. hMPV is an RNA virus of the Paramyxoviridae family, and it has been isolated on every continent and from individuals of all ages. hMPV causes 7 to 19% of all cases of ARTIs in both hospitalized and outpatient children, and the rate of detection in adults is approximately 3%. Symptoms of hMPV infection range from a mild cold to a severe disease requiring a ventilator and cardiovascular support...
August 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27428241/general-anesthesia-exposure-in-early-life-reduces-the-risk-of-allergic-diseases-a-nationwide-population-based-cohort-study
#14
Ho-Chang Kuo, Ya-Ling Yang, Shu-Chen Ho, Mindy Ming-Huey Guo, Jyun-Hong Jiang, Ying-Hsien Huang
General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27402424/perioperative-management-of-pediatric-en-bloc-combined-heart-liver-transplants-a-case-series-review
#15
Manchula Navaratnam, Ann Ng, Glyn D Williams, Katsuhide Maeda, Julianne M Mendoza, Waldo Concepcion, Seth A Hollander, Chandra Ramamoorthy
BACKGROUND: Combined heart and liver transplantation (CHLT) in the pediatric population involves a complex group of patients, many of whom have palliated congenital heart disease (CHD) involving single ventricle physiology. OBJECTIVE: The purpose of this study was to describe the perioperative management of pediatric patients undergoing CHLT at a single institution and to identify management strategies that may be used to optimize perioperative care. METHODS: We did a retrospective database review of all patients receiving CHLT at a children's hospital between 2006 and 2014...
October 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27375179/-congenital-neuromuscular-diseases-with-neonatal-respiratory-failure-excluding-myotonic-dystrophy-type-1-and-infantile-spinal-muscular-atrophy-diagnosis-strategy-according-to-a-19-child-series
#16
J Raignoux, U Walther-Louvier, C Espil, L Berthomieu, E Uro-Coste, F Rivier, C Cances
UNLABELLED: Apart from spinal muscular atrophy (SMA) and myotonic dystrophy type 1 (DM1), congenital neuromuscular diseases with early neonatal symptoms mean diagnostic and prognostic challenges mainly when infants require ventilatory support. OBJECTIVES: Consider a standardized strategy for infants suspected of congenital neuromuscular disease from analysis of the literature and retrospective experience with floppy and ventilatory support-dependent infants, after exclusion of well-known diseases (DM1, SMA)...
September 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27362854/burden-and-outcomes-of-severe-pertussis-infection-in-critically-ill-infants
#17
Lahn Straney, Andreas Schibler, Anusha Ganeshalingham, Janet Alexander, Marino Festa, Anthony Slater, Graeme MacLaren, Luregn J Schlapbach
OBJECTIVES: Despite World Health Organization endorsed immunization schedules, Bordetella pertussis continues to cause severe infections, predominantly in infants. There is a lack of data on the frequency and outcome of severe pertussis infections in infants requiring ICU admission. We aimed to describe admission rates, severity, mortality, and costs of pertussis infections in critically ill infants. DESIGN: Binational observational multicenter study. SETTING: Ten PICUs and 19 general ICUs in Australia and New Zealand contributing to the Australian and New Zealand Paediatric Intensive Care Registry...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27355979/retrospective-analysis-of-an-interdisciplinary-ventilator-care-program-intervention-on-survival-of-infants-with-ventilator-dependent-bronchopulmonary-dysplasia
#18
Jason Gien, John Kinsella, Jodi Thrasher, Alicia Grenolds, Steven H Abman, Christopher D Baker
Background The clinical needs of infants with severe bronchopulmonary dysplasia (BPD) that remain ventilator-dependent are complex, and management strategies that optimize survival and long-term outcomes controversial. We hypothesized that an interdisciplinary ventilator care program (VCP), committed to the care of this population will improve survival through standardized approaches to cardiopulmonary care and related comorbidities, enhanced communication, and continuity of care. Methods Retrospective chart reviews were performed on patients at Children's Hospital Colorado's neonatal intensive care unit, who underwent tracheostomy placement between 2000 and 2013...
June 29, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27267913/experiences-of-households-using-integrated-malaria-prevention-in-two-rural-communities-in-wakiso-district-uganda-a-qualitative-study
#19
David Musoke, George Karani, Rawlance Ndejjo, Peter Okui, Miph Boses Musoke
BACKGROUND: The integrated approach to malaria prevention which advocates use of several methods in a holistic manner is being explored to complement existing strategies. A pilot project that promoted integrated malaria prevention established 40 demonstration households using the approach. As part of impact evaluation of the project 2 years after implementation, the experiences of these households using integrated malaria prevention were assessed. METHODS: A qualitative cross-sectional survey was carried out in Wakiso district, Uganda which involved 40 in-depth interviews among households implementing integrated malaria prevention...
2016: Malaria Journal
https://www.readbyqxmd.com/read/27246828/direct-cost-of-critical-illness-associated-healthcare-expenditures-among-children-admitted-in-pediatric-intensive-care-unit-in-rural-india
#20
Vivek V Shukla, Somashekhar M Nimbalkar, Jaishree D Ganjiwale, Denny John
OBJECTIVE: To assess the direct costs involved in treatment of children receiving intensive care in a university-affiliated teaching hospital and its associated implications on the children's families, in rural India. METHODS: It was a prospective observational study for cost-analysis using questionnaire based interviews and billing records data collection for admissions to the PICU over 27 consecutive months (January 2010 through March 2012). RESULTS: A total of 784 children were admitted to the unit during the assessment period...
October 2016: Indian Journal of Pediatrics
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