2,155 results match your criteria Pediatrics Sedation


Flualprazolam: Report of an Outbreak of a New Psychoactive Substance in Adolescents.

Pediatrics 2020 Jun 24. Epub 2020 Jun 24.

Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, California.

Flualprazolam is a nonregistered drug in the benzodiazepine family and constitutes a new psychoactive substance (NPS). Since 2014, a growing number of designer benzodiazepines have become available over the Internet and on the counterfeit drug market. In June 2019, a cluster of patients intoxicated with flualprazolam was identified by the Oregon Poison Center. Read More

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http://dx.doi.org/10.1542/peds.2019-2953DOI Listing

Dexmedetomidine in children - when should we be using it?

Authors:
C R Bailey

Anaesthesia 2020 Jun 24. Epub 2020 Jun 24.

Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, London, UK.

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http://dx.doi.org/10.1111/anae.15169DOI Listing

Comparison between sedation room and operating room in central venous catheter positioning in children.

J Vasc Access 2020 Jun 22:1129729820932415. Epub 2020 Jun 22.

Department of Anesthesia and Pain Therapy, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

Background: Placement of central venous access devices is a clinical procedure associated with some risk of adverse events and with a relevant cost. Careful choice of the device, appropriate insertion technique, and proper management of the device are well-known strategies commonly adopted to achieve an optimal clinical result. However, the environment where the procedure takes place may have an impact on the overall outcome in terms of safety and cost-effectiveness. Read More

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http://dx.doi.org/10.1177/1129729820932415DOI Listing

Adjuvant lidocaine to a propofol-ketamine-based sedation regimen for bone marrow aspirates and biopsy in the pediatric population.

Eur J Pediatr 2020 Jun 16. Epub 2020 Jun 16.

Department of Pediatrics, Division of Pediatric Critical Care Medicine, Riley Hospital for Children at Indiana University Health and Indiana University School of Medicine, 705 Riley Hospital Drive, Phase 2, Room 4900, Indianapolis, IN, 46202-5225, USA.

Pediatric patients with hematological malignancies repeatedly undergo painful bone marrow aspirates and biopsies (BMABs) in routine care. No standard sedation regimen has been established. This study evaluated the addition of injected local lidocaine to a propofol-ketamine sedation for BMAB and its effects on propofol dosing, safety, and efficacy. Read More

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http://dx.doi.org/10.1007/s00431-020-03713-5DOI Listing

Impact of Anesthetic and Ventilation Strategies on Invasive Hemodynamic Measurements in Pediatric Heart Transplant Recipients.

Pediatr Cardiol 2020 Jun 18;41(5):962-971. Epub 2020 Jun 18.

Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.

Background: Care of pediatric heart transplant recipients relies upon serial invasive hemodynamic evaluation, generally performed under the artificial conditions created by anesthesia and supportive ventilation.

Objectives: This study aimed to evaluate the hemodynamic impacts of different anesthetic and ventilatory strategies.

Methods: We compared retrospectively the cardiac index, right- and left-sided filling pressures, and pulmonary and systemic vascular resistances of all clinically well and rejection-free heart transplant recipients catheterized from 2005 through 2017. Read More

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http://dx.doi.org/10.1007/s00246-020-02344-9DOI Listing

Image guided sacroiliac joint corticosteroid injections in children: an 18-year single-center retrospective study.

Pediatr Rheumatol Online J 2020 Jun 17;18(1):52. Epub 2020 Jun 17.

Division of Image Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.

Background: Sacroiliitis is commonly seen in enthesitis-related arthritis (ERA), a subtype of juvenile idiopathic arthritis (JIA). Sacroiliitis is characterized by the inflammation of the sacroiliac (SI) joints (+/- adjacent tissues). The treatment options include systemic therapy with or without corticosteroid SI joint injections. Read More

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http://dx.doi.org/10.1186/s12969-020-00435-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7301971PMC

Gentle Touch: Noninvasive Approaches to Improve Patient Comfort and Cooperation for Pediatric Imaging.

