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Sepsis in children

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https://www.readbyqxmd.com/read/29677008/evolution-of-acute-kidney-injury-and-its-association-with-systemic-hemodynamics-in-children-with-fluid-refractory-septic-shock
#1
Akash Deep, Hiremath Sagar, Chulananda Goonasekera, Palaniswamy Karthikeyan, Joe Brierley, Abdel Douiri
OBJECTIVES: There are no studies in pediatrics evaluating the progression of acute kidney injury in septic shock. We investigated the evolution of sepsis-associated acute kidney injury and its association with systemic hemodynamics in children with fluid-refractory septic shock. DESIGN: Prospective cohort study. SETTING: PICU of a tertiary care hospital. PATIENTS: All patients with fluid-refractory septic shock (n = 61) between September 2010 and February 2014...
April 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29675402/poor-compliance-with-sepsis-guidelines-in-a-tertiary-care-children-s-hospital-emergency-room
#2
Benjamin Louis Moresco, Clinton Woosley, Morris Sauter, Utpal Bhalala
Objectives: This study aimed to assess factors related to adherence to the Pediatric Advanced Life Support guidelines for severe sepsis and septic shock in an emergency room (ER) of a tertiary care children's hospital. Methods: This was a retrospective, observational study of children (0-18 years old) in The Children's Hospital of San Antonio ER over 1 year with the International Consensus Definition Codes, version-9 (ICD-9) diagnostic codes for "severe sepsis" and "shocks...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29666163/neurodevelopmental-impairment-among-extremely-preterm-infants-in-the-neonatal-research-network
#3
Ira Adams-Chapman, Roy J Heyne, Sara B DeMauro, Andrea F Duncan, Susan R Hintz, Athina Pappas, Betty R Vohr, Scott A McDonald, Abhik Das, Jamie E Newman, Rosemary D Higgins
OBJECTIVES: Evaluate the spectrum of neurodevelopmental outcome in a contemporary cohort of extremely preterm infants. We hypothesize that the rate of severe neurodevelopmental impairment (NDI) decreases over time. METHODS: Retrospective analysis of neurodevelopmental outcome of preterm infants ≤27 weeks' gestational age (GA) from a Neonatal Research Network center that completed neurodevelopmental follow-up assessments between April 1, 2011, and January 1, 2015...
April 17, 2018: Pediatrics
https://www.readbyqxmd.com/read/29664874/traumatic-brain-injury-and-infectious-encephalopathy-in-children-from-four-resource-limited-settings-in-africa
#4
Ericka L Fink, Amelie von Saint Andre-von Arnim, Rashmi Kumar, Patrick T Wilson, Tigist Bacha, Abenezer Tirsit Aklilu, Tsegazeab Laeke Teklemariam, Shubhada Hooli, Lisine Tuyisenge, Easmon Otupiri, Anthony Fabio, John Gianakas, Patrick M Kochanek, Derek C Angus, Robert C Tasker
OBJECTIVES: To assess the frequency, interventions, and outcomes of children presenting with traumatic brain injury or infectious encephalopathy in low-resource settings. DESIGN: Prospective study. SETTING: Four hospitals in Sub-Saharan Africa. PATIENTS: Children age 1 day to 17 years old evaluated at the hospital with traumatic brain injury or infectious encephalopathy. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We evaluated the frequency and outcomes of children presenting consecutively over 4 weeks to any hospital department with traumatic brain injury or infectious encephalopathy...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29652944/epidemiology-of-sepsis-in-brazil-incidence-lethality-costs-and-other-indicators-for-brazilian-unified-health-system-hospitalizations-from-2006-to-2015
#5
Ricardo Alfredo Quintano Neira, Silvio Hamacher, André Miguel Japiassú
BACKGROUND: Sepsis is considered a major worldwide health burden, with high mortality and associated costs. Health indicators are essential to define strategies to improve the treatment of diseases, and the epidemiology information of sepsis in developing countries is scarce. Thus, the aim of this work is to assess trends in the incidence, lethality, costs, and other indicators of sepsis for Brazilian Unified Health System (SUS-Sistema Único de Saúde) hospitalizations for the period from January 2006 to December 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29650343/safety-efficacy-and-management-of-subcutaneous-treprostinil-infusions-in-the-treatment-of-severe-pediatric-pulmonary-hypertension
