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Admission criteria in picu

Lital Oz-Alcalay, Shai Ashkenazi, Aharona Glatman-Freedman, Sarit Weisman-Demri, Alexander Lowenthal, Gilat Livni
BACKGROUND: Respiratory syncytial virus (RSV)-related bronchiolitis is a common cause of morbidity in young infants. The recommendations for its passive prevention by palivizumab are currently under intensive debate. OBJECTIVES: To elucidate the optimal prevention strategy by studying the morbidity of RSV disease under the current recommendations for palivizumab prophylaxis in Israel. METHODS: We collected demographic and clinical data of all children hospitalized with microbiologically confirmed RSV bronchiolitis during 2015-2016 at Schneider Children's Medical Center...
February 2019: Israel Medical Association Journal: IMAJ
David Brossier, Isabelle Goyer, Lydia Ziani, Christopher Marquis, Grant Mitchell, Bruno Ozanne, Philippe Jouvet
The purpose of the study was to evaluate the influence of establishing a protocol for the use of combined sodium benzoate and sodium phenylacetate (SBSP) (Ammonul®) to treat acute hyperammonemia. This was a retrospective, single-center study in a 24-bed medical and surgical pediatric intensive care unit (PICU) in a tertiary care teaching maternal-child hospital in Canada. Inclusion criteria were age < 18 years, PICU admission between 1 January 2000 and 30 June 2016, and SBSP treatment. An SBSP delivery protocol was implemented in our hospital on 30 August 2008 in order to improve management of acute hyperammonemia...
January 2019: Journal of Inherited Metabolic Disease
Ronan McKenna, Lindsay Joseph, Philip Sargent, Meryta May, Sarah Tozer, Seweryn Bialasiewicz, Claire Heney, Luregn J Schlapbach, Julia E Clark
AIM: The human parechovirus (HPeV) has emerged as a pathogen causing sepsis-like presentations in young infants, but there is a lack of data on HPeV presentations requiring intensive care support. We aimed to characterise the clinical presentation, disease severity, management and outcome of a population-based cohort of children with microbiologically confirmed HPeV infection requiring admission to paediatric intensive care units (PICUs) in Queensland, Australia during a recent outbreak...
January 24, 2019: Journal of Paediatrics and Child Health
Jhuma Sankar, Nitin Dhochak, Kiran Kumar, Man Singh, M Jeeva Sankar, Rakesh Lodha
OBJECTIVES: To evaluate the proportion of children fulfilling "Sepsis-3" definition and International Pediatric Sepsis Consensus Conference definition among children diagnosed to have septic shock and compare the mortality risk between the two groups. DESIGN: Retrospective chart review. SETTING: PICU of a tertiary care teaching hospital from 2014 to 2017. PATIENTS: Children (≤ 17 yr old) with a diagnosis of septic shock at admission or during PICU stay...
January 11, 2019: Pediatric Critical Care Medicine
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
Zoe C Bedford, Suzanne Bench
BACKGROUND: Having a child admitted to a paediatric intensive care unit (PICU) is a highly stressful experience, and post-traumatic stress among parents is well documented. How best to support these parents is currently unclear. AIM: To review research on interventions to support the psychological well-being of parents after their child's discharge from paediatric intensive care. METHODS: Searches were conducted using Medline, PsycINFO, PubMed, CINAHL and The Cochrane library in January 2017...
December 10, 2018: Nursing in Critical Care
Chandini Raina MacIntyre, Abrar Ahmad Chughtai, Michelle Barnes, Iman Ridda, Holly Seale, Renin Toms, Anita Heywood
BACKGROUND: The aim of this study was to estimate the prevalence of pneumonia and secondary bacterial infections during the pandemic of influenza A(H1N1)pdm09. METHODS: A systematic review was conducted to identify relevant literature in which clinical outcomes of pandemic influenza A(H1N1)pdm09 infection were described. Published studies (between 01/01/2009 and 05/07/2012) describing cases of fatal or hospitalised A(H1N1)pdm09 and including data on bacterial testing or co-infection...
December 7, 2018: BMC Infectious Diseases
Tariq O Alofisan, Yasser A Algarni, Ibrahim M Alharfi, Michael R Miller, Tanya Charyk Stewart, Douglas D Fraser, Janice A Tijssen
OBJECTIVE: To describe paroxysmal sympathetic hyperactivity in pediatric patients with severe traumatic brain injury using the new consensus definition, the risk factors associated with developing paroxysmal sympathetic hyperactivity, and the outcomes associated with paroxysmal sympathetic hyperactivity. DESIGN: Retrospective cohort study. SETTING: Academic children's hospital PICU. PATIENTS: All pediatric patients more than 1 month and less than 18 years old with severe traumatic brain injury between 2000 and 2016...
November 26, 2018: Pediatric Critical Care Medicine
Ahmed Nabih El Shazly, Doaa Refaey Soliman, Shuzan Ali Mohammed, Rasha Mohammed Zakaria, Fatma Elzahraa Mohammed Awais
Background: Hospital acquired infection (HAI) and multiple organ dysfunctions (MODS) remain a leading cause of death in pediatric intensive care unit (PICU) despite the great efforts to control it. Objective: Our objective was to assess the mRNA of TNFα and BCL2 for prediction of HAI and/or MODS in our community. Patients and methods: Fifty children, admitted to PICU, were included in the study after exclusion of cases of end-stage renal failure, end-stage liver failure and congenital immune deficiency...