Top Magn Reson Imaging 2020 Jun 11. Epub 2020 Jun 11.

Department of Radiology, University of Washington School of Medicine, Seattle, WA.

Pediatric imaging presents unique challenges related to patient anxiety, cooperation, and safety. Techniques to reduce anxiety and patient motion in adults must often be augmented in pediatrics, because it is always mentioned in the field of pediatrics, children are not miniature adults. This article will review methods that can be considered to improve patient experience and cooperation in imaging studies. Read More

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http://dx.doi.org/10.1097/RMR.0000000000000245DOI Listing

Comparative safety profile of chloral hydrate versus other sedatives for procedural sedation in hospitalized infants.

J Neonatal Perinatal Med 2020 ;13(2):159-165

Department of Pediatrics, Duke Clinical Research Institute, Duke University, Durham, NC, USA.

Background: Given the limited available evidence on chloral hydrate safety in neonatal populations and the discrepancy in chloral hydrate acceptance between the US and other countries, we sought to clarify the safety profile of chloral hydrate compared to other sedatives in hospitalized infants.

Methods: We included all infants <120 days of life who underwent a minor procedure and were administered chloral hydrate, clonidine, clonazepam, dexmedetomidine, diazepam, ketamine, lorazepam, midazolam, propofol, or pentobarbital on the day of the procedure. We characterized the distribution of infant characteristics and evaluated the relationship between drug administration and any adverse event. Read More

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http://dx.doi.org/10.3233/NPM-190214DOI Listing
January 2020

Neonatal Ketamine Alters High-Frequency Oscillations and Synaptic Plasticity in the Subiculum But Does not Affect Sleep Macrostructure in Adolescent Rats.

Front Syst Neurosci 2020 26;14:26. Epub 2020 May 26.

Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.

Exposure to sedative/hypnotic and anesthetic drugs, such as ketamine, during the critical period of synaptogenesis, causes profound neurotoxicity in the developing rodent and primate brains and is associated with poor cognitive outcomes later in life. The subiculum is especially vulnerable to acute neurotoxicity after neonatal exposure to sedative/hypnotic and anesthetic drugs. The subiculum acts as a relay center between the hippocampal complex and various cortical and subcortical brain regions and is also an independent generator of gamma oscillations. Read More

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http://dx.doi.org/10.3389/fnsys.2020.00026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7264261PMC

Pediatric procedural sedation in Japan: A single-facility study of 1,436 cases.

Pediatr Int 2020 Jun 5. Epub 2020 Jun 5.

Department of Pediatrics, Oita University, Faculty of Medicine, Yufu, Japan.

Background: Pediatric procedural sedation (PPS) has been established worldwide as standard practice for several decades. However, there are no comprehensive guidelines or multi-facility databases of PPS in Japan, and the current status of PPS and PPS-related adverse events is unclear. The objectives of this study were to investigated the current status of PPS and clarify the adverse events and risk factors in Japan. Read More

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http://dx.doi.org/10.1111/ped.14331DOI Listing

Effects of Sedation Performed by an Anesthesiologist on Pediatric Endoscopy: a Single-Center Retrospective Study in Korea.

J Korean Med Sci 2020 Jun 1;35(21):e183. Epub 2020 Jun 1.

Department of Pediatrics, Hanil General Hospital, Seoul, Korea.

Background: Endoscopy is used for diagnosing and treating various digestive diseases in children as well as in adults. However, in pediatric patients, it is recommended that sufficient sedation should be ensured before conducting endoscopy, since insufficient sedation may cause serious complications. However, in Korea, no studies have yet described the types of sedation drugs, effects of sedation, and efficiency of endoscopy with respect to the sedation instructor. Read More

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http://dx.doi.org/10.3346/jkms.2020.35.e183DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261697PMC

The propofol-sparing effect of intravenous lidocaine in elderly patients undergoing colonoscopy: a randomized, double-blinded, controlled study.

BMC Anesthesiol 2020 May 30;20(1):132. Epub 2020 May 30.