#6
Marilyne Levy, Maria-Jesus Del Cerro, Sophie Nadaud, Karunakar Vadlamudi, Elizabeth Colgazier, Jeff Fineman, Damien Bonnet, Ian Adatia
BACKGROUND: Continuous intravenous epoprostenol was the first treatment approved for pulmonary arterial hypertension (PAH) but administration through a central venous line carries risks of thrombosis and sepsis, particularly in children. We sought to evaluate the safety, efficacy and management of subcutaneous (SC) treprostinil in children with PAH. METHODS: Fifty-six children (median age 65, range 1-200 months) were treated with SC treprostinil. Clinical status, echocardiography, NT-proBNP, and site pain and infection were evaluated...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29643892/association-of-in-hospital-outcome-of-acute-kidney-injury-aki-with-etiology-among-newborns-at-a-tertiary-care-unit
#7
Muhammad Asghar Ali, Abdur Rehman, Ejaz Ahmed
Objective: To determine association of in-hospital outcome of AKI with etiology in newborns at a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted at Department of Pediatric Neonatology, The Children's Hospital and Institute of the Child Health, Multan by using non-probability purposive sampling technique from June 2016 to June 2017. A total of 101 newborns diagnosed with acute kidney injury were registered. Etiological factors were assessed and these patients were followed till discharge to monitor in-hospital outcomes...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29616405/ventilator-associated-pneumonia-in-pediatric-intensive-care-unit-incidence-risk-factors-and-etiological-agents
#8
Gnanaguru Vijay, Anirban Mandal, Jhuma Sankar, Arti Kapil, Rakesh Lodha, S K Kabra
OBJECTIVES: To study the incidence, etiology and risk factors associated with ventilator associated pneumonia (VAP) in children. METHODS: This prospective cohort study was conducted on patients admitted to the Pediatric Intensive Care Unit (PICU) of a tertiary care institute of North India, from June 2012 through March 2014, who received mechanical ventilation for more than 24 h. All enrolled children were assessed daily for development of ventilator associated pneumonia (VAP) using the case definition given by Centers for Disease Control and Prevention (CDC)...
April 4, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29615003/role-of-cytarabine-in-paediatric-acute-promyelocytic-leukemia-treated-with-the-combination-of-all-trans-retinoic-acid-and-arsenic-trioxide-a-randomized-controlled-trial
#9
Li Zhang, Yao Zou, Yumei Chen, Ye Guo, Wenyu Yang, Xiaojuan Chen, Shuchun Wang, Xiaoming Liu, Min Ruan, Jiayuan Zhang, Tianfeng Liu, Fang Liu, Benquan Qi, Wenbin An, Yuanyuan Ren, Lixian Chang, Xiaofan Zhu
BACKGROUND: The combination of all-trans-retinoic acid (ATRA) and arsenic trioxide (ATO) has been suggested to be safe and effective for adult acute promyelocytic leukaemia (APL). As of 2010, the role of cytarabine (Ara-C) in APL was controversial. The aim of this study was to test the efficacy and safety of ATRA and ATO in paediatric APL patients. Also, we assessed whether Ara-C could be omitted in ATO and ATRA- based trials in children. METHODS: We performed a randomized controlled trial in paediatric APL patients (≤14 years of age) in our hospital from May 2010 to December 2016...
April 3, 2018: BMC Cancer
https://www.readbyqxmd.com/read/29608958/point-prevalence-surveys-of-antimicrobial-use-among-eight-neonatal-intensive
#10
Sumanth Gandra, Gerardo Alvarez-Uria, Srinivas Murki, Sanjeev K Singh, Ravishankar Kanithi, Dasaratha R Jinka, Ashok K Chikkappa, Sreeram Subramanian, Anita Sharma, Dhanya Dharmapalan, Hemasree Kandraju, Anil Kumar Vasudevan, Onkaraiah Tunga, Akhila Akula, Yingfen Hsia, Mike Sharland, Ramanan Laxminarayan
BACKGROUND: Information about antimicrobial use is scarce and poorly understood among neonatal intensive care units (NICUs) in India. In this study, we describe antimicrobial use in eight NICUs using four point prevalence surveys (PPSs). METHODS: As part of the Global Antimicrobial Resistance, Prescribing, and Efficacy in Neonates and Children (GARPEC) study, one-day, cross-sectional, hospital-based PPSs were conducted four times between 1 February 2016 and 28 February 2017 in eight NICUs...
