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Sepsis in children

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https://www.readbyqxmd.com/read/29471722/outcomes-and-resource-use-among-overweight-and-obese-children-with-sepsis-in-the-pediatric-intensive-care-unit
#1
Laura S Peterson, Cecilia Gállego Suárez, Hannah E Segaloff, Cameron Griffin, Emily T Martin, Folafoluwa O Odetola, Kanakadurga Singer
OBJECTIVE: To evaluate the effect of overweight and obesity on outcomes and resource use among patients with sepsis in the pediatric intensive care unit (PICU). DESIGN: Retrospective analysis of clinical characteristics, resource use, and mortality among children 0 to 20 years of age admitted to the C.S. MottChildren's Hospital PICU (University of Michigan) between January 2009 and December 2015, with a diagnostic code for sepsis at admission (based on International Classification of Diseases, Ninth Revision- Clinical Modification codes) and with weight and height measurements at PICU admission...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29470918/early-immune-function-and-duration-of-organ-dysfunction-in-critically-ill-septic-children
#2
Jennifer A Muszynski, Ryan Nofziger, Melissa Moore-Clingenpeel, Kristin Greathouse, Larissa Anglim, Lisa Steele, Josey Hensley, Lisa Hanson-Huber, Jyotsna Nateri, Octavio Ramilo, Mark W Hall
RATIONALE: Late immune suppression is associated with nosocomial infection and mortality in septic adults and children. Relationships between early immune suppression and outcomes in septic children remain unclear. OBJECTIVE: Prospective observational study to test the hypothesis that early innate and adaptive immune suppression are associated with longer duration of organ dysfunction in children with severe sepsis/septic shock. Methods, Measurements and Main Results: Children aged < 18 years meeting consensus criteria for severe sepsis or septic shock were sampled within 48 hours of sepsis onset...
February 22, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29470247/hypofibrinogenemia-is-associated-with-poor-outcome-and-secondary-hemophagocytic-lymphohistiocytosis-macrophage-activation-syndrome-in-pediatric-severe-sepsis
#3
Jessica K Signoff, Julie C Fitzgerald, David T Teachey, Fran Balamuth, Scott L Weiss
OBJECTIVES: Some children with sepsis exhibit a sustained hyperinflammatory response that can trigger secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. Although hypofibrinogenemia is a shared feature of sepsis and hemophagocytic lymphohistiocytosis, there are no data about fibrinogen as a biomarker to identify children with sepsis/secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome overlap. We hypothesized that hypofibrinogenemia is associated with poor outcomes and secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome and has utility as a screening biomarker for this sepsis phenotype...
February 21, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29469010/effect-of-blood-thiamine-concentrations-on-mortality-influence-of-nutritional-status
#4
Heitor Pons Leite, Lúcio Flávio Peixoto de Lima, José Augusto de A C Taddei, Ângela Tavares Paes
OBJECTIVE: To test the hypothesis that low blood thiamine concentrations in malnourished critically ill children are associated with higher risk of 30-d mortality. METHODS: Prospective cohort study in 202 consecutively admitted children who had whole blood thiamine concentrations assessed on admission and on days 5 and 10 of intensive care unit (ICU) stay. The primary outcome variable was 30-d mortality. Mean blood thiamine concentrations within the first 10 d of ICU stay, age, sex, malnutrition, C-reactive protein concentration, Pediatric Index of Mortality 2 score, and severe sepsis/septic shock were the main potential exposure variables for outcome...
December 7, 2017: Nutrition
https://www.readbyqxmd.com/read/29466967/a-pediatric-death-audit-in-a-large-referral-hospital-in-malawi
#5
Elizabeth Fitzgerald, Rachel Mlotha-Mitole, Emily J Ciccone, Alyssa E Tilly, Jennie M Montijo, Hans-Joerg Lang, Michelle Eckerle
BACKGROUND: Death audits have been used to describe pediatric mortality in under-resourced settings, where record keeping is often a challenge. This information provides the cornerstone for the foundation of quality improvement initiatives. Malawi, located in sub-Saharan Africa, currently has an Under-5 mortality rate of 64/1000. Kamuzu Central Hospital, in the capital city Lilongwe, is a busy government referral hospital, which admits up to 3000 children per month. A study published in 2013 reported mortality rates as high as 9%...
