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https://www.readbyqxmd.com/read/29140970/clinical-impact-of-external-laryngeal-manipulation-during-laryngoscopy-on-tracheal-intubation-success-in-critically-ill-children
#1
Taiki Kojima, Elizabeth K Laverriere, Erin B Owen, Ilana Harwayne-Gidansky, Asha N Shenoi, Natalie Napolitano, Kyle J Rehder, Michelle A Adu-Darko, Sholeen T Nett, Debbie Spear, Keith Meyer, John S Giuliano, Keiko M Tarquinio, Ronald C Sanders, Jan Hau Lee, Dennis W Simon, Paula A Vanderford, Anthony Y Lee, Calvin A Brown, Peter W Skippen, Ryan K Breuer, Iris Toedt-Pingel, Simon J Parsons, Eleanor A Gradidge, Lily B Glater, Kathleen Culver, Simon Li, Lee A Polikoff, Joy D Howell, Gabrielle Nuthall, Gokul K Bysani, Ana L Graciano, Guillaume Emeriaud, Osamu Saito, Alberto Orioles, Karen Walson, Philipp Jung, Awni M Al-Subu, Takanari Ikeyama, Rakshay Shetty, Kathleen M Yoder, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVES: External laryngeal manipulation is a commonly used maneuver to improve visualization of the glottis during tracheal intubation in children. However, the effectiveness to improve tracheal intubation attempt success rate in the nonanesthesia setting is not clear. The study objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in PICUs. DESIGN: A retrospective observational study using a multicenter emergency airway quality improvement registry...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29140968/end-tidal-carbon-dioxide-use-for-tracheal-intubation-analysis-from-the-national-emergency-airway-registry-for-children-near4kids-registry
#2
Melissa L Langhan, Beth L Emerson, Sholeen Nett, Matthew Pinto, Ilana Harwayne-Gidansky, Kyle J Rehder, Conrad Krawiec, Keith Meyer, John S Giuliano, Erin B Owen, Keiko M Tarquinio, Ron C Sanders, Michael Shepherd, Gokul Kris Bysani, Asha N Shenoi, Natalie Napolitano, Sandeep Gangadharan, Simon J Parsons, Dennis W Simon, Vinay M Nadkarni, Akira Nishisaki
OBJECTIVE: Waveform capnography use has been incorporated into guidelines for the confirmation of tracheal intubation. We aim to describe the trend in waveform capnography use in emergency departments and PICUs and assess the association between waveform capnography use and adverse tracheal intubation-associated events. DESIGN: A multicenter retrospective cohort study. SETTING: Thirty-four hospitals (34 ICUs and nine emergency departments) in the National Emergency Airway Registry for Children quality improvement initiative...
November 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29117092/the-development-and-validation-of-a-concise-instrument-for-formative-assessment-of-team-leader-performance-during-simulated-pediatric-resuscitations
#3
Lindsay D Nadkarni, Cindy G Roskind, Marc A Auerbach, Aaron W Calhoun, Mark D Adler, David O Kessler
AIM: The aim of this study was to assess the validity of a formative feedback instrument for leaders of simulated resuscitations. METHODS: This is a prospective validation study with a fully crossed (person × scenario × rater) study design. The Concise Assessment of Leader Management (CALM) instrument was designed by pediatric emergency medicine and graduate medical education experts to be used off the shelf to evaluate and provide formative feedback to resuscitation leaders...
November 8, 2017: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
https://www.readbyqxmd.com/read/29078933/neutropenic-fever
#4
REVIEW
Lindsey White, Michael Ybarra
Fever is a common presenting complaint among adult or pediatric patients in the emergency department setting. Although fever in healthy individuals does not necessarily indicate severe illness, fever in patients with neutropenia may herald a life-threatening infection. Therefore, prompt recognition of patients with neutropenic fever is imperative. Serious bacterial illness is a significant cause of morbidity and mortality for neutropenic patients. Neutropenic fever should trigger the initiation of a rapid work-up and the administration of empiric systemic antibiotic therapy to attenuate or avoid the progression along the spectrum of sepsis, severe sepsis, septic shock syndrome, and death...