March 30, 2018: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29607473/emergency-blood-transfusion-in-children-in-a-tertiary-hospital-in-nigeria-indications-frequency-and-outcome
#11
B I Abhulimhen-Iyoha, Y T Israel-Aina
BACKGROUND: Blood transfusion is a life-saving procedure in paediatric practice. It is important in replacing blood volume in cases of haemorrhage or providing specific blood components as required. However, the procedure carries some risks and complications. The decision to transfuse, frequency of transfusion and the availability of safe blood and blood products are essential determinants of the success of the procedure. Hence, knowledge of the indications and rate of transfusion is important to ensure that blood for transfusion is safe and made available as at when due...
January 2018: West African Journal of Medicine
https://www.readbyqxmd.com/read/29605342/safety-and-postoperative-adverse-events-in-management-of-acute-mastoiditis-in-children-30-day-nsqip-outcomes
#12
Matthew G Crowson, Jeffrey Cheng
OBJECTIVE: To examine preoperative risk factors, postoperative 30-day outcomes and adverse events of acute mastoiditis using a national pediatric surgical database. METHODS: We explored our objectives using a cross-sectional analysis of a hospital-based reporting system database. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) pediatric database was used to identify surgical encounters for the treatment of acute mastoiditis from 2012 to 2015...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29601458/epidemiology-and-clinical-relevance-of-toxic-shock-syndrome-in-us-children
#13
James T Gaensbauer, Meghan Birkholz, Michael A Smit, Roger Garcia, James K Todd
INTRODUCTION: It is important for clinicians to recognize the contribution of toxic shock syndrome (TSS) to the overall burden of pediatric septic shock because the clinical features, optimal therapy and prognosis differ from non-TSS septic shock. METHODS: We analyzed cases of pediatric septic shock reported to the Pediatric Health Information Systems (PHIS) database between 2009 and 2013 to define the clinical and demographic characteristics of pediatric TSS in the US...
March 27, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29581998/long-term-effect-of-critical-illness-after-severe-paediatric-burn-injury-on-cardiac-function-in-adolescent-survivors-an-observational-study
#14
Gabriel Hundeshagen, David N Herndon, Robert P Clayton, Paul Wurzer, Alexis McQuitty, Kristofer Jennings, Ludwik Branski, Vanessa N Collins, Nicole Ribeiro Marques, Celeste C Finnerty, Oscar E Suman, Michael P Kinsky
Background: Sepsis, trauma, and burn injury acutely depress systolic and diastolic cardiac function; data on long-term cardiac sequelae of pediatric critical illness are sparse. This study evaluated long-term systolic and diastolic function, myocardial fibrosis, and exercise tolerance in survivors of severe pediatric burn injury. Methods: Subjects at least 5 years after severe burn (post-burn:PB) and age-matched healthy controls (HC) underwent echocardiography to quantify systolic function (ejection fraction[EF%]), diastolic function (E/e'), and myocardial fibrosis (calibrated integrated backscatter) of the left ventricle...
December 2017: Lancet Child & Adolescent Health
https://www.readbyqxmd.com/read/29577411/a-pneumococcal-conjugate-vaccination-programme-reduced-clinically-suspected-invasive-disease-in-unvaccinated-children
#15
A A Palmu, H Rinta-Kokko, J P Nuorti, H Nohynek, J Jokinen
AIM: The 10-valent pneumococcal conjugate vaccine was introduced to the Finnish national vaccination programme for children born since June 2010. We evaluated the changes in the rates of clinically suspected invasive pneumococcal disease (IPD) in unvaccinated children to estimate the indirect herd protection impact of the programme. METHODS: The target cohort for this ecological before and after comparison were unvaccinated children born from January 2008 to May 2010 and ineligible for the vaccination programme, who were followed up from 2011-2014...
