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JOURNAL ARTICLE
Britta Darchinger, Jürgen Härlein, Gabriele Fley
Withdrawal of Life-Sustaining Treatment in the PICU From the Nursing Staff's Perspective: Integrative Review Abstract: Background: Withdrawal of life sustaining measures is a common mode of treatment prior to the death of a critically ill child and has implications for all involved. The perspective of nurses has not yet been considered in this context. Aim: How do nurses experience the termination of life-sustaining measures in the paediatric intensive care unit? What is their role in this process? Methods: An integrative review was conducted to answer the research question...
April 23, 2024: Pflege
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JOURNAL ARTICLE
Ashley Young, Krupa Patel, Kiona Allen, Saied Ghadersohi, Matthew Rowland, Inbal Hazkani
BACKGROUND: We aim to describe our experience with bronchoscopy to diagnose and relieve tracheobronchial obstruction in anticipation of decannulation in children on extracorporeal membrane oxygenation (ECMO) support. METHODS: A retrospective cohort study of children on ECMO between 1/2018 and 12/2022. RESULTS: A total of 107 children required ECMO support during the study period for cardiac (n = 48, 45%), pulmonary (n = 38, 36%), or cardiopulmonary dysfunction (n = 21, 20%)...
April 23, 2024: Laryngoscope
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JOURNAL ARTICLE
Khalid W Taher, Rahaf Yaseen, Mayas Alnan, Wejdan Aburas, Hala Khalil, Moath Alabdulsalam
INTRODUCTION: Gastrointestinal bleeding (GI) is a prevalent condition among pediatric patients, with a reported incidence of 6.4%, often severe enough to require admission to the pediatric intensive care unit (PICU). There are multiple therapies utilized in the management of GI bleeding in pediatrics, among which continuous intravenous (IV) infusion of omeprazole is used off-label without standard pediatric dosing recommendations. Reviewing the current literature reveals a lack of studies assessing the efficacy, safety, and appropriate dosing regimen of continuous omeprazole infusion in children with GI bleeding...
2024: Frontiers in Pediatrics
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JOURNAL ARTICLE
Gabriel Hundeshagen, Elisabeth Blears, Viktoria Mertin, Andrew G Day, Alen Palackic, Christian Tapking, Valentin Haug, Ulrich Kneser, Björn Bliesener, Adriana C Panayi, Ariel Aballay, Francois Depret, Christian Stoppe, Daren K Heyland
BACKGROUND: Prospective randomized trials in severely burned children have shown the positive effects of oxandrolone (OX), beta blockers (BB) and a combination of the two (BBOX) on hypermetabolism, catabolism and hyperinflammation short- and long-term post-burn. Although data on severely burned adults are lacking in comparison, BB, OX and BBOX appear to be commonly employed in this patient population. In this study, we perform a secondary analysis of an international prospective randomized trial dataset to provide descriptive evidence regarding the current utilization patterns and potential treatment effects of OX, BB and BBOX...
2024: Burns and Trauma
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JOURNAL ARTICLE
S Schumacher, B Mitzlaff, C Mohrmann, K M Fiedler, A Heep, F Beske, F Hoffmann, M Lange
BACKGROUND: As a rule, newborns do not require special medical care. If unexpected complications occur peripartum or postpartum, support from and transport to specialised neonatal hospitals might be needed. METHODS: In a retrospective study, all transport protocols of a supraregional paediatric‑neonatological maximum care hospital in northwestern Germany from 01.10.2018 through 30.09.2021 were analysed. The particular focus was on transports of newborns (<7 days) and the leading symptoms that led to contact...