December 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/28801724/pneumococcal-meningitis-and-endocarditis-in-an-infant-possible-improved-survival-with-factor-v-leiden-mutation
#5
Sitikant Mohapatra, Assaf Doulah, Elspeth Brown
Streptococcus pneumoniae infections continue to remain associated with high morbidity and mortality. Although the incidence of invasive meningeal and/or lung disease are not uncommon, Streptococcus pneumoniae endocarditis is rare especially in healthy pediatric population. New studies have suggested a strong association between factor V leiden (FVL) mutation and favorable outcomes in critically ill children. A healthy 10 month old presented with sepsis and meningeal signs, was later confirmed to have Streptococcus pneumoniae meningitis and endocarditis...
August 12, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28795054/sepsis-in-the-burn-patient-a-different-problem-than-sepsis-in-the-general-population
#6
REVIEW
David G Greenhalgh
Sepsis has recently been defined as "life-threatening organ dysfunction caused by a dysregulated host response to infection". A great amount of effort has been made to develop early treatments for sepsis through the Surviving Sepsis Campaign. There are similar but slightly different recommendations for the treatment of sepsis in the pediatric population. These international efforts have led to earlier diagnosis and treatments for sepsis that have led to improvements in survival. Sepsis is also the leading cause of death in the burn patient but most clinical sepsis studies have excluded burns...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28729906/update-on-pediatric-sepsis-a-review
#7
REVIEW
Tatsuya Kawasaki
BACKGROUND: Sepsis is one of the leading causes of mortality among children worldwide. Unfortunately, however, reliable evidence was insufficient in pediatric sepsis and many aspects in clinical practice actually depend on expert consensus and some evidence in adult sepsis. More recent findings have given us deep insights into pediatric sepsis since the publication of the Surviving Sepsis Campaign guidelines 2012. MAIN TEXT: New knowledge was added regarding the hemodynamic management and the timely use of antimicrobials...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28719479/a-simulation-based-quality-improvement-initiative-improves-pediatric-readiness-in-community-hospitals
#8
Travis Whitfill, Marcie Gawel, Marc Auerbach
BACKGROUND: The National Pediatric Readiness Project Pediatric Readiness Survey (PRS) measured pediatric readiness in 4149 US emergency departments (EDs) and noted an average score of 69 on a 100-point scale. This readiness score consists of 6 domains: coordination of pediatric patient care (19/100), physician/nurse staffing and training (10/100), quality improvement activities (7/100), patient safety initiatives (14/100), policies and procedures (17/100), and availability of pediatric equipment (33/100)...
July 17, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#9
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28654550/promoters-and-barriers-to-implementation-of-tracheal-intubation-airway-safety-bundle-a-mixed-method-analysis
#10
Katherine Finn Davis, Natalie Napolitano, Simon Li, Hayley Buffman, Kyle Rehder, Matthew Pinto, Sholeen Nett, J Dean Jarvis, Pradip Kamat, Ronald C Sanders, David A Turner, Janice E Sullivan, Kris Bysani, Anthony Lee, Margaret Parker, Michelle Adu-Darko, John Giuliano, Katherine Biagas, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: To describe promoters and barriers to implementation of an airway safety quality improvement bundle from the perspective of interdisciplinary frontline clinicians and ICU quality improvement leaders. DESIGN: Mixed methods. SETTING: Thirteen PICUs of the National Emergency Airway Registry for Children network. INTERVENTION: Remote or on-site focus groups with interdisciplinary ICU staff. Two semistructured interviews with ICU quality improvement leaders with quantitative and qualitative data-based feedbacks...
