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REVIEW
Raquel Farias-Moeller, Nora Wong
The post-intensive care syndrome (PICS) concept whereby the ICU experience of the patient as well as their family can have long-term deleterious health outcomes in both the patient and the family provides a rationale and impetus for modifying the ICU experience for the parents of patients receiving pediatric neurocritical care. This article uses the PICS framework to provide insight to that parental experience. Included are the words of parents who tell what they felt and what they most needed from their children's doctors while their children were receiving neurocritical care...
April 2024: Seminars in Pediatric Neurology
#42
JOURNAL ARTICLE
Fajr A Saeedi, Moustafa A Hegazi, Hani Alsaedi, Ahmed Hussain Alganmi, Jawahir A Mokhtar, Eilaf Majdi Metwalli, Hanaa Hamadallah, Ghassan S Siam, Abdullah Alaqla, Abdullah Alsharabi, Sultan Ahmed Alotaibi
Multidrug-resistant bacterial infections (MDRIs) constitute a major global threat due to increased patient morbidity/mortality and hospital stay/healthcare costs. A few studies from KSA, including our locality, addressed antimicrobial resistance in pediatric patients. This study was performed to recognize the incidence and clinical/microbiologic features of MDRIs in hospitalized pediatric patients. A retrospective cross-sectional study included pediatric patients < 18 years, admitted to King Abdulaziz University Hospital, between October 2021 and November 2022, with confirmed positive cultures of bacteria isolated from blood/body fluids...
April 7, 2024: Children
#43
JOURNAL ARTICLE
Tommaso Zini, Lucia Corso, Cinzia Mazzi, Cecilia Baraldi, Elisa Nieddu, Laura Rinaldi, Francesca Miselli, Luca Bedetti, Eugenio Spaggiari, Katia Rossi, Alberto Berardi, Licia Lugli, On Behalf Of The Cvc Study Group
BACKGROUND: Centrally inserted central catheters (CICCs) are increasingly used in neonatal care. CICCs have garnered attention and adoption owing to their advantageous features. Therefore, achieving clinical competence in ultrasound-guided CICC insertion in term and preterm infants is of paramount importance for neonatologists. A safe clinical training program should include theoretical teaching and clinical practice, simulation and supervised CICC insertions. METHODS: We planned a training program for neonatologists for ultrasound-guided CICCs placement at our level III neonatal intensive care unit (NICU) in Modena, Italy...
March 26, 2024: Children
#44
JOURNAL ARTICLE
Aweke Tadesse, Jesse J Helton, Kenan Li
This study investigates the well-being of primary caregivers responsible for orphaned and vulnerable children. Well-being is defined as overall wellness, happiness, and satisfaction. Through mixed methods case studies and purposive sampling, we analyzed data from the Ziway Food for the Hungry Ethiopia program in 2017. Our explanatory analytic approach highlighted issues including resource constraints, chronic illnesses, and community challenges faced by the respondents. Nonetheless, spiritual well-being emerged as a crucial factor for their coping mechanisms...
March 22, 2024: Children
#45
JOURNAL ARTICLE
Arnold J Sansevere, Julia S Keenan, Elizabeth Pickup, Caroline Conley, Katelyn Staso, Dana B Harrar
BACKGROUND: The ictal-interictal continuum (IIC) consists of several electroencephalogram (EEG) patterns that are common in critically ill adults. Studies focused on the IIC are limited in critically ill children and have focused primarily on associations with electrographic seizures (ESs). We report the incidence of the IIC in the pediatric intensive care unit (PICU). We then compare IIC patterns to rhythmic and periodic patterns (RPP) not meeting IIC criteria looking for associations with acute cerebral abnormalities, ES, and in-hospital mortality...
April 26, 2024: Neurocritical Care
#46
JOURNAL ARTICLE
Alberto García-Salido, Vicente Modesto I Alapont, Alberto Medina-Villanueva
OBJECTIVE: To describe the high-flow nasal cannula (HFNC) indications in the Spanish pediatric critical care units (PICUs). DESIGN: Descriptive cross-sectional observational study. SETTING: Electronic survey among members of the Spanish Society of Pediatric Intensive Care (SECIP). It was sent weekly from April 10, 2023, to May 21, 2023. PARTICIPANTS: All SECIP members. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: The questions focused on workplace, years of experience, use or non-use of HFNC, justification and expectations regarding its application, starting point within each center, clinical criteria for indication, existence of clinical guidelines, evaluation during its use, and criteria and mode of withdrawal...