Department of Anesthesiology and Perioperative Medicine, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 West Xueyuan Road, Wenzhou, 325027, China.

Background: Propofol provides a prominent sedation effect in colonoscopy. However, anesthesia and sedation induced with propofol in the elderly might result in cardiopulmonary complications, especially when it is combined with opoids in the regimen. This study aimed to test the hypothesis that the addition of intravenous lidocaine to propofol-based sedation could decrease the overall propofol requirement in elderly patients during colonoscopy while the procedural sedation satisfaction and the hemodynamic stability were not compromised. Read More

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http://dx.doi.org/10.1186/s12871-020-01049-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7260845PMC
May 2020
1.333 Impact Factor

[Validity and reliability of the Niño Jesús Hospital procedural sedation-analgesia scale of the under deep sedation-analgesia].

An Pediatr (Barc) 2020 May 23. Epub 2020 May 23.

Servicio de Pediatría, Hospital General Universitario de Albacete, Albacete, España.

Introduction: The procedural sedation scale of the Niño Jesús Hospital (Madrid) (SSPNJH) has not been validated.

Patients And Methods: A prospective analytical study was conducted in 2 hospitals on patients ≥ 6 months undergoing invasive procedures using sedation-analgesia with propofol or midazolam and fentanyl. All were monitored using the bispectral index (BIS). Read More

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http://dx.doi.org/10.1016/j.anpedi.2020.04.009DOI Listing

Long-term impact of systematic pain and sedation management on cognitive, motor, and behavioral outcomes of extremely preterm infants at preschool age.

Pediatr Res 2020 May 26. Epub 2020 May 26.

Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.

Background: Providing optimal pain relief is a challenging task when caring for premature infants. The aim of this study was to compare the long-term cognitive, motor, and behavioral outcomes of preterm infants before and after the implementation of a pain and sedation protocol. In addition, we investigated whether the increased opiate administration resulting after the implementation process had an impact on these outcomes. Read More

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http://dx.doi.org/10.1038/s41390-020-0979-2DOI Listing

Dexmedetomidine for Prolonged Sedation in the PICU: A Systematic Review and Meta-Analysis.

Pediatr Crit Care Med 2020 Mar 13. Epub 2020 Mar 13.

Pediatric Intensive Care Unit, Department of Woman's and Child's Health, University-Hospital, Padova, Italy.

Objectives: We aimed to systematically describe the use of dexmedetomidine as a treatment regimen for prolonged sedation in children and perform a meta-analysis of its safety profile.

Data Sources: PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov, and CINAHL were searched from inception to November 30, 2018. Read More

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http://dx.doi.org/10.1097/PCC.0000000000002325DOI Listing

Sedation in Pediatric Bronchoscopy: Propofol versus Fentanyl: Authors' Reply.

Indian Pediatr 2020 May;57(5):484

Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.

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Sedation in Pediatric Bronchoscopy: Propofol versus Fentanyl.

Indian Pediatr 2020 May;57(5):483-484

Department of Pediatrics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.

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Intravenous dexmedetomidine sedation for magnetoencephalography: A retrospective study.

Paediatr Anaesth 2020 May 20. Epub 2020 May 20.

Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH, USA.

Background: Magnetoencephalography (MEG) plays a preponderant role in the preoperative assessment of patients with drug-resistant epilepsy (DRE). However, the magnetoencephalography of patients with drug-resistant epilepsy can be difficult without sedation and/or general anesthesia. Our objective is to describe our experience with intravenous dexmedetomidine as sedation for magnetoencephalography and its effect, if any, on the ability to recognize epileptic spikes. Read More

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http://dx.doi.org/10.1111/pan.13925DOI Listing
May 2020
1.742 Impact Factor

Faecal calprotectin and ultrasonography as non-invasive screening tools for detecting colorectal polyps in children with sporadic rectal bleeding: a prospective study.

Ital J Pediatr 2020 May 20;46(1):66. Epub 2020 May 20.