March 25, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29576361/can-energy-intake-alter-clinical-and-hospital-outcomes-in-picu
#16
Bodil M K Larsen, Megan R Beggs, Amanda Y Leong, Sung Hyun Kang, Rabin Persad, Gonzalo Garcia Guerra
BACKGROUND & AIMS: Energy is essential for the treatment and recovery of children admitted to Pediatric Intensive Care Units (PICU). There are significant immediate and long-term health consequences of both under- and over-feeding in this population. Energy requirements of critically ill children vary depending on age, nutritional status, sepsis, fever, pharmacotherapy, and duration and stage of critical illness. This study aimed to determine the incidence of over- and under-feeding and to compare hospital outcomes between these feeding categories...
April 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29573141/a-multicenter-investigation-of-respiratory-syncytial-viral-infection-in-children-with-hematopoietic-cell-transplantation
#17
Courtney M Rowan, Shira J Gertz, Matt S Zinter, Jerelyn Moffet, Rajinder Ps Bajwa, Jessie L Barnum, Michele Kong
BACKGROUND: Hematopoietic cell transplant (HCT) may be a risk factor for morbidity and mortality from respiratory syncytial virus (RSV). Previous studies have been limited by small sample size. We took a multicenter approach with the goal of better understanding the epidemiology, risk factors, treatment, morbidity and mortality associated with RSV infections among children with HCT in the United States. METHODS: A retrospective, multicenter, cohort study of pediatric HCT recipients diagnosed with RSV infection between January 2010 and December 2014...
March 23, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29570588/hla-dr-expression-on-monocyte-subsets-in-critically-ill-children
#18
Navin P Boeddha, Dorian Kerklaan, Albert Dunbar, Esther van Puffelen, Nicole M A Nagtzaam, Ilse Vanhorebeek, Greet Van den Berghe, Jan A Hazelzet, Koen F Joosten, Sascha C Verbruggen, Willem A Dik, Gertjan J Driessen
BACKGROUND: To longitudinally study blood monocyte subset distribution and human leukocyte antigen-DR (HLA-DR) expression on monocyte subsets in children with sepsis, post-surgery, and trauma in relation to nosocomial infections and mortality. METHODS: In 37 healthy children and 37 critically ill children (12 sepsis, 11 post-surgery, 10 trauma, and 4 admitted for other reasons) - participating in a randomized controlled trial on early versus late initiation of parenteral nutrition - monocyte subset distribution and HLA-DR expression on monocyte subsets were measured by flow cytometry upon admission and on day 2, 3, and 4 of PICU stay...
March 21, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29567042/face-and-content-validity-of-variables-associated-with-the-difficult-to-sedate-child-in-the-paediatric-intensive-care-unit-a-survey-of-paediatric-critical-care-clinicians
#19
Ruth M Lebet, Lisa A Asaro, Athena F Zuppa, Martha A Q Curley
BACKGROUND: Clinicians recognise that some critically ill children are difficult-to-sedate. It may be possible to identify this clinical phenotype for sedation response using statistical modelling techniques adopted from machine learning. This requires identification of a finite number of variables to include in the statistical model. OBJECTIVE: To establish face and content validity for 17 candidate variables identified in the international literature as characteristic of the difficult-to-sedate child phenotype...
March 19, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29566368/the-trend-of-%C3%AE-3-adrenergic-receptor-in-the-development-of-septic-myocardial-depression-a-lipopolysaccharide-induced-rat-septic-shock-model
#20
Ni Yang, Xiao-Lu Shi, Bing-Lun Zhang, Jian Rong, Tie-Ning Zhang, Wei Xu, Chun-Feng Liu
Septic shock with low cardiac output is very common in children. However, the mechanism underlying myocardial depression is unclear. The role of β3-AR in the development of myocardial depression in sepsis is unknown. In the present study, we generated an adolescent rat model of hypodynamic septic shock induced by lipopolysaccharide (LPS). Neonatal cardiomyocytes were also treated with LPS to mimic myocardial depression in sepsis, which was confirmed via an in vivo left ventricular hemodynamic study, and measurements of contractility and the Ca2+ transient in isolated adolescent and neonatal cardiomyocytes...
March 22, 2018: Cardiology
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