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Pediatric sepsis initiative

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https://www.readbyqxmd.com/read/27891727/rehospitalization-after-pediatric-heart-transplantation-incidence-indications-and-outcomes
#1
Seth A Hollander, Doff B McElhinney, Christopher S Almond, Nancy McDonald, Sharon Chen, Beth D Kaufman, Daniel Bernstein, David N Rosenthal
We report the patterns of rehospitalization after pediatric heart transplant (Htx) at a single center. Retrospective review of 107 consecutive pediatric Htx recipients between January 22, 2007, and August 28, 2014, who survived their initial transplant hospitalization. The frequency, duration, and indications for all hospitalizations between transplant hospitalization discharge and September 30, 2015, were analyzed. A total of 444 hospitalization episodes occurred in 90 of 107 (84%) patients. The median time to first rehospitalization was 59...
November 27, 2016: Pediatric Transplantation
https://www.readbyqxmd.com/read/27828898/pediatric-ventilator-associated-infections-the-ventilator-associated-infection-study
#2
Douglas F Willson, Michelle Hoot, Robinder Khemani, Christopher Carrol, Aileen Kirby, Adam Schwarz, Rainer Gedeit, Sholeen T Nett, Simon Erickson, Heidi Flori, Spencer Hays, Mark Hall
OBJECTIVE: Suspected ventilator-associated infection is the most common reason for antibiotics in the PICU. We sought to characterize the clinical variables associated with continuing antibiotics after initial evaluation for suspected ventilator-associated infection and to determine whether clinical variables or antibiotic treatment influenced outcomes. DESIGN: Prospective, observational cohort study conducted in 47 PICUs in the United States, Canada, and Australia...
November 8, 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27826650/protocol-based-management-of-154-cases-of-pediatric-liver-abscess
#3
Subhasis Roy Choudhury, Niyaz Ahmed Khan, Rahul Saxena, Partap Singh Yadav, Jigar N Patel, Rajiv Chadha
AIM: Although liver abscess (LA) is prevalent worldwide, especially in developing countries, there is a paucity of data regarding the protocol for management of LA in children. The aim of this study was to analyze the outcome of a protocol-based management of pediatric LA from a single institution. MATERIALS AND METHODS: This prospective observational study was conducted in a tertiary-care children's hospital and included all patients with LA managed over a 5-year period...
November 8, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27767356/etiology-clinical-profile-and-short-term-outcome-of-acute-kidney-injury-in-children-at-a-tertiary-care-pediatric-nephrology-center-in-pakistan
#4
Vina Tresa, Afshan Yaseen, Ali Asghar Lanewala, Seema Hashmi, Sabeeta Khatri, Irshad Ali, Muhammed Mubarak
BACKGROUND: The reported prevalence rates and etiologies of acute kidney injury (AKI) are quite variable in different regions of the world. The current study was planned to determine the etiology, clinical profile, and short-term outcome of pediatric AKI at our hospital. METHODS: A prospective, observational study was carried out from April 2014 to March 2015. All pediatric patients (1 month to ≤15 years) diagnosed as AKI using modified pRIFLE criteria were studied and followed for 3 months to document short-term outcome...
October 21, 2016: Renal Failure
https://www.readbyqxmd.com/read/27749512/2016-update-for-the-rogers-textbook-of-pediatric-intensive-care-recognition-and-initial-management-of-shock
#5
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed (www.ncbi.nlm.nih.gov/pubmed) was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
November 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27670223/extracorporeal-membrane-oxygenation-for-hemophagocytic-lymphohistiocytosis
#6
Victoria Anne Saites, Rachel Hadler, Jacob Thomas Gutsche, Krzysztof Laudanski
BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a rare hematological disease characterized by an excessive inflammatory response to various triggers, resulting in rapid multi-organ failure. Its incidence may be underestimated due to its rarity, its variable clinical presentation, and its high mortality rate prior to diagnosis. Oftentimes, HLH is mistaken for refractory sepsis and improperly treated as such. Left untreated, the disease is universally fatal. With treatment, case series of adults with HLH report a 30-day mortality of up to 44% and an overall mortality of up to 75%...
September 27, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27604184/high-reliability-pediatric-septic-shock-quality-improvement-initiative-and-decreasing-mortality
#7
Roni D Lane, Tomohiko Funai, Ron Reeder, Gitte Y Larsen
BACKGROUND AND OBJECTIVE: Septic shock impacts mortality, morbidity, and health care costs. A quality improvement (QI) initiative was launched to improve early recognition and timely treatment of patients with septic shock in a pediatric emergency department (PED). Our primary aim was to describe the longitudinal effectiveness of the program, iterative changes in clinical practice, and associated outcomes. METHODS: We implemented multiple interventions during our QI initiative (February 2007 to December 2014)...