Gastroenterology and Gastrointestinal Endoscopy Unit, Sapienza University of Rome, Sant'Andrea University Hospital, Rome, Italy.

Background: Colorectal polyps are reported in 6,1% of paediatric colonoscopies and in 12% of those performed for lower gastrointestinal bleeding. Although colonoscopy is widely used in paediatric patients, it requires bowel preparation and general anaesthesia or deep sedation, and in rare cases, it can cause complications. Non-invasive screening techniques able to predict polyps in children with isolated and sporadic rectal bleeding may play a key role in the selection of patients needing colonoscopy. Read More

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http://dx.doi.org/10.1186/s13052-020-00828-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238517PMC

Pediatric Emergency Medicine Training in Procedural Sedation: Is It Time for a Standardized Curriculum?

Pediatr Emerg Care 2020 May 15. Epub 2020 May 15.

From the Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.

Objectives: Pediatric procedural sedation (PS) has been performed with increasing frequency by pediatric emergency physicians for recent years. Accreditation Council for Graduate Medical Education Pediatric Emergency Medicine fellowship core competency requirements do not specify the manner in which fellows should become proficient in pediatric PS. We surveyed the variety of training experience provided during fellowship and whether those surveyed felt that their training was sufficient. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002121DOI Listing

Report on the Short Endoscopic Exocrine Pancreatic Function Test in Children and Young Adults.

Pancreas 2020 May/Jun;49(5):642-649

From the Center for Digestive Health and Nutrition, Arnold Palmer Hospital for Children, Orlando, FL.

Objectives: Endoscopic pancreatic function test (ePFT) has been in use for exocrine function testing since the 1990s. In patients, short ePFT assesses acinar function, unlike the longer version for ductal function in adults. The present study summarizes characteristics of 1913 short ePFTs (S-ePFT) performed at 2 centers since 2001. Read More

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http://dx.doi.org/10.1097/MPA.0000000000001540DOI Listing

Evaluation of an Innovative Model of Care for a Limited-Stay Pediatric Unit.

J Nurs Adm 2020 Jun;50(6):328-334

Author Affiliations: Director of Operational Performance Improvement and Staffing Resource Operations (Ms Johnson-Salerno), Director of Advanced Practice Nursing (Ms Bachman), Medical Director of Unit 4W (Dr Jones), Senior Director of Nursing, Acute Inpatient Services, Day Medicine/Sedation (Mr Hancox), Coordinator of Research and Evidence-Based Practice (Dr Haut), and Operational Vice President and Chief Nursing Executive (Dr Mericle), Nemours/Alfred I. duPont Hospital for Children, Wilmington, Delaware.

Information about pediatric observation and limited-stay unit design and function is lacking in the literature. A quality improvement approach was used to create new care processes on an inpatient unit within a large children's hospital. Outcomes included the use of advanced practice nurse patient care management, creation of 30 clinical pathways to model care, and consistent and faster transfer from emergency department to inpatient unit, resulting in high-level parent and patient satisfaction and decreased nursing turnover. Read More

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http://dx.doi.org/10.1097/NNA.0000000000000893DOI Listing

The ICU Liberation Bundle and Strategies for Implementation in Pediatrics.

Curr Pediatr Rep 2020 May 16:1-10. Epub 2020 May 16.

3Department of Pediatrics, Vanderbilt University School of Medicine, Doctors Office Tower 5114, 2200 Children's Way, Nashville, TN 37232 USA.

Purpose Of Review: We briefly review post-intensive care syndrome (PICS) and the morbidities associated with critical illness that led to the intensive care unit (ICU) liberation movement. We review each element of the ICU liberation bundle, including pediatric support data, as well as tips and strategies for implementation in a pediatric ICU (PICU) setting.

Recent Findings: Numerous studies have found children have cognitive, physical, and psychiatric deficits after a PICU stay. Read More

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http://dx.doi.org/10.1007/s40124-020-00216-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229434PMC

Potential Neurodevelopmental Effects of Pediatric Intensive Care Sedation and Analgesia: Repetitive Benzodiazepine and Opioid Exposure Alters Expression of Glial and Synaptic Proteins in Juvenile Rats.

