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Predictor picu

Gregory Hansen, Joshua Hochman, Meghan Garner, Jeffrey Dmytrowich, Tanya Holt
BACKGROUND: Delivery of noninvasive ventilation commonly occurs in the pediatric intensive care unit (PICU). With the advent of high flow nasal cannula (HFNC), patients with respiratory distress may be rescued on the ward without a PICU admission. We evaluated our ward HFNC algorithm to determine its safety profile and independent predictors for non-responders, defined as requiring a subsequent PICU admission. METHODS: A retrospective chart review for patients <17 years of age admitted with respiratory distress between 2016-17...
January 15, 2019: Pediatrics International: Official Journal of the Japan Pediatric Society
Sandra A Asner, Philipp K A Agyeman, Eugénie Gradoux, Klara M Posfay-Barbe, Ulrich Heininger, Eric Giannoni, Pierre A Crisinel, Martin Stocker, Sara Bernhard-Stirnemann, Anita Niederer-Loher, Christian R Kahlert, Paul Hasters, Christa Relly, Walter Baer, Christoph Aebi, Luregn J Schlapbach, Christoph Berger
Background: Population-based studies assessing the impact of pneumococcal conjugate vaccines (PCV) on burden of pneumococcal sepsis in children are lacking. We aimed to assess this burden following introduction of PCV-13 in a nationwide cohort study. Methods: The Swiss Pediatric Sepsis Study (09/2011-12/2015) prospectively recruited children <17 years of age with blood culture-proven sepsis due to Streptococcus pneumoniae, meeting criteria for systemic inflammatory response syndrome...
January 2, 2019: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Scott J Luhmann, Ryan Furdock
OBJECTIVE: The objective of this study is to identify preoperative laboratory values and patient factors that are associated with postoperative respiratory complications in pediatric neuromuscular scoliosis (NMS) populations undergoing posterior spinal fusion (PSF) with instrumentation. SUMMARY OF BACKGROUND DATA: PSF in NMS patients are high-risk surgeries. Respiratory complications are the most common postoperative event, with rates up to 28.2% following surgery...
January 2019: Spine Deformity
Mary Sandquist, Ken Tegtmeyer
Reducing or eliminating code blues that occur on the inpatient, noncritical care units of children's hospitals is a challenging yet achievable goal. The mechanism to accomplish this involves several levels of effort. The implementation of effective pediatric rapid response teams is a well identified part of the process. Rapid response teams can allow for appropriate clinical interventions for deteriorating patients and may ultimately result in a reduction in hospital-wide mortality as well as efficient transfer to the pediatric intensive care unit (PICU) when necessary...
October 2018: Translational Pediatrics
Indah K Murni, Trevor Duke, Andrew J Daley, Sharon Kinney, Yati Soenarto
BACKGROUND: Nosocomial bloodstream infection (BSI) is associated with high mortality rates. Evaluating factors to predict mortality is important for prevention and improving clinical outcomes. AIM: To evaluate the clinical predictors of mortality in paediatric nosocomial bloodstream infection. METHODS: A prospective cohort study was conducted from 1 December 2010 until 28 February 2013 in a teaching hospital in Yogyakarta, Indonesia. All patients admitted consecutively to the paediatric ICU (PICU) and paediatric wards after > 48 h of hospitalisation were eligible...
October 17, 2018: Paediatrics and International Child Health
Sietske C van Nassau, Ron H van Beek, Gertjan J Driessen, Jan A Hazelzet, Herbert M van Wering, Navin P Boeddha
Background: Recent attempts to translate Sepsis-3 criteria to children have been restricted to PICU patients and did not target children in emergency departments (ED). We assessed the prognostic accuracy of the age-adjusted quick Sequential Organ Failure Assessment score (qSOFA) and compared the performance to SIRS and the quick Pediatric Logistic Organ Dysfunction-2 score (qPELOD-2). We studied whether the addition of lactate (qSOFA-L) would increase prognostic accuracy. Methods: Non-academic, single-center, retrospective study in children visiting the ED and admitted with suspected bacterial infection between March 2013 and January 2018...
2018: Frontiers in Pediatrics
Leila Khajavi, Gholamreza Khademi, Mehraneh Mehramiz, Abdolreza Norouzy, Mohammad Safarian
Khajavi L, Khademi G, Mehramiz M, Norouzy A, Safarian M. Association of dysglycemia with mortality in children receiving parenteral nutrition in pediatric intensive care unit. Turk J Pediatr 2018; 60: 134-141. One of the most important complications of parenteral nutrition (PN) is a high incidence of hyperglycemia. The aim of this study was to assess the effect of parenteral nutrition dysglycemia on clinical outcomes among critically ill children in pediatric intensive care unit (PICU). Charts of 201 critically ill children admitted in PICU during 2012-2015 were reviewed retrospectively...