October 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28598565/atypical-teratoid-rhabdoid-tumors-in-children-treated-with-multimodal-therapies-the-necessity-of-upfront-radiotherapy-after-surgery
#11
Jeongshim Lee, Dong-Seok Kim, Jung Woo Han, Chang-Ok Suh
BACKGROUND: Atypical teratoid/rhabdoid tumor (ATRT) is a rare malignant pediatric brain tumor with a dismal prognosis. We evaluated the efficacy of multimodal therapy in children with ATRT. PROCEDURE: Nine children diagnosed with cranial ATRT, who received multimodal therapy between 2005 and 2014, including surgical resection followed by radiotherapy (RT), systemic chemotherapy (CT), and high-dose chemotherapy/stem cell transplantation (HDCT/SCT), were analyzed retrospectively...
December 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28583403/improving-recognition-of-pediatric-severe-sepsis-in%C3%A2-the-emergency-department-contributions-of%C3%A2-a%C3%A2-vital-sign-based-electronic-alert-and-bedside-clinician-identification
#12
Fran Balamuth, Elizabeth R Alpern, Mary Kate Abbadessa, Katie Hayes, Aileen Schast, Jane Lavelle, Julie C Fitzgerald, Scott L Weiss, Joseph J Zorc
STUDY OBJECTIVE: Recognition of pediatric sepsis is a key clinical challenge. We evaluate the performance of a sepsis recognition process including an electronic sepsis alert and bedside assessment in a pediatric emergency department (ED). METHODS: This was a cohort study with quality improvement intervention in a pediatric ED. Exposure was a positive electronic sepsis alert, defined as elevated pulse rate or hypotension, concern for infection, and at least one of the following: abnormal capillary refill, abnormal mental status, or high-risk condition...
June 2, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28538388/myxedema-coma-a-case-report-of-pediatric-emergency-care
#13
Yueniu Zhu, Wenjuan Qiu, Mengyan Deng, Xiaodong Zhu
RAIONALE: Myxedema coma (MC) is extremely rare but lethal in pediatric patients with hypothyroidism leading to altered mental status and hypothermia. But there is no clinical guideline for such cases. PATIENT CONCERNS: A 6-year-old Chinese girl presented with coma and hypothermia preceded by pneumonia. Her lab results were: free thyroxin (T4) 4.18 pmol/L and thyroid-stimulating hormone (TSH) > 150 μIU/mL with extremely elevated anti-thyroid peroxidase (TPO-Ab) and anti-thyroglobulin...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28509730/american-college-of-critical-care-medicine-clinical-practice-parameters-for-hemodynamic-support-of-pediatric-and-neonatal-septic-shock
#14
Alan L Davis, Joseph A Carcillo, Rajesh K Aneja, Andreas J Deymann, John C Lin, Trung C Nguyen, Regina S Okhuysen-Cawley, Monica S Relvas, Ranna A Rozenfeld, Peter W Skippen, Bonnie J Stojadinovic, Eric A Williams, Tim S Yeh, Fran Balamuth, Joe Brierley, Allan R de Caen, Ira M Cheifetz, Karen Choong, Edward Conway, Timothy Cornell, Allan Doctor, Marc-Andre Dugas, Jonathan D Feldman, Julie C Fitzgerald, Heidi R Flori, James D Fortenberry, Ana Lia Graciano, Bruce M Greenwald, Mark W Hall, Yong Yun Han, Lynn J Hernan, Jose E Irazuzta, Elizabeth Iselin, Elise W van der Jagt, Howard E Jeffries, Saraswati Kache, Chhavi Katyal, Niranjan Tex Kissoon, Alexander A Kon, Martha C Kutko, Graeme MacLaren, Timothy Maul, Renuka Mehta, Fola Odetola, Kristine Parbuoni, Raina Paul, Mark J Peters, Suchitra Ranjit, Karin E Reuter-Rice, Eduardo J Schnitzler, Halden F Scott, Adalberto Torres, Jacki Weingarten-Abrams, Scott L Weiss, Jerry J Zimmerman, Aaron L Zuckerberg
OBJECTIVES: The American College of Critical Care Medicine provided 2002 and 2007 guidelines for hemodynamic support of newborn and pediatric septic shock. Provide the 2014 update of the 2007 American College of Critical Care Medicine "Clinical Guidelines for Hemodynamic Support of Neonates and Children with Septic Shock." DESIGN: Society of Critical Care Medicine members were identified from general solicitation at Society of Critical Care Medicine Educational and Scientific Symposia (2006-2014)...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28420570/herpesviradae-infections-in-severely-burned-children
#15
Paul Wurzer, Megan R Cole, Robert P Clayton, Gabriel Hundeshagen, Omar Nunez Lopez, Janos Cambiaso-Daniel, Raimund Winter, Ludwik K Branski, Hal K Hawkins, Celeste C Finnerty, David N Herndon, Jong O Lee
OBJECTIVE: Burn-related immunosuppression can promote human herpesviridae infections. However, the effect of these infections on morbidity and mortality after pediatric burn injuries is unclear. METHODS: We retrospectively analyzed pediatric patients with burns ≥10% of the total body surface area (TBSA) who were admitted between 2010 and 2015. On clinical suspicion of a viral infection, antiviral therapy was initiated. Viral infection was confirmed via Tzanck smear, viral culture, and/or PCR...