Crit Care Explor 2020 Apr 29;2(4):e0105. Epub 2020 Apr 29.

Department of Biochemistry and Molecular Biology, Virginia Commonwealth University School of Medicine, Richmond, VA.

Sedatives are suspected contributors to neurologic dysfunction in PICU patients, to whom they are administered during sensitive neurodevelopment. Relevant preclinical modeling has largely used comparatively brief anesthesia in infant age-approximate animals, with insufficient study of repetitive combined drug administration during childhood. We hypothesized that childhood neurodevelopment is selectively vulnerable to repeated treatment with benzodiazepine and opioid. Read More

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http://dx.doi.org/10.1097/CCE.0000000000000105DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7188419PMC

Lung Ultrasound in Children with COVID-19: Preliminary Findings.

Ultrasound Med Biol 2020 Aug 3;46(8):2094-2098. Epub 2020 May 3.

Pediatric Unit, University Department of Pediatrics, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.

Recent evidence indicates the usefulness of lung ultrasound (LUS) in detecting coronavirus disease 19 (COVID-19) pneumonia. However, no data are available on the use of LUS in children with COVID-19 pneumonia. In this report, we describe LUS features of 10 consecutively admitted children with COVID-19 in two tertiary-level pediatric hospitals in Rome. Read More

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http://dx.doi.org/10.1016/j.ultrasmedbio.2020.04.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196401PMC

Parents Demand and Teenager Refuses Epidural Anesthesia.

Pediatrics 2020 Jun 12;145(6). Epub 2020 May 12.

Department of Pediatrics and Bioethics Center, Children's Mercy Hospital, Kansas City, Missouri

A 15-year-old girl is scheduled to undergo an upper lobectomy to debulk metastatic Ewing sarcoma. The anesthesiologist recommended placement of a thoracic epidural catheter to provide postoperative analgesia. The patient did not want a needle to be placed near her spine. Read More

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http://dx.doi.org/10.1542/peds.2019-3295DOI Listing

Comparison of Intranasal Dexmedetomidine and Oral Midazolam for Premedication in Pediatric Dental Patients under General Anesthesia: A Randomised Clinical Trial.

Biomed Res Int 2020 24;2020:5142913. Epub 2020 Apr 24.

The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laoratory of Oral Biomedicine Ministry of Education, Wuhan University, Wuhan, Hubei 430079, China.

The aim of this study was to compare the effects of preoperative intranasal dexmedetomidine and oral midazolam on preoperative sedation and postoperative agitation in pediatric dentistry. A total of 60 children (ASA grade I, aged 3-6 years) scheduled for elective pediatric dental treatment were randomly divided into the dexmedetomidine (DEX) and midazolam (MID) groups. Ramsay sedation score, parental separation anxiety scale, mask acceptance scale, pediatric anesthesia emergence delirium scale, and hemodynamic parameters were recorded. Read More

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http://dx.doi.org/10.1155/2020/5142913DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196136PMC

Continuous deep sedation at the end of life in children with cancer: experience at a single center in Japan.

Pediatr Hematol Oncol 2020 May 7:1-10. Epub 2020 May 7.

Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

Continuous deep sedation (CDS) is used to alleviate unbearable and otherwise refractory symptoms in patients dying of cancer. No data are available concerning CDS in children from Japan to date. This study primarily aimed to describe experience in CDS in child cancer patients at Kyoto University Hospital. Read More

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http://dx.doi.org/10.1080/08880018.2020.1744781DOI Listing

Palliative care, resuscitation status, and end-of-life considerations in pediatric anesthesia.

Curr Opin Anaesthesiol 2020 Jun;33(3):354-360

Baylor College of Medicine Department of Pediatrics, Texas Children's Hospital Palliative Care Team, Houston, Texas, USA.

Purpose Of Review: To familiarize pediatric anesthesiologists with primary palliative care procedural communication skills and recommendations for discussions involving complex medical decision-making or advance care planning, such as discussions about resuscitation status.