2018: Turkish Journal of Pediatrics
Rinske Ijsselhof, Hua Liu, Frank Pigula, Kimberlee Gauvreau, John E Mayer, Pedro Del Nido, Meena Nathan
BACKGROUND: In the current era, coarctation repair is usually performed as soon as diagnosis is established. We sought to determine if neonatal isolated coarctation repair had a higher rate of interventions post-discharge when compared to older infants. METHODS: Retrospective review of neonates (≤30 days) and infants(1-6 months) undergoing isolated coarctation repair between 1/1/2000-3/31/2016. Preoperative/postoperative Z scores of arch, aortic valve and isthmus, rates of reintervention and length of stay were compared between groups...
September 1, 2018: Annals of Thoracic Surgery
Mohamed A El-Gamasy, Akram E El-Sadek, Ahmed R Fakhreldin, Ashraf Kamel, Eman G Elbehery
Acute kidney injury (AKI) is an independent predictor of morbidity and mortality for critically ill children at pediatric Intensive Care Units (PICU). It is proposed that heat shock protein 60 (HSP60) may be either a biomarker or a co-factor of survival in PICU. The aim of this work is to assess plasma levels of HSP60 in critically ill pediatric patients with AKI secondary to septic shock within the first 24 h of admission. This study was carried out on 120 pediatric patients admitted to PICUs of four university hospitals...
July 2018: Saudi Journal of Kidney Diseases and Transplantation
Marianne E Nellis, Ruchika Goel, Sydney Feinstein, Sevini Shahbaz, Savneet Kaur, Chani Traube
OBJECTIVES: To determine the temporal relationship between the transfusion of RBCs and the subsequent development of delirium in a cohort of critically ill children. DESIGN: Nested retrospective cohort study within prospective cohort study. SETTING: Urban academic tertiary care PICU. PATIENTS: All consecutive admissions from September 2014 through August 2015. INTERVENTIONS: Children were screened twice daily for delirium during their PICU admission...
October 2018: Pediatric Critical Care Medicine
Jochen Meyburg, Markus Ries, Matthias Zielonka, Karin Koch, Anja Sander, Rebecca von Haken, Gitta Reuner
OBJECTIVES: To investigate the long-term impact of postoperative delirium in children. DESIGN: Single-center point prevalence study. SETTING: Twenty-two bed PICU. PATIENTS: Forty-seven patients 1-16 years old. INTERVENTIONS: Standardized neuropsychologic follow-up investigation after a mean time of 17.7 ± 2.9 months after PICU discharge. MEASUREMENTS AND MAIN RESULTS: Pediatric delirium did not have significant long-term impact on global cognition, executive functions, or behavior...
October 2018: Pediatric Critical Care Medicine
Rania Salah El-Zayat, Awny Gamal Shalaby
OBJECTIVES: Myocardial dysfunction is well recognized in severe sepsis and septic shock. Echocardiography provides rapid, noninvasive, and bedside evaluation of cardiac function in patients with hemodynamic instability. Mitral annular plane systolic excursion is an M-mode-derived echocardiographic variable used to assess longitudinal left ventricular systolic function. No data are available about the uses of mitral annular plane systolic excursion in children with septic shock. Therefore, we aimed to assess the prognostic significance of mitral annular plane systolic excursion in children with septic shock and to correlate it with the most commonly used measures of left ventricular systolic function and myocardial injury...
September 2018: Pediatric Critical Care Medicine
Fabian B Fahlbusch, Thomas Heinlein, Manfred Rauh, Sven Dittrich, Robert Cesnjevar, Julia Moosmann, Jennifer Nadal, Matthias Schmid, Frank Muench, Michael Schroth, Wolfgang Rascher, Hans-Georg Topf
OBJECTIVES: Coagulation factor XIII (FXIII) plays a key role in fibrin clot stabilization-an essential process for wound healing following cardiothoracic surgery. However, FXIII deficiency as a risk for post-operative bleeding in pediatric cardiac surgery involving cardiopulmonary bypass (CPB) for congenital heart disease (CHD) is controversially discussed. Thus, as primary outcome measures, we analyzed the association of pre-operative FXIII activity and post-operative chest tube drainage (CTD) loss with transfusion requirements post-operatively...