September 7, 2016: Pediatrics
https://www.readbyqxmd.com/read/27598937/-rocky-mountain-spotted-fever-in-mexican-children-clinical-and-mortality-factors
#8
Gerardo Álvarez-Hernández, María Del Carmen Candia-Plata, Jesús Delgado-de la Mora, Natalia Haydeé Acuña-Meléndrez, Anabel Patricia Vargas-Ortega, Jesús David Licona-Enríquez
OBJECTIVE: Characterize clinical manifestations and predictors of mortality in children hospitalized for spotted fever. MATERIALS AND METHODS: Cross-sectional study in 210 subjects with a diagnosis of Rocky Mountain spotted fever (RMSF) in a pediatric hospital in Sonora, from January 1st, 2004 to June 30th, 2015. Data were analyzed using descriptive statistics and multivariate logistic regression. RESULTS: An upward trend was observed in RMSF morbidity and mortality...
June 2016: Salud Pública de México
https://www.readbyqxmd.com/read/27596080/-current-situation-of-enteral-nutrition-interruptions-in-sepsis-children-in-pediatric-intensive-care-unit
#9
B L Fang, S Y Qian, X L Jia, Z Li, J Liu
OBJECTIVE: To analyze the interruptions of enteral nutrition (EN) and it's relationship to prognosis in children with sepsis in pediatric intensive care unit (PICU). METHOD: Daily EN intake and reasons for EN interruptions were prospectively observed and recorded in children with sepsis who were admitted to our PICU from November 2012 to April 2013. Clinical prognosis was compared between children with and without EN interruptions by t, rank-sum and χ(2) tests...
September 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/27548818/development-and-validation-of-a-score-to-predict-mortality-in-children-undergoing-extracorporeal-membrane-oxygenation-for-respiratory-failure-pediatric-pulmonary-rescue-with-extracorporeal-membrane-oxygenation-prediction-score
#10
David K Bailly, Ron W Reeder, Luke A Zabrocki, Anna M Hubbard, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
OBJECTIVE: Our objective was to develop and validate a prognostic score for predicting mortality at the time of extracorporeal membrane oxygenation initiation for children with respiratory failure. Preextracorporeal membrane oxygenation mortality prediction is important for determining center-specific risk-adjusted outcomes and counseling families. DESIGN: Multivariable logistic regression of a large international cohort of pediatric extracorporeal membrane oxygenation patients...
August 19, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27520452/the-value-of-blood-lactate-kinetics-in-critically-ill-patients-a-systematic-review
#11
Jean-Louis Vincent, Amanda Quintairos E Silva, Lúcio Couto, Fabio S Taccone
BACKGROUND: The time course of blood lactate levels could be helpful to assess a patient's response to therapy. Although the focus of published studies has been largely on septic patients, many other studies have reported serial blood lactate levels in different groups of acutely ill patients. METHODS: We performed a systematic search of PubMed, Science Direct, and Embase until the end of February 2016 plus reference lists of relevant publications. We selected all observational and interventional studies that evaluated the capacity of serial blood lactate concentrations to predict outcome...
August 13, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27513860/quality-of-care-is-improved-by-rapid-short-incubation-maldi-tof-identification-from-blood-cultures-as-measured-by-reduced-length-of-stay-and-patient-outcomes-as-part-of-a-multi-disciplinary-approach-to-bacteremia-in-pediatric-patients
#12
Johannes A Delport, Arend Strikwerda, Amanda Armstrong, David Schaus, Michael John
Sepsis has seen an incremental increase in cases of about 13% annually in the USA and accounts for approximately 4400 deaths among pediatric patients. Early identification of the specific pathogen allows the clinician to ensure that the antibiotic coverage is optimal, an intervention that has been shown to improve patient outcomes in sepsis. Our study's objective was to assess the impact of a rapid Bruker MALDI-Tof identification protocol on pediatric sepsis cases by assessing various indicators. We assessed the quality of care by measuring the following indicators; time to identification of the pathogen, initiation of the most appropriate antibiotic, length of stay (LOS) in hospital and patient outcomes, using a retrospective review over three consecutive years...
2016: PloS One
https://www.readbyqxmd.com/read/27500722/treatment-of-pediatric-septic-shock-with-the-surviving-sepsis-campaign-guidelines-and-picu-patient-outcomes
#13
Jennifer K Workman, Stefanie G Ames, Ron W Reeder, E Kent Korgenski, Susan M Masotti, Susan L Bratton, Gitte Y Larsen
OBJECTIVES: The Surviving Sepsis Campaign recommends rapid recognition and treatment of severe sepsis and septic shock. Few reports have evaluated the impact of these recommendations in pediatrics. We sought to determine if outcomes in patients who received initial care compliant with the Surviving Sepsis Campaign time goals differed from those treated more slowly. DESIGN: Single center retrospective cohort study. SETTING: Emergency department and PICU at an academic children's hospital...
October 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27500629/the-current-state-of-the-diagnosis-and-management-of-acute-kidney-injury-by-pediatric-critical-care-physicians
#14
Amanda B Hassinger, Sudha Garimella, Brian H Wrotniak, Jo L Freudenheim
OBJECTIVES: Increasingly prevalent in pediatric intensive care, acute kidney injury imparts significant short- and long-term consequences. Despite advances in acute kidney injury research, clinical outcomes are worsening. We surveyed pediatric critical care physicians to describe the current state of acute kidney injury diagnosis and management in critically ill children. DESIGN: Anonymous electronic questionnaire. PARTICIPANTS: Pediatric critical care physicians from academic centers, the Pediatric Acute Lung Injury and Sepsis Investigators network, and/or the pediatric branch of Society of Critical Care Medicine...