February 21, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29461600/evaluation-of-the-application-of-high-volume-hemofiltration-in-sepsis-combined-with-acute-kidney-injury
#6
S-Q Meng, W-B Yang, J-G Liu, J-Y Yuan, K Zhang, W-Y Ding, S-Q Yang, J-H Liu
OBJECTIVE: To investigate the safety and effectiveness of the application of high-volume hemofiltration (HVHF) in children with sepsis combined with acute kidney injury. PATIENTS AND METHODS: A total of 76 child patients were enrolled and randomly divided equally (n=38) into control and the observation groups respectively. The control group received conventional volume hemofiltration (the ultrafiltration rate of 35-50 ml/kg/h), and the observation group received HVHF (50-100 ml/kg/h)...
February 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29461021/respiratory-syncytial-virus-is-an-opportunistic-killer
#7
REVIEW
Mauricio T Caballero, Fernando P Polack
Respiratory syncytial virus (RSV), responsible for more than three million yearly hospitalizations and up to 118 000 deaths in children under 5 years, is the leading pulmonary cause of death for this age group that lacks a licensed vaccine. Ninety-nine percent of deaths due to the virus occur in developing countries. In-hospital RSV fatalities affect previously healthy term infants in association with bacterial sepsis, clinically significant pneumothoraxes and, to a lesser extent, comorbid conditions. Community deaths affect low-income children from socially vulnerable families and appear to be as frequent as inpatient fatalities...
February 20, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29459939/cognitive-outcomes-of-children-born-extremely-or-very-preterm-since-the-1990s-and-associated-risk-factors-a-meta-analysis-and-meta-regression
#8
E Sabrina Twilhaar, Rebecca M Wade, Jorrit F de Kieviet, Johannes B van Goudoever, Ruurd M van Elburg, Jaap Oosterlaan
Importance: Despite apparent progress in perinatal care, children born extremely or very preterm (EP/VP) remain at high risk for cognitive deficits. Insight into factors contributing to cognitive outcome is key to improve outcomes after EP/VP birth. Objective: To examine the cognitive abilities of children of EP/VP birth (EP/VP children) and the role of perinatal and demographic risk factors. Data Sources: PubMed, Web of Science, and PsycINFO were searched without language restriction (last search March 2, 2017)...
February 19, 2018: JAMA Pediatrics
https://www.readbyqxmd.com/read/29455437/live-donor-liver-transplantation-for-acute-liver-failure-a-single-center-experience
#9
Siddharth Mehrotra, Naimish Mehta, Prashantha S Rao, Shailendra Lalwani, Vivek Mangla, Samiran Nundy
INTRODUCTION: Acute liver failure (ALF) is an indication for emergency liver transplantation (LT). Although centers performing only deceased donor liver transplants (DDLT) have shown improved outcomes in this situation, they still have relatively long waiting lists. An alternative would be living donor liver transplantation (LDLT), which has shown equivalent outcomes in the elective situation but there is limited evidence of its results in ALF. AIM: The purpose of this study was to assess the outcomes in patients with ALF undergoing emergency LDLT in our center in Delhi, India...
February 17, 2018: Indian Journal of Gastroenterology: Official Journal of the Indian Society of Gastroenterology
https://www.readbyqxmd.com/read/29454844/the-epidemiology-of-febrile-illness-in-sub-saharan-africa-implications-for-diagnosis-and-management
#10
REVIEW
Michael J Maze, Quique Bassat, Nicholas A Feasey, Inácio Mandomando, Patrick Musicha, John A Crump
BACKGROUND: Fever is among the most common symptoms of people living in Africa, and clinicians are challenged by the similar clinical features of a wide spectrum of potential aetiologies. AIM: To summarise recent studies of fever aetiology in sub-Saharan Africa focusing on causes other than malaria. SOURCES: A narrative literature review by searching the MEDLINE database, and recent conference abstracts. CONTENT: Studies of multiple potential causes of fever are scarce, and for many participants the infecting organism remains unidentified, or multiple co-infecting microorganisms are identified, and establishing causation is challenging...