2018: PloS One
Amee M Bigelow, Katherine T Flynn-O'Brien, Pippa M Simpson, Mahua Dasgupta, Sheila J Hanson
OBJECTIVES: Frequency of venous thromboembolism in pediatric trauma patients admitted to PICUs is not insignificant, ranging up to 6%. Risk factors have been identified in this population. However, there is little consensus of actual venous thromboembolism prophylaxis practice. We examined factors associated with venous thromboembolism prophylaxis in PICUs. DESIGN: A retrospective study evaluating associations with mechanical venous thromboembolism prophylaxis, pharmacologic venous thromboembolism prophylaxis, or dual therapy (DUAL) prophylaxis compared with no venous thromboembolism prophylaxis...
September 2018: Pediatric Critical Care Medicine
Zhenjiang Bai, Fang Fang, Zhong Xu, Chunjiu Lu, Xueqin Wang, Jiao Chen, Jian Pan, Jian Wang, Yanhong Li
BACKGROUND: Fibroblast growth factor 23 (FGF23) and insulin-like growth factor binding protein 7 (IGFBP-7) are suggested to be biomarkers for predicting acute kidney injury (AKI). We compared them with proposed AKI biomarker of cystatin C (CysC), and aimed (1) to examine whether concentrations of these biomarkers vary with age, body weight, illness severity assessed by pediatric risk of mortality III score, and kidney function assessed by estimated glomerular filtration rate (eGFR), (2) to determine the association between these biomarkers and AKI, and (3) to evaluate whether these biomarkers could serve as early independent predictors of AKI in critically ill children...
June 15, 2018: BMC Pediatrics
Rebecca L Hascall, R Serene Perkins, Lauren Kmiecik, Priya R Gupta, Carolyn F Shelak, Shaban Demirel, Mark T Buchholz
OBJECTIVE: We investigated the proportion of encounters that were interrupted during family-centered rounds in the pediatric intensive care unit (PICU) to determine whether the use of a physician assistant (PA) significantly affected the proportion of interrupted encounters. METHODS: We evaluated 2,657 rounding encounters in our 24-bed regional referral unit. The duration of each rounding encounter and total rounding duration were recorded. The presence or absence of a PA during each rounding encounter, the occurrence of an interruption, and other potential predictors of interruptions were recorded...
June 2018: JAAPA: Official Journal of the American Academy of Physician Assistants
Paula Heikkilä, Paula Sokuri, Minna Mecklin, Kirsi Nuolivirta, Terhi Tapiainen, Outi Peltoniemi, Marjo Renko, Matti Korppi
AIM: Using a high-flow nasal cannula (HFNC) for infant bronchiolitis is increasingly common, but insufficiently studied. In this retrospective study, we examined the outcomes of HFNC and compared infants who did and did not respond to this oxygen delivery method. METHODS: This 2012-2015 study of six Finnish hospitals focused on 88 infants under 12 months who received HFNC: 53 on paediatric wards and 35 in paediatric intensive care units (PICUs). We reviewed patient files for underlying factors, clinical parameters and HFNC treatment...
November 2018: Acta Paediatrica
Tanya Holt, Michael Prodanuk, Gregory Hansen
OBJECTIVE: Determining pediatric severity of illness in referring centers may be useful for establishing appropriate patient disposition and interfacility transport. For this retrospective review, the authors evaluated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient disposition and outcomes. METHODS: A disposition score using the PaedCTAS algorithm was retrospectively calculated from referring center data at the time our transport team was consulted...
2018: American Journal of Disaster Medicine
Hansa Haftu, Tedrose Hailu, Araya Medhaniye, Teklit G/Tsadik
OBJECTIVE: To describe admission pattern and outcome with its predictor variable on the mortality of children admitted to pediatric intensive care unit (PICU), Ayder Referral Hospital, Northern Ethiopia, from September 2012 to August 2014. RESULT: From 680 admitted patients, 400 patients were analyzed. Average age at admission was 62.99 ± 60.94 months, with F:M ratio of 1:1.2. Overall (from infectious and non-infectious) the most commonly affected systems were respiratory (90/400 pts...
May 24, 2018: BMC Research Notes
Hajrija Maksić, Suada Heljić, Fahrija Skokić, Darinka Šumanović-Glamuzina, Veroslava Milošević, Almir Zlatanović, Notario Gerard
Prematurity is a risk factor for respiratory syncytial virus (RSV)-associated lower respiratory tract infections (LRTIs), due to immature humoral and cell-mediated immune system in preterm newborns, as well as their incomplete lung development. Palivizumab, a humanized monoclonal antibody against the F glycoprotein of RSV, is licensed for the prevention of severe RSV LRTI in children at high risk for the disease. This study is a part of a larger observational, retrospective-prospective epidemiological study (PONI) conducted at 72 sites across 23 countries in the northern temperate zone...
August 1, 2018: Bosnian Journal of Basic Medical Sciences
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