Recent Findings: Recent publications highlight the benefits of pediatric palliative care (PPC) for seriously ill patients and their families, and how PPC principles might be applied to perioperative communication and decision-making. Both prospective and retrospective reports reveal improved quality of life, symptom management, and avoidance of unnecessary interventions when PPC is introduced early for a child with serious illness. Read More

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http://dx.doi.org/10.1097/ACO.0000000000000860DOI Listing

ACR Appropriateness Criteria® Head Trauma-Child.

J Am Coll Radiol 2020 May;17(5S):S125-S137

Specialty Chair, Riley Hospital for Children Indiana University, Indianapolis, Indiana.

Head trauma is a frequent indication for cranial imaging in children. The majority of accidental pediatric head trauma is minor and sustained without intracranial injury. Well-validated pediatric-specific clinical decision guidelines should be used to identify very low-risk children who can safely forgo imaging. Read More

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http://dx.doi.org/10.1016/j.jacr.2020.01.026DOI Listing

Sedative Medications for Critically Ill Children during and after Mechanical Ventilation: A Retrospective Observational Study.

Can J Hosp Pharm 2020 Mar-Apr;73(2):125-132. Epub 2020 Apr 1.

, PharmD, ACPR, RPh, was, at the time of this study, a pharmacy resident at McMaster Children's Hospital, Hamilton, Ontario. She is now with the Department of Pharmacy, London Health Sciences, London, Ontario, BScPharm, PharmD, ACPR, RPh, is with the Department of Pharmacy, McMaster Children's Hospital, Hamilton, Ontario, BSc(Pharm), MSc, PhD, ACPR, RPh, is with the Department of Pediatrics, McMaster University, and the Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario.

Background: Providing safe and effective sedation to critically ill children is challenging. The assessment, prevention, and treatment of symptoms of iatrogenic withdrawal are critical aspects of sedation practice.

Objective: To describe the use of sedative medications in critically ill children at McMaster Children's Hospital. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182370PMC

Efficacy and safety of intravenous thiamylal in pediatric procedural sedation for magnetic resonance imaging.

Brain Dev 2020 Aug 28;42(7):477-483. Epub 2020 Apr 28.

Department of Pediatrics, Japanese Red Cross Kumamoto Hospital, Japan.

Objective: To evaluate the efficacy and safety of intravenous (i.v.) thiamylal in pediatric magnetic resonance imaging (MRI) sedation. Read More

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http://dx.doi.org/10.1016/j.braindev.2020.04.005DOI Listing

The development of a Consensus Conference on Pediatric Procedural Sedation in the Emergency Department in Italy: from here where to?

Ital J Pediatr 2020 May 1;46(1):57. Epub 2020 May 1.

Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy.

Background: In Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard. We aimed to describe the procedures and results of the first multidisciplinary and multi-professional Consensus Conference in Italy on safe and effective pediatric PSA in Italian EDs. Read More

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http://dx.doi.org/10.1186/s13052-020-0812-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7195721PMC

Safety and Efficacy of Procedural Sedation and Analgesia in Pediatric Oncology Patients.

Cureus 2020 Mar 28;12(3):e7442. Epub 2020 Mar 28.

Internal Medicine, United Medical and Dental College, Creek General Hospital, Karachi, PAK.

Objective Procedural sedation and analgesia are the standard of care for painful procedures in children that require immobility. The aim is to assess the safety and efficacy of procedural sedation and analgesia in pediatric oncological patients in a large tertiary care hospital. Method An observational study performed to review medical records of children who received procedural sedation and analgesia (PSA) for pediatric oncological procedures from July 2018 to September 2018. Read More

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http://dx.doi.org/10.7759/cureus.7442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186096PMC

A comparative evaluation of dexmedetomidine and midazolam in pediatric sedation: A meta-analysis of randomized controlled trials with trial sequential analysis.

CNS Neurosci Ther 2020 Apr 29. Epub 2020 Apr 29.

Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China.

