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Pediatric Acute Heart Failure

Ali Yurtseven, Caner Turan, Eren Erseven, Eylem Ulas Saz
OBJECTIVE: We aimed to compare the heated humidified high-flow nasal cannula (HHHFNC) flow rate of 1-L·kg·min-1 (1 L) with 2-L·kg·min -1 (2 L) in patients with severe bronchiolitis presenting to the pediatric emergency department. STUDY DESIGN: We performed a study in which all patients were allocated to receive these two flow rates. The primary outcome was admitted as treatment failure, which was defined as a clinical escalation in respiratory status...
March 18, 2019: Pediatric Pulmonology
Naohiro Shioji, Tomoyuki Kanazawa, Tatsuo Iwasaki, Kazuyoshi Shimizu, Tomohiko Suemori, Yasutoshi Kuroe, Hiroshi Morimatsu
We compared the reintubation rate in children who received high-flow nasal cannula (HFNC) therapy to the rate in children who received noninvasive ventilation (NIV) therapy for acute respiratory failure (ARF) after cardiac surgery. This was a retrospective analysis of 35 children who received HFNC therapy for ARF after cardiac surgery in 2014-2015 (the HFNC group). We selected 35 children who had received NIV therapy for ARF after cardiac surgery in 2009-2012 as a control group. The matching parameters were body weight and risk adjustment for congenital heart surgery category 1...
February 2019: Acta Medica Okayama
Scott A McAninch, Jared W Glenn, Kellie Quinn, Jacob K Barney
We present an unusual case of a 6-year-old boy who presented with the sudden presence of left neck mass and acute hypoxemic respiratory failure, whose subsequent imaging demonstrated a previously undiagnosed anterior mediastinal mass (AMM) extending into the left neck. Biopsy of the mass was consistent with a desmoid tumor, which is a rare cause of AMM in children. Desmoid tumors are locally aggressive, often invading and enveloping surrounding tissues, but overall slow growing. The sudden growth of the neck mass suggests a very aggressive desmoid tumor, causing an unexpected respiratory compromise...
February 20, 2019: Pediatric Emergency Care
Zachary Hena, Megan E McCabe, Michelle M Perez, Madhu Sharma, Nicole J Sutton, Giles J Peek, Bradley C Clark
Aluminum phosphide (AlP) is an insecticide and rodenticide that produces phosphine gas when exposed to moisture. Exposure to AIP has been described as through inhalation and ingestion routes and is typically either accidental or a suicidal attempt. The result is potential multiorgan toxicity involving the heart, kidneys, lungs, and liver, with an overall mortality related to exposure reported from 30% to 77%. The initial symptoms are nonspecific and can include epigastric pain, vomiting, diarrhea, dizziness, and dyspnea...
December 2018: International journal of pediatrics & adolescent medicine
Jack F Price
Congestive heart failure is a final common clinical pathway for several diseases in childhood, such as familial cardiomyopathy, viral myocarditis, inborn errors of metabolism, and autoimmune disorders. Early identification and treatment can reduce symptom severity and may affect outcomes. In this review, the clinical characteristics of pediatric heart failure are described, and the initial diagnostic evaluation is outlined. Evidence-based heart failure treatment strategies at various clinical stages are discussed in detail, including the management of acute decompensated heart failure...
February 2019: Pediatrics in Review
Lars Michel, Tienush Rassaf, Matthias Totzeck
Progress in cancer therapy over the past decades improved long-term survival but increased cancer therapy-related cardiotoxicity. Many novel treatment options have been implemented with yet incompletely characterized cardiovascular side effects including heart failure, coronary artery disease, arrhythmias, valvular disease, venous thromboembolism and myocarditis. Diagnosis of potential cardiotoxic side effects is essential for an optimal treatment but remains challenging. Cardiac biomarkers troponin and brain natriuretic peptide/N-terminal proBNP (BNP/NT-proBNP) have been extensively studied in heart failure and acute coronary syndromes...
December 2018: Journal of Thoracic Disease
Rachel Manalo, Laura Bourget, Ashish Garg, Sethuraman Swaminathan
Myocarditis is a common cause for acute heart failure in the pediatric population. Various imaging modalities have evolved over the past 3 decades in order to noninvasively image the myocardium in this patient population. These include standard 2-dimensional echocardiographic imaging, tissue Doppler imaging, and magnetic resonance imaging of the heart. More recently, myocardial speckle tracking also known as strain imaging has been utilized to assess regional wall motion abnormalities with increasing accuracy...