February 15, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29441651/invasive-pneumococcal-infections-in-pediatric-liver-small-bowel-pancreas-transplant-recipients
#11
Hanh D Vo, Diana F Florescu, Cindy R Brown, Heather E Chambers, David F Mercer, Luciano M Vargas, Wendy J Grant, Alan N Langnas, Ruben E Quiros-Tejeira
Children undergoing LSBPTx are at increased risk of IPI due to splenectomy. We aimed to describe the clinical features and outcomes of IPI in pediatric LSBPTx recipients. Between 2008 and 2016, 122 LSBPTx children at our center were retrospectively reviewed. Nine patients had 12 episodes of IPI; the median age at first infection was 3.5 years (range: 1.5-7.1 years). The median time from transplant to first infection was 3 years (range: 0.8-5.8 years). Clinical presentation included as follows: pneumonia (n = 1), bacteremia/sepsis (n = 7), pneumonia with sepsis (n = 1), meningitis with sepsis (n = 2), pneumonia and meningitis with sepsis (n = 1)...
February 13, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29436406/management-of-suspected-paediatric-meningitis-a-multicentre-prospective-cohort-study
#12
Roshan Ramasamy, Louise Willis, Seilesh Kadambari, Dominic F Kelly, Paul T Heath, Simon Nadel, Andrew J Pollard, Manish Sadarangani
OBJECTIVE: To quantify delays during management of children with suspected meningitis. DESIGN: Multicentre prospective cohort study. SETTING: Three UK tertiary paediatric centres; June 2011-June 2012 PATIENTS: 388 children aged <16 years hospitalised with suspected meningitis or undergoing lumbar puncture (LP) during sepsis evaluation. MAIN OUTCOME MEASURES: Time of prehospital and in-hospital assessments, LP, antibiotic treatment and discharge; types of prehospital medical assessment and microbiological results...
February 7, 2018: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/29433093/-use-of-plasma-exchange-in-pediatric-severe-sepsis-in-children-s-hospitals
#13
Lisa M Lima, Courtney E McCracken, James D Fortenberry, Kiran B Hebbar
No abstract text is available yet for this article.
February 3, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29432403/neutrophil-extracellular-traps-in-children-with-meningococcal-sepsis
#14
Tamara Hoppenbrouwers, Navin P Boeddha, Ebru Ekinci, Marieke Emonts, Jan A Hazelzet, Gertjan J Driessen, Moniek P de Maat
OBJECTIVES: Children with meningococcal sepsis are highly at risk for fulminant disease, multiple organ failure, and death. Recently, neutrophil extracellular traps levels have been indicated as a marker for severity in different kinds of sepsis. Our aim was to study the role of neutrophil extracellular traposis in meninogococcal sepsis in children. DESIGN: We measured myeloperoxidase-DNA, a marker for neutrophil extracellular traps, in serum of meningococcal sepsis patients upon admission to PICU, at 24 hours, and at 1 month and studied the association with clinical outcome...
February 9, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#15
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29424065/trend-and-outcome-of-sepsis-in-children-a-nationwide-cohort-study
#16
Chia-Hung Yo, Tzu-Chun Hsu, Meng-Tse Gabriel Lee, Lorenzo Porta, Po-Yang Tsou, Yu-Hsun Wang, Wan-Chien Lee, Szu-Ta Chen, Chien-Chang Lee
AIM: The aim of this study was to investigate the trend of incidence and outcome of paediatric sepsis in a population-based database. METHODS: Children with sepsis were identified from the 23 million nationwide health insurance claims database of Taiwan. Sepsis was defined by the presence of single ICD-9 code for severe sepsis or septic shock or a combination of ICD-9 codes for infection and organ dysfunction. We analysed the trend of incidence, mortality and source of infection in three age groups: infant (28 days to 1 year), child (1-9 years) and adolescent (10-18 years)...