April 19, 2024: Early Human Development
#26
Shiji Chalipat, Jyothsna Sree Madala, Sanjay Chavan, Sudhir Malwade, Shilpa Baviskar
Critical illness polyneuropathy (CIP) and myopathy (CIM) are underreported conditions in critically ill children with prolonged intensive care unit stays and mechanical ventilation. We report a case of a 10-year-old boy with pneumococcal meningoencephalitis with severe sepsis and multiorgan dysfunction. The child required prolonged ventilation, sedation, and inotropic support. He had repeated extubation failures and the development of quadriparesis with areflexia. Electrophysiology studies were consistent with CIP with acute motor and sensory axonal polyneuropathy and elevated muscle enzymes...
March 2024: Curēus
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JOURNAL ARTICLE
Anja Große Lordemann, Dirk Sommerfeldt, Lukas Mileder
INTRODUCTION: Structured emergency room concepts have been shown to contribute to patient safety. Until now there has been no uniform emergency room concept for critically ill and seriously injured children and adolescents in the emergency room at the Altona Children's Hospital in Hamburg. This concept has been newly developed in interdisciplinary cooperation and includes the use of new clinical premises as well as new responsibilities and team compositions. The introduction of new processes and rooms for handling emergencies is associated with a risk of overlooking latent safety deficiencies or detecting them only after the process has been implemented...
April 20, 2024: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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REVIEW
Mariana Correia Marques, Michael J Ombrello, Grant S Schulert
INTRODUCTION: Systemic juvenile idiopathic arthritis (sJIA) is a severe inflammatory condition with onset in childhood. It is sporadic, but elements of its stereotypical innate immune responses are likely genetically encoded by both common variants with small effect sizes and rare variants with larger effects. AREAS COVERED: Genomic investigations have defined the unique genetic architecture of sJIA. Identification of the class II HLA locus as the strongest sJIA risk factor for the first time brought attention to T lymphocytes and adaptive immune mechanisms in sJIA...
April 20, 2024: Expert Review of Clinical Immunology
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JOURNAL ARTICLE
Tomas Slåtten Nenningsland, Babak Asadi-Azarbaijani, Hanne Birgit Alfheim, Elisabeth Holm Hansen
PURPOSE: The purpose of this study is to explore factors influencing sleep in pediatric intensive care units as perceived by parents of critically ill children. DESIGN AND METHODS: This descriptive qualitative study used individual semistructured interviews. Parents were recruited through purposive sampling from two pediatric intensive care units at two locations in one university hospital in Norway. Ten parents were interviewed. The interviews were analyzed using a six-phase reflexive thematic analysis...
April 18, 2024: Journal of Pediatric Nursing
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JOURNAL ARTICLE
Gailing Hao, Lian Jiang, Li Wen, Weili Guo, Wenjin Geng, Quanheng Li
OBJECTIVE: Epstein-Barr virus (EBV) is a common virus that infects a large portion of the world's population, with most people becoming infected during childhood or adolescence. The objective of this article is to analyze the clinical and laboratory examination results of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in children, summarize its characteristics, identify critically ill children as soon as possible, and provide a basis for diagnosis and treatment...
April 18, 2024: Alternative Therapies in Health and Medicine
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JOURNAL ARTICLE
Li-Min Zhu, Chun-Xiang Li, Xiao-Lei Gong, Zhuo-Ming Xu, Jin-Long Liu, Hai-Bo Zhang
BACKGROUND: Plastic bronchitis (PB) can occur in patients who have undergone congenital heart surgery (CHS). This study aimed to investigate the clinical features of PB in children after CHS. METHODS: We conducted a retrospective cohort study using the electronic medical record system. The study population consisted of children diagnosed with PB after bronchoscopy in the cardiac intensive care unit after CHS from May 2016 to October 2021. RESULTS: A total of 68 children after CHS were finally included in the study (32 in the airway abnormalities group and 36 in the right ventricular dysfunction group)...