December 2018: Annals of Medicine and Surgery
Elizabeth J Kerris, Jason T Patregnani, Matthew Sharron, Anthony A Sochet
OBJECTIVE: To assess the frequency of post-procedural complications, medical interventions, and hospital costs associated with microlaryngobronchoscopy (MLB) in children prophylactically admitted for pediatric intensive care unit (PICU) monitoring for age ≤ 2 years. METHODS: We performed a single-center, retrospective, descriptive study within a 44-bed PICU in a stand-alone, tertiary, pediatric referral center. Inclusion criteria were age ≤2 years and pre-procedural selection of prophylactic PICU monitoring after MLB between January 2010 and December 2015...
December 2018: International Journal of Pediatric Otorhinolaryngology
Avichai Weissbach, Noy Zur, Eytan Kaplan, Gili Kadmon, Yulia Gendler, Elhanan Nahum
OBJECTIVES: Acute kidney injury in the critically ill pediatric population is associated with worse outcome. The aim of this study was to assess the prevalence, associated clinical variables, and outcomes of acute kidney injury in children admitted to the PICU with diabetic ketoacidosis. DESIGN: Retrospective cohort. SETTING: PICU of a tertiary, university affiliated, pediatric medical center. PATIENTS: All children less than age 18 years with a primary diagnosis of diabetic ketoacidosis admitted to the PICU between November 2004 and October 2017...
January 2019: Pediatric Critical Care Medicine
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
Murray M Pollack, Richard Holubkov, Robert A Berg, Christopher J L Newth, Kathleen L Meert, Rick E Harrison, Joseph Carcillo, Heidi Dalton, David L Wessel, J Michael Dean
BACKGROUND: Early identification of children at risk for cardiac arrest would allow for skill training associated with improved outcomes and provides a prevention opportunity. OBJECTIVE: Develop and assess a predictive model for cardiopulmonary arrest using data available in the first 4 h. METHODS: Data from PICU patients from 8 institutions included descriptive, severity of illness, cardiac arrest, and outcomes. RESULTS: Of the 10074 patients, 120 satisfying inclusion criteria sustained a cardiac arrest and 67 (55...
December 2018: Resuscitation
Zhiyuan Wu, Yafeng Liang, Zhihao Li, Guangjian Liu, Jianbin Zheng, Yunlong Zuo, Lijuan Li, Xiaojun Cao, Jianhui Zhang, Huiying Liang
OBJECTIVES: Sepsis-3 consensus suggests "the need to develop similar updated definitions for pediatric populations". Sequential organ failure assessment (SOFA) and systemic inflammatory response syndrome (SIRS) criteria are two systems widely used to define the status of infection. However, It is still unclear whether SOFA is more accurate than SIRS in predicting children mortality in low- and middle-income countries. Thus, we validated the accuracy of age-adapted SOFA and SIRS in predicating the poor prognosis of infected children in China's pediatric intensive care unit (PICU)...
September 11, 2018: Shock
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
Atsushi Kawaguchi, L Duncan Saunders, Yutaka Yasui, Allan DeCaen
BACKGROUND AND OBJECTIVES: The need to centralize patients for specialty care in the setting of regionalization may delay access to specialist services and compromise outcomes, particularly in a large geographic area. The aim of this study was to explore the effects of interhospital transferring of children requiring intensive care in a Canadian regionalization model. METHODS: A retrospective cohort design with a matched pair analysis was adopted to compare the outcomes in children younger than 17 years admitted to a pediatric intensive care unit (PICU) of a Canadian children's hospital by a specialized transport team (pediatric critical care transported [PCCT] group) and those children admitted directly to PICU from its pediatric emergency department (PED group)...
September 6, 2018: Journal of Intensive Care Medicine
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
F F Girrbach, F Hilbig, M Michael, M Bernhard
BACKGROUND: A myriad of publications have contributed to an evidence-based approach to airway management in emergency services and admissions in recent years; however, it remains unclear which international registries on airway management in emergency medicine currently exist and how they are characterized concerning inclusion criteria, patient characteristics and definition of complications. METHODS: A systematic literature research was carried out in PubMed with respect to publications from 2007-2017...
September 2018: Der Anaesthesist
Mark J Peters, Rachel Agbeko, Peter Davis, Nigel Klein, Zohra Zenasni, Amy Jones, Christine Mackerness, Susan George, Paul Veys, Samiran Ray, Paul R Mouncey, David A Harrison, Kathy Rowan
OBJECTIVES: Previous trials in adults with impaired immunity and respiratory failure suggest that early noninvasive ventilation avoids endotracheal intubation and improves survival. No randomized clinical trials have addressed this question in children. DESIGN: We undertook an open, parallel-group randomized trial in three pediatric hospitals. SUBJECTS: Children with impaired immunity and acute respiratory failure defined as tachypnoea (> 90th centile); a new requirement for supplemental oxygen; and new chest radiograph infiltrates...
October 2018: Pediatric Critical Care Medicine
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