April 25, 2024: Medicina intensiva
#47
REVIEW
Mariah K Tanious, Grant Goodrich, Virginia Pedigo, Shelly Ozark, Joshua Arenth
An adolescent's last moment of life is an emotionally and medically complex time. Children may grapple with understanding the things happening to them and with grief of a future lost; caregivers struggle to simultaneously balance deep sorrow, hope, and love; and healthcare providers fight to maintain sound medical and ethical decision making. Increased discussion regarding adolescent end-of-life care is needed so that clinicians may better understand how to engage in ethically based medical management during these events...
April 26, 2024: HEC Forum
#48
JOURNAL ARTICLE
Micah Kadden, Anqing Zhang, Michael Shoykhet
OBJECTIVE: To determine whether ICU temperature management strategy is associated with fever in children with return of spontaneous circulation (ROSC) after out-of-hospital cardiac arrest (OHCA). METHODS: We conducted a single-center retrospective cohort study at a quaternary Children's hospital between 1/1/2016-31/12/2020. Mechanically ventilated children (<18 y/o) admitted to Pediatric or Cardiac ICU (PICU/CICU) with ROSC after OHCA who survived at least 72 h were included...
2024: Frontiers in Pediatrics
#49
JOURNAL ARTICLE
Ceyhun Bozkurt, Volkan Hazar, Barış Malbora, Alphan Küpesiz, Utku Aygüneş, Tunç Fışgın, Musa Karakükçü, Barış Kuşkonmaz, Suar Çakı Kılıç, Derya Bayırlı, Özlem Arman Bilir, Koray Yalçın, Salih Gözmen, Vedat Uygun, Murat Elli, Hakan Sarbay, Funda Tayfun Küpesiz, Hatice İlgen Şaşmaz, Başak Adaklı Aksoy, Ebru Yılmaz, Fatma Visal Okur, Funda Tekkeşin, Fatma Demir Yenigürbüz, Gülcihan Özek, Abdullah Avni Atay, İkbal Ok Bozkaya, Suna Çelen, Seda Öztürkmen, Adalet Meral Güneş, Orhan Gürsel, Elif Güler, Alper Özcan, Duygu Uçkan Çetinkaya, Selime Aydoğdu, Namık Yaşar Özbek, Gülsün Karasu, Gülay Sezgin, Ömer Doğru, Davut Albayrak, Gülyüz Öztürk, Serap Aksoylar, Hayriye Daloğlu, Işık Odaman Al, Melike Sezgin Evim, Sinan Akbayram, Yurday Öncül, Emine Zengin, Canan Albayrak, Çetin Timur, Yeter Düzenli Kar, Hasan Fatih Çakmaklı, Özlem Tüfekçi, Ersin Töret, Bülent Antmen
BACKGROUND: Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. OBJECTIVES: The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection. METHOD: In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022...
May 2024: Pediatric Transplantation
#50
JOURNAL ARTICLE
Pedro Ivo C Ravizzini, Henrique Lino, Eduardo de Faria Castro Fleury, Daniel Azevedo Rangel, Luís Gustavo Morato de Toledo
PURPOSE: Ultrasound-guided percutaneous biopsy (USPB) of the native kidneys is the preferred diagnostic method for several nephrological conditions in both adult and pediatric populations. Conventionally, native kidney biopsies are conducted with patients in the prone position (PP). However, an alternative approach involving the supine oblique antero-lateral position (SALP) has been explored, particularly for individuals who are obese, elderly, or critically ill. METHODS: This study aimed to assess the feasibility and outcomes of USPB performed in SALP with a Free-Flank setting (FF-SALP) in pediatric patients (Group A) compared to adults (Group B)...
April 24, 2024: Abdominal Radiology
#51
JOURNAL ARTICLE
Mohannad Abu-Sultanah, Riad Lutfi, Samer Abu-Sultaneh, Kellie J Pearson, Erin E Montgomery, Travis Whitfill, Marc A Auerbach, Kamal Abulebda
OBJECTIVE: We hypothesized that collaborative intervention to improve weighted pediatric readiness score (WPRS) will be associated with decreased pediatric intensive care (PICU) mortality, PICU and hospital length of stay. METHODS: This study analyzes the transfer of acutely ill and injured patients from general emergency departments (GEDs) to our institution. The intervention involved customized assessment reports focusing on team performance and systems improvement for pediatric readiness, sharing best practices and clinical resources, designation of a nurse PECC at each GED and ongoing interactions at 2 and 4 months...