April 19, 2024: Italian Journal of Pediatrics
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JOURNAL ARTICLE
Laura D Zambrano, Margaret M Newhams, Regina M Simeone, Amanda B Payne, Michael Wu, Amber O Orzel-Lockwood, Natasha B Halasa, Jemima M Calixte, Pia S Pannaraj, Kanokporn Mongkolrattanothai, Julie A Boom, Leila C Sahni, Satoshi Kamidani, Kathleen Chiotos, Melissa A Cameron, Aline B Maddux, Katherine Irby, Jennifer E Schuster, Elizabeth H Mack, Austin Biggs, Bria M Coates, Kelly N Michelson, Katherine E Bline, Ryan A Nofziger, Hillary Crandall, Charlotte V Hobbs, Shira J Gertz, Sabrina M Heidemann, Tamara T Bradford, Tracie C Walker, Stephanie P Schwartz, Mary Allen Staat, Samina S Bhumbra, Janet R Hume, Michele Kong, Melissa S Stockwell, Thomas J Connors, Melissa L Cullimore, Heidi R Flori, Emily R Levy, Natalie Z Cvijanovich, Matt S Zinter, Mia Maamari, Cindy Bowens, Danielle M Zerr, Judith A Guzman-Cottrill, Ivan Gonzalez, Angela P Campbell, Adrienne G Randolph
Pediatric COVID-19 vaccination is effective in preventing COVID-19-related hospitalization, but duration of protection of the original monovalent vaccine during SARS-CoV-2 Omicron predominance merits evaluation, particularly given low coverage with updated COVID-19 vaccines. During December 19, 2021-October 29, 2023, the Overcoming COVID-19 Network evaluated vaccine effectiveness (VE) of ≥2 original monovalent COVID-19 mRNA vaccine doses against COVID-19-related hospitalization and critical illness among U...
April 18, 2024: MMWR. Morbidity and Mortality Weekly Report
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JOURNAL ARTICLE
Jean Hatcherson
Recent studies show that Traditional Ecological Knowledge (TEK) of Indigenous Peoples' food systems and the transfer of that knowledge to their children are critical to physical and mental health, promote the transfer of language and culture, and further resilience. The aim of this exploratory, medical ecological study was to document TEK about foraging and plant use among the Dukha, a small, semi-nomadic reindeer herding community in Northern Mongolia. Field research was conducted at multiple remote camps in 2019 and 2023...
December 2024: International Journal of Circumpolar Health
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JOURNAL ARTICLE
Tanja Belser, Matthias Thomas Exl, Peter Nydahl, Maya Zumstein-Shaha, Marie-Madlen Jeitziner
OBJECTIVES: The objective of this study was to explore experiences and needs of parents visiting critically ill family members in intensive care units (ICUs) accompanied by their underaged children (<18 years). METHODS: Six semistructured interviews with parents were conducted in a qualitative design. Data analysis and synthesis were performed using Braun and Clarke's thematic analysis. This study was conducted in five adult ICUs in Switzerland. FINDINGS: Parents opted for early and truthful involvement of their children, and the majority initiated the visits themselves...
April 17, 2024: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
#35
JOURNAL ARTICLE
Yi Wang, Ying Zheng, Lijia Chen, Lingjie Lin, Binwu Chen, Zhengfeng Lin, Shihui Bao
OBJECTIVE: To investigate the independent risk factors associated with iatrogenic withdrawal syndrome in pediatric intensive care units (PICUs) and to establish receiver operator characteristic (ROC) curve to facilitate the diagnosis of iatrogenic withdrawal syndrome in clinical settings. METHOD: Pediatric patients who received analgesic and sedative medication at a tertiary hospital in the southern Zhejiang region of China between January 2016 and December 2022 were selected for the study...
April 17, 2024: Pharmacology
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JOURNAL ARTICLE
Wakato Matsuoka, Soichi Mizuguchi, Noriyuki Kaku, Kanako Higashi, Kenichi Tetsuhara, Tomohiko Akahoshi, Shouichi Ohga
OBJECTIVES: To develop an equation for defining a low skeletal muscle mass (SMM) in children and to investigate risk factors and outcomes associated with low SMM in critically ill pediatric patients. DESIGN: Single-center retrospective pediatric cohorts, 2011-2018. SETTING: Tertiary Emergency and Critical Care Center of Kyushu University Hospital in Japan. PATIENTS: We studied two cohorts of pediatric patients 1-15 years old who underwent abdominal CT at the level of the third lumbar vertebra (L3)...