January 24, 2019: Echocardiography
Ming-Shyan Lin, Yu-Hsiang Tseng, Mei-Yen Chen, Chang-Min Chung, Ming-Horng Tsai, Po-Chang Wang, Jung-Jung Chang, Tien-Hsing Chen, Yu-Sheng Lin
BACKGROUND: High-dose steroids and intravenous immunoglobulin (IVIG) are controversial treatments for pediatric patients with acute myocarditis. This study aimed to investigate their efficacies in the Taiwanese pediatric population. METHODS: This study evaluated 5563 acute myocarditis patients from the Taiwan's National Health Insurance Research Database and identified 1542 pediatric patients hospitalized for acute myocarditis between January 1, 2001 and December 31, 2011...
January 9, 2019: BMC Cardiovascular Disorders
Jiun Hsu, Chia-Hsuin Chang, Liang-Ting Chiang, James L Caffrey, Jou-Wei Lin, Yih-Sharng Chen
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) provides short-term cardiopulmonary support for patients with acute cardiac and respiratory failure. This study reported the survival rate for pediatric patients from Taiwan's national cohort. METHODS: Patients under the age of 18 who received ECMO from January 1, 2002 to December 31, 2012 were identified from the Taiwan National Health Insurance Research Database. The underlying etiology for ECMO use was categorized into post-operative (n = 410), cardiac (245), pulmonary (146) groups, and others (120)...
January 4, 2019: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Shaodong Zhao, Xuhua Ge, Penghong Xu, Yong Liu, Jun Shi, Hongjun Miao
OBJECTIVE: To explore the clinical application value of the continuous blood purification (CBP) technology in pediatric intensive care unit (ICU). METHODS: A retrospective study was conducted. All CBP patients admitted to pediatric ICU of Children's Hospital of Nanjing Medical University from 2015 to 2017 were enrolled. The disease diagnosis, CBP treatment mode, catheter placement, anticoagulation way, treatment time and adverse reactions were summarized and analyzed...
December 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Maura Faraci, Alice Bertaina, Arnaud Dalissier, Marianne Ifversen, Ansgar Schulz, Andrew Gennery, Birgit Burkhardt, Isabel Badell Serra, Cristina Diaz-de-Heredia, Edoardo Lanino, Arjan C Lankester, Bernd Gruhn, Susanne Matthes-Martin, Joern S Kühl, Stefania Varotto, Catherine Paillard, Audrey Guilmatre, Ana Sastre, Manuel Abecasis, Birgit Garwer, Petr Sedlacek, Jaap J Boelens, Eric Beohou, Peter Bader
We report data obtained from a retrospective multicenter pediatric survey on behalf of the European Society for Blood and Marrow Transplantation (EBMT). Information on solid organ transplantation (SOT) performed in pediatric recipients of either autologous or allogeneic hematopoietic stem cell transplantation (HSCT) between 1984 and 2016 was collected in 20 pediatric EBMT Centers (25.6%). Overall, we evaluated data on 44 SOTs following HSCT including 20 liver (LTx), 12 lung (LuTx), 6 heart (HTx), and 6 kidney (KTx) transplantations...
December 26, 2018: American Journal of Transplantation
Chiu-Yu Chen, Paul Warner, Erin L Albers, Mariska S Kemna, Meghan Delaney, Borah J Hong, Yuk M Law
ABO-i heart transplantation can be performed in infants with end-stage heart failure to increase organ availability. The development of newly detected DSAs is associated with decreased cardiac graft survival, and the effect of ABO-i transplantation on DSA production is unknown. We examined DSA production and rejection frequency in infant recipients of ABO-i and ABO-c heart transplants via a retrospective cohort study of infant heart transplant recipients transplanted at a single pediatric center between January 2004 and November 2014...
December 4, 2018: Pediatric Transplantation
Kristen A Smith, Heidi R Flori
In caring for critically ill children, recognition and management often begins in the pediatric emergency department. A seamless transition in care is needed to ensure appropriate care to the sickest of children. This review covers the management of critically ill children in the pediatric emergency department beyond the initial stabilization for conditions such as acute respiratory failure and pediatric acute respiratory distress syndrome, traumatic brain injury, status epilepticus, congenital heart disease, and metabolic emergencies...
December 2018: Pediatric Clinics of North America
Mohamed N El-Gamasy, Walid Ahmed El-Shehaby
INTRODUCTION: Acute nephritic syndrome (ANS) is the most common cause of hypertensive heart failure in pediatric population. There are few publications on myocardial evaluation using electrocardiographic and echocardiographic data in pediatric patients with ANS. This study aimed to evaluate myocardial function by electrocardiography and 2-dimensional echocardiography in Egyptian pediatric patients with ANS. MATERIALS AND METHODS: Sixty children with ANS were included and subjected to clinical, laboratory, electrocardiography for corrected QT interval, and 2-dimensional echocardiographic study on admission, and repeated at 6 and 12 weeks to measure left ventricular ejection fraction, left atrium-aorta ratio, and the ratio of peak early filling (E wave) to late diastolic filling (A wave) velocities (E/A ratio)...