April 22, 2024: Academic Pediatrics
#52
JOURNAL ARTICLE
Arno Téblick, Ilse Vanhorebeek, Inge Derese, An Jacobs, Renata Haghedooren, Sofie Maebe, Gerdian A Zeilmaker-Roest, Enno D Wildschut, Lies Langouche, Greet Van den Berghe
In critically ill adults, high plasma cortisol in face of low ACTH coincides with high pro-opiomelanocortin (POMC) levels. Glucocorticoids further lower ACTH without affecting POMC. We hypothesized that in pediatric cardiac surgery-induced critical illness, plasma POMC is elevated, plasma ACTH transiently rises intraoperatively but becomes suppressed post-operatively, and glucocorticoid administration amplifies this phenotype. From 53 patients (0-36 months), plasma was obtained pre-operatively, intraoperatively and on post-operative day 1 and 2...
April 1, 2024: Endocrine Connections
#53
JOURNAL ARTICLE
Laura Butragueño-Laiseca, Iñaki F Troconiz, Santiago Grau, Nuria Campillo, Belén Padilla, Sarah Nicole Fernández, María Slöcker, Laura Herrera, María José Santiago
Standard dosing could fail to achieve adequate systemic concentrations in ICU children or may lead to toxicity in children with acute kidney injury. The population pharmacokinetic analysis was used to simultaneously analyze all available data (plasma, prefilter, postfilter, effluent, and urine concentrations) and provide the pharmacokinetic characteristics of meropenem. The probability of target fT > MIC attainment, avoiding toxic levels, during the entire dosing interval was estimated by simulation of different intermittent and continuous infusions in the studied population...
April 24, 2024: Antimicrobial Agents and Chemotherapy
#54
REVIEW
Reinout A Bem, Joris Lemson
PURPOSE OF REVIEW: To review the evaluation and management of fluid overload in critically ill children. RECENT FINDINGS: Emerging evidence associates fluid overload, i.e. having a positive cumulative fluid balance, with adverse outcome in critically ill children. This is most likely the result of impaired organ function due to increased extravascular water content. The combination of a number of parameters, including physical, laboratory and radiographic markers, may aid the clinician in monitoring and quantifying fluid status, but all have important limitations, in particular to discriminate between intra- and extravascular water volume...
June 1, 2024: Current Opinion in Pediatrics
#55
JOURNAL ARTICLE
Reinout A Bem, Joris Lemson
PURPOSE OF REVIEW: To review the evaluation and management of fluid overload in critically ill children. RECENT FINDINGS: Emerging evidence associates fluid overload, i.e. having a positive cumulative fluid balance, with adverse outcome in critically ill children. This is most likely the result of impaired organ function due to increased extravascular water content. The combination of a number of parameters, including physical, laboratory and radiographic markers, may aid the clinician in monitoring and quantifying fluid status, but all have important limitations, in particular to discriminate between intra- and extravascular water volume...
March 22, 2024: Current Opinion in Pediatrics
#56
JOURNAL ARTICLE
Mahmoud Khodabandeh, Elham Moradian, Maedeh Sarvari, Mahsa Soti Khiabani
BACKGROUND: Black disease, also known as visceral leishmaniasis (VL), is a parasitic illness caused by various Leishmania species. The risk of morbidity and mortality increases with delayed diagnosis and treatment. Early VL diagnosis and fast appropriate treatment are critical issues in endemic areas. METHODS: This study was a retrospective cross-sectional study to investigate the diagnostic and therapeutic course of patients admitted with the diagnosis of VL in the Children's Medical Center (CMC) Hospital, Tehran, Iran...
2024: Iranian Journal of Parasitology
#57
JOURNAL ARTICLE
Stephanie Hodgson, Kirsten Noack, Ashleigh Griffiths, Michael Hodgins
BACKGROUND: Children with medical complexity (CMC) comprise 1% of the paediatric population, but account for over 30% of health service costs. Lack of healthcare integration and coordination for CMC is well-documented. To address this, a deep understanding of local contextual factors, experiences, and family-identified needs is crucial. The aim of this research was to investigate the lived experiences of CMC, their families, and healthcare staff, focusing on understanding the dynamics of care coordination and the challenges faced in providing integrated care, in order to inform the development of effective, family-centred models of care...
April 23, 2024: BMC Health Services Research
#58
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
#59
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
#60
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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