August 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28329452/effect-of-prime-blood-storage-duration-on-clinical-outcome-after-pediatric-cardiac-surgery
#16
Arvind Kumar Bishnoi, Pankaj Garg, Kartik Patel, Parth Solanki, Jigar Surti, Atul Solanki, Komal Shah, Sanjay Patel
BACKGROUND: In this study, we tested the hypothesis that in pediatric patients undergoing cardiac surgery using cardiopulmonary bypass (CPB) with blood prime, the storage duration of the packed red blood cells (PRBCs) used in prime led to differences in postoperative complications and metabolic profiles of the patients. METHODS: For this prospective observational study we included 400 pediatric patients undergoing cardiac operations using CPB and requiring PRBCs prime...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28324661/improved-risk-stratification-in-pediatric-septic-shock-using-both-protein-and-mrna-biomarkers-persevere-xp
#17
Hector R Wong, Natalie Z Cvijanovich, Nick Anas, Geoffrey L Allen, Neal J Thomas, Michael T Bigham, Scott L Weiss, Julie C Fitzgerald, Paul A Checchia, Keith Meyer, Michael Quasney, Mark Hall, Rainer Gedeit, Robert J Freishtat, Jeffrey Nowak, Shekhar S Raj, Shira Gertz, Jocelyn R Grunwell, Christopher J Lindsell
RATIONALE: We previously derived and validated the Pediatric Sepsis Biomarker Risk Model (PERSEVERE) to estimate baseline mortality risk in children with septic shock. The PERSEVERE biomarkers are serum proteins selected from among the proteins directly related to 80 mortality risk assessment genes. The initial approach to selecting the PERSEVERE biomarkers left 68 genes unconsidered. OBJECTIVES: To determine if the 68 previously unconsidered genes can improve upon the performance of PERSEVERE and to provide biological information regarding the pathophysiology of septic shock...
August 15, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#18
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28072671/evaluation-of-the-association-of-early-elevated-lactate-with-outcomes-in-children-with-severe-sepsis-or-septic-shock
#19
Noelle Gorgis, Jeannette M Asselin, Cynthia Fontana, R Scott Heidersbach, Heidi R Flori, Shan L Ward
OBJECTIVE: The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis. METHODS: This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay...
January 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28068437/association-between-early-lactate-levels-and-30-day-mortality-in-clinically-suspected-sepsis-in-children
#20
Halden F Scott, Lina Brou, Sara J Deakyne, Allison Kempe, Diane L Fairclough, Lalit Bajaj
Importance: Improving emergency care of pediatric sepsis is a public health priority, but optimal early diagnostic approaches are unclear. Measurement of lactate levels is associated with improved outcomes in adult septic shock, but pediatric guidelines do not endorse its use, in part because the association between early lactate levels and mortality is unknown in pediatric sepsis. Objective: To determine whether the initial serum lactate level is associated with 30-day mortality in children with suspected sepsis...
March 1, 2017: JAMA Pediatrics
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