February 9, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29415741/elucidating-the-impact-of-the-pneumococcal-conjugate-vaccine-programme-on-pneumonia-sepsis-and-otitis-media-hospital-admissions-in-england-using-a-composite-control
#17
Dominic Thorrington, Nick Andrews, Julia Stowe, Elizabeth Miller, Albert Jan van Hoek
BACKGROUND: The seven-valent pneumococcal conjugate vaccine (PCV) was introduced in England in September 2006, changing to the 13-valent vaccine in April 2010. PCV impact on invasive pneumococcal disease (IPD) has been extensively reported, but less described is its impact on the burden of pneumonia, sepsis and otitis media in the hospital. METHODS: Using details on all admissions to hospitals in England, we compared the incidence of pneumococcal-specific and syndromic disease endpoints in a 24-month pre-PCV period beginning April 2004 to the 24-month period ending March 2015 to derive incidence rate ratios (IRRs)...
February 8, 2018: BMC Medicine
https://www.readbyqxmd.com/read/29406378/downward-trend-in-pediatric-resident-laryngoscopy-participation-in-picus
#18
Aayush Gabrani, Taiki Kojima, Ronald C Sanders, Asha Shenoi, Vicki Montgomery, Simon J Parsons, Sandeep Gangadharan, Sholeen Nett, Natalie Napolitano, Keiko Tarquinio, Dennis W Simon, Anthony Lee, Guillaume Emeriaud, Michelle Adu-Darko, John S Giuliano, Keith Meyer, Ana Lia Graciano, David A Turner, Conrad Krawiec, Adnan M Bakar, Lee A Polikoff, Margaret Parker, Ilana Harwayne-Gidansky, Benjamin Crulli, Paula Vanderford, Ryan K Breuer, Eleanor Gradidge, Aline Branca, Lily B Grater-Welt, David Tellez, Lisa V Wright, Matthew Pinto, Vinay Nadkarni, Akira Nishisaki
OBJECTIVES: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. DESIGN: Prospective cohort study. SETTING: Twenty-five PICUs at various children's hospitals across the United States. PATIENTS: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children)...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29403648/bacteriological-profile-and-antibiotic-susceptibility-pattern-of-common-isolates-of-neonatal-sepsis-ho-municipality-ghana-2016
#19
Fortress Yayra Aku, Patricia Akweongo, Kofi Nyarko, Samuel Sackey, Fredrick Wurapa, Edwin Andrew Afari, Donne Kofi Ameme, Ernest Kenu
Background: Globally, 4 million neonates die annually, with one-third of such deaths occurring as a result of infections. In 2011, there were 7.2million deaths in children below 5 years globally, and a proportion of 40% of these deaths occurred in neonates. Sepsis was reported to account for one-third of these deaths. Presently, multidrug antibiotic resistance is rapidly increasing in Neonatal Intensive Care Units (NICUs), particularly in developing countries and poses a threat to public health...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29394150/pediatric-sepsis-update-how-are-children-different
#20
Bryanna M Emr, Alicia M Alcamo, Joseph A Carcillo, Rajesh K Aneja, Kevin P Mollen
BACKGROUND: Although there are some commonalities between pediatric and adult sepsis, there are important differences in pathophysiology, clinical presentation, and therapeutic approaches. The recognition and diagnosis of sepsis is a significant challenge in pediatric patients as vital sign aberrations and examination findings are often subtle as compared to those observed in adults. Gaps in knowledge that have been studied in depth in adult sepsis are still being investigated in pediatric patients such as best practices in ventilation, invasive monitoring, and resuscitation...
February 2, 2018: Surgical Infections
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