April 17, 2024: Pediatric Critical Care Medicine
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JOURNAL ARTICLE
Robert Darnell, Alanna Brown, Emma Laing, Julia Edwards, David A Harrison, Joseph C Manning, Mark J Peters, Padmanabhan Ramnarayan, Samiran Ray, Zia Sadique, Barnaby R Scholefield, Dermot Shortt, Lamprini Lampro, Carly Au, Kathy M Rowan, Paul Mouncey, David P Inwald
OBJECTIVES: Management of hypotension is a fundamental part of pediatric critical care, with cardiovascular support in the form of fluids or vasoactive drugs offered to every hypotensive child. However, optimal blood pressure (BP) targets are unknown. The PRotocolised Evaluation of PermiSSive BP Targets Versus Usual CaRE (PRESSURE) trial aims to evaluate the clinical and cost-effectiveness of a permissive mean arterial pressure (MAP) target of greater than a fifth centile for age compared with usual care...
April 17, 2024: Pediatric Critical Care Medicine
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JOURNAL ARTICLE
Solange Durão, Emmanuel Effa, Nyanyiwe Mbeye, Mashudu Mthethwa, Michael McCaul, Celeste Naude, Amanda Brand, Ntombifuthi Blose, Denny Mabetha, Moriam Chibuzor, Dachi Arikpo, Roselyn Chipojola, Gertrude Kunje, Per Olav Vandvik, Ekpereonne Esu, Simon Lewin, Tamara Kredo
BACKGROUND: Sub-Saharan Africa is the region with the highest under-five mortality rate globally. Child healthcare decisions should be based on rigorously developed evidence-informed guidelines. The Global Evidence, Local Adaptation (GELA) project is enhancing capacity to use global research to develop locally relevant guidelines for newborn and child health in South Africa (SA), Malawi, and Nigeria. The first step in this process was to identify national priorities for newborn and child health guideline development, and this paper describes our approach...
April 16, 2024: Health Research Policy and Systems
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JOURNAL ARTICLE
Sonia Labarinas, Kalpana Norbisrath, Dana Johnson, Jon Meliones, Christopher Greenleaf, Jorge Salazar, Oliver Karam
INTRODUCTION: As international guidelines suggest keeping the platelet count between 50 and 100 × 109 cells/L in children on extracorporeal membrane oxygenation (ECMO), platelet transfusions are administered to two-thirds of ECMO days, and up to 70% of these patients still bleed. We aim to describe outcomes in critically ill children who develop severe thrombocytopenia on ECMO. METHODS: Single-center retrospective study, enrolling critically ill children on ECMO admitted at Children's Memorial Hermann, TX, between 1/2018 and 12/2022, with at least one platelet count below 50 × 109 cells/L (severe thrombocytopenia)...
April 16, 2024: Perfusion
#40
JOURNAL ARTICLE
Fen Lin, Dao-Ju Jiang, Song Zhang, Zhe Yang, Hua-Song Zeng, Zhi-Ping Liu, Li-Ye Yang
BACKGROUND: SARS-CoV-2 infection is described as asymptomatic, mild, or moderate disease in most children. SARS-CoV-2 infection related death in children and adolescents is rare according to the current reports. COVID-19 cases increased significantly in China during the omicron surge, clinical data regarding pediatric critical patients infected with the omicron variant is limited. In this study, we aim to provide an overview of the clinical characteristics and outcomes of critically ill children admitted to a national children's medical center in Guangdong Province, China, during the outbreak of the omicron variant infection...
April 15, 2024: BMC Pediatrics
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