October 2018: Iranian Journal of Kidney Diseases
Punkaj Gupta, Jeffrey M Gossett, Danny Kofos, Mallikarjuna Rettiganti
PURPOSE: To create a real-time prediction tool to predict probability of ECMO deployment in children with cardiac or pulmonary failure. MATERIALS AND METHODS: Patients ≤18 years old admitted to an ICU that participated in the Virtual Pediatric Systems database (2009-2015) were included. Logistic regression models using adaptive lasso methodology were used to identify independent factors associated with ECMO use. RESULTS: A total of 538,202 ICU patients from 140 ICUs qualified for inclusion...
February 2019: Journal of Critical Care
Xin Xu, Sheng Nie, Aihua Zhang, Jianhua Mao, Hai-Peng Liu, Huimin Xia, Hong Xu, Zhangsuo Liu, Shipin Feng, Wei Zhou, Xuemei Liu, Yonghong Yang, Yuhong Tao, Yunlin Feng, Chunbo Chen, Mo Wang, Yan Zha, Jian-Hua Feng, Qingchu Li, Shuwang Ge, Jianghua Chen, Yongcheng He, Siyuan Teng, Chuanming Hao, Bi-Cheng Liu, Ying Tang, Wenjuan He, Pinghong He, Fan Fan Hou
BACKGROUND AND OBJECTIVES: High-quality epidemiologic data on AKI in children are particularly lacking in developing countries. This study aimed to assess the epidemiology and clinical correlates of AKI among hospitalized children in China. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a multicenter study, in a cohort of hospitalized children aged 1 month to 18 years, from 25 general and children's hospitals in China during 2013-2015. We obtained patient-level data from the electronic hospitalization information system and laboratory databases of all children who had at least two serum creatinine tests within any 7-day window during their first 30 days of hospitalization...
December 7, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Mayuko Yamamoto, Yoshihiro Oshima, Hironori Matsuhisa, Tomonori Higuma, Ryuma Iwaki, Shunsuke Matsushima, Yu Murakami
Extracorporeal membrane oxygenation via cervical cannulation is an established option for pediatric patients with acute cardiopulmonary failure. However, left heart decompression is sometimes mandatory in patients with severe left ventricular dysfunction. We describe a fast and less invasive technique for placing a left atrial cannula through a left anterior minithoracotomy approach. In 4 critically ill children, this minimally invasive technique provided satisfactory left heart decompression, and we describe a representative case...
September 29, 2018: Annals of Thoracic Surgery
Luyun Fan, Huimin Zhang, Jun Cai, Wenjun Ma, Lei Song, Ying Lou
No abstract text is available yet for this article.
October 2018: Journal of Hypertension
Billy C Wang, Theodore Pei, Cheryl B Lin, Rong Guo, David Elashoff, James A Lin, Carol Pineda
AIM: To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation (NIMV) use in acute pediatric respiratory failure. METHODS: We identified all patients treated with NIMV in the pediatric intensive care unit (PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers. Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included. Data included demographics, vital signs on admission and prior to initiation of NIMV, pediatric risk of mortality III (PRISM-III) scores, complications, respiratory support characteristics, PICU and hospital length of stays, duration of respiratory support, and complications...
September 7, 2018: World Journal of Critical Care Medicine
Stacey L Valentine, Melania M Bembea, Jennifer A Muszynski, Jill M Cholette, Allan Doctor, Phillip C Spinella, Marie E Steiner, Marisa Tucci, Nabil E Hassan, Robert I Parker, Jacques Lacroix, Andrew Argent, Jeffrey L Carson, Kenneth E Remy, Pierre Demaret, Guillaume Emeriaud, Martin C J Kneyber, Nina Guzzetta, Mark W Hall, Duncan Macrae, Oliver Karam, Robert T Russell, Paul A Stricker, Adam M Vogel, Robert C Tasker, Alexis F Turgeon, Steven M Schwartz, Ariane Willems, Cassandra D Josephson, Naomi L C Luban, Leslie E Lehmann, Simon J Stanworth, Nicole D Zantek, Timothy E Bunchman, Ira M Cheifetz, James D Fortenberry, Meghan Delaney, Leo van de Watering, Karen A Robinson, Sara Malone, Katherine M Steffen, Scot T Bateman
OBJECTIVES: To date, there are no published guidelines to direct RBC transfusion decision-making specifically for critically ill children. We present the recommendations from the Pediatric Critical Care Transfusion and Anemia Expertise Initiative. DESIGN: Consensus conference series of multidisciplinary, international experts in RBC transfusion management of critically ill children. SETTING: Not applicable. INTERVENTION: None...
September 2018: Pediatric Critical Care Medicine
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