August 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/27496218/high-variability-in-the-reported-management-of-hepatic-veno-occlusive-disease-in-children-after-hematopoietic-stem-cell-transplantation
#15
Micah A Skeens, Jennifer McArthur, Ira M Cheifetz, Christine Duncan, Adrienne G Randolph, Joseph Stanek, Leslie Lehman, Rajinder Bajwa
Veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic stem cell transplantation (HSCT). Patients with VOD are often critically ill and require close collaboration between transplant physicians and intensivists. We surveyed members of a consortium of pediatric intensive care unit (PICU) and transplant physicians to assess variability in the self-reported approach to the diagnosis and management of VOD. An internet-based self-administered survey was sent to pediatric HSCT and PICU providers from September 2014 to February 2015...
October 2016: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/27454387/the-epidemiology-of-sepsis-in-childhood
#16
Daniela Carla de Souza, Eliane Roseli Barreira, Lucília Santana Faria
BACKGROUND: Sepsis, or systemic inflammatory response to infection, is a major childhood disease and a common cause of death in children. Despite its importance, a global perspective on the epidemiology and mortality of pediatric sepsis across the world is still lacking. METHODS: A non-systematic review of the medical articles published in Medline from 2005-2015. RESULTS: Studies suggest that there has been a rise in the number of pediatric sepsis cases along the last two decades, which may relate to the increased survival of preterm and low birth-weight infants and children with severe chronic conditions...
July 21, 2016: Shock
https://www.readbyqxmd.com/read/27335998/validation-of-cefazolin-as-initial-antibiotic-for-first-upper-urinary-tract-infection-in-children
#17
Yoshifusa Abe, Hitomi Wakabayashi, Yasuha Ogawa, Ayano Machida, Mio Endo, Tetsuro Tamai, Shunsuke Sakurai, Satoshi Hibino, Takeshi Mikawa, Yoshitaka Watanabe, Kazuhisa Ugajin, Kunihiko Fukuchi, Kazuo Itabashi
To validate the policy of administering cefazolin (CEZ) as a first-line antibiotic to children who are hospitalized with their first febrile urinary tract infection (UTI), we evaluated microbial susceptibility to CEZ and the efficacy of CEZ. The 75 enrolled children with febrile UTI were initially treated with CEZ. Switching CEZ was not required in 84% of the patients. The median fever duration, prevalence of bacteremia, prevalence of UTI caused by extended-spectrum β-lactamase (ESBL)-producing Escherichia coli, and median duration of hospitalization were significantly higher in the CEZ-ineffective group...
2016: Global Pediatric Health
https://www.readbyqxmd.com/read/27316915/french-intensive-care-society-international-congress-r%C3%A3-animation-2016
#18
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27299599/a-pilot-study-of-intensified-peg-asparaginase-in-high-risk-acute-lymphoblastic-leukemia-children-s-oncology-group-study-aall08p1
#19
Vilmarie Rodriguez, John Kairalla, Wanda L Salzer, Elizabeth A Raetz, Mignon Lc Loh, Andrew J Carroll, Nyla A Heerema, Brent L Wood, Michael J Borowitz, Michael J Burke, Barbara L Asselin, Meenakshi Devidas, Naomi J Winick, William L Carroll, Stephen P Hunger, ZoAnn E Dreyer
AALL08P1 was designed to determine whether biweekly intensified pegaspargase (I-PEG) was feasible and safe in pediatric patients with newly diagnosed high-risk B-precursor lymphoblastic leukemia when given with Children's Oncology Group hemiaugmented BFM therapy. High-risk average (HR-Avg) patients received standard pegaspargase dosing (6 doses), whereas high-risk high (HR-High) patients received I-PEG biweekly from the start of Consolidation until day 1 of Maintenance. Feasibility and safety were defined in advance as ≥65% of patients tolerating at least 8 doses of I-PEG and 90% requiring ≤49 weeks from day 1 of Consolidation to the initiation of Maintenance...
August 2016: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/27232185/tuberculosis-before-and-after-antiretroviral-therapy-among-hiv-infected-children-in-nigeria-what-are-the-risk-factors
#20
Emmanuel A Anígilájé, Sunday A Aderibigbe, Adekunle O Adeoti, Nnamdi O Nweke
INTRODUCTION: In Nigeria, there is a dearth of pediatric data on the risk factors associated with tuberculosis (TB), before and after antiretroviral therapy (ART). METHODOLOGY: A retrospective observational cohort study, between October 2010 and December 2013, at the Federal Medical Centre, Makurdi, Nigeria. TB was noted among children less than 15 years of age at ART enrolment (prevalent TB-PrevTB), within 6 months (early incident tuberculosis-EITB) and after 6 months (late incident tuberculosis-LITB) of a 12-month follow-up on ART...
2016: PloS One
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