Background: The present study with trial sequential analysis (TSA) was conducted to evaluate comprehensively the efficacy and safety of dexmedetomidine and midazolam in pediatric sedation, and to investigate whether the outcomes achieved the required information size to draw the conclusions.

Methods: PubMed, Embase, and Cochrane Library were searched from inception to October 2019. All randomized controlled trials used dexmedetomidine and midazolam in pediatric sedation were enrolled. Read More

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http://dx.doi.org/10.1111/cns.13377DOI Listing

Molluscum contagiosum in pediatric patients: to treat or not to treat? Could a personalized imiquimod regimen be the answer to the dilemma?

J Dermatolog Treat 2020 Jun 22:1-6. Epub 2020 Jun 22.

Department of Dermatology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.

Although molluscum contagiosum virus (MCV) infection is a common disease widespread among children and young adults, there is no shared opinion on treatment that can be divided into physical, chemical, medical (immunomodulating or anti-viral). According to some authors, MCV is best left to clear by itself. To assess the clearance of MCV lesions in a sample of pediatric patients. Read More

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http://dx.doi.org/10.1080/09546634.2020.1762840DOI Listing

Vallecular cyst with coexisting laryngomalacia: Successful diagnosis and laser therapy by flexible endoscopy with a novel noninvasive ventilation support in infants.

Pediatr Pulmonol 2020 Jul 28;55(7):1750-1756. Epub 2020 Apr 28.

Division of Pediatric Pulmonology, China Medical University Children's Hospital, China Medical University, Taichung, Taiwan.

Objective: Vallecular cyst coexisting with laryngomalacia (VC-LM) can cause significant pharyngolaryngeal obstruction. Traditionally, it is diagnosed with flexible endoscopy (FE) and treated by rigid endoscopy. This study evaluates the effectiveness of solely using FE with novel noninvasive ventilation (NIV) of sustained pharyngeal inflation (SPI) support for both diagnosis and treatment in such infants. Read More

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http://dx.doi.org/10.1002/ppul.24796DOI Listing

Diffusion weighted imaging is a promising method to detect acute pyelonephritis in non-sedated free breathing infants.

J Pediatr Urol 2020 Jun 6;16(3):320-325. Epub 2020 Apr 6.

Department of Radiation Physics, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Introduction: Urinary tract infection (UTI) is a common disease in infants. The initial evaluation includes imaging to identify risk factors for permanent renal damage, such as malformation and renal parenchymal involvement of the infection i.e. Read More

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http://dx.doi.org/10.1016/j.jpurol.2020.03.027DOI Listing

The Time Is Now: Standardized Sedation Training for Pediatric Hospitalists.

Pediatrics 2020 May;145(5)

Wolfson Children's Hospital, Jacksonville, Florida;

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http://dx.doi.org/10.1542/peds.2020-0446DOI Listing

Trends in Outpatient Procedural Sedation: 2007-2018.

Pediatrics 2020 May;145(5)

Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Harvard University and Boston Children's Hospital, Boston, Massachusetts.

Background: Pediatric subspecialists routinely provide procedural sedation outside the operating room. No large study has reported trends in outpatient pediatric procedural sedation. Our purpose in this study was to identify significant trends in outpatient procedural sedation using the Pediatric Sedation Research Consortium. Read More

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http://dx.doi.org/10.1542/peds.2019-3559DOI Listing

Predictors of Potentially Unnecessary Transfers to Pediatric Emergency Departments.

Hosp Pediatr 2020 May;10(5):424-429

Department of Pediatrics.

Objectives: With soaring US health care costs, identifying areas for reducing cost is prudent. Our objective was to identify the burden of potentially unnecessary pediatric emergency department (ED) transfers and factors associated with these transfers.

Methods: We performed a retrospective analysis of Pediatric Hospital Information Systems data. Read More

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http://dx.doi.org/10.1542/hpeds.2019-0307DOI Listing

Anesthetic care for patients with anti-NMDA receptor encephalitis.

Saudi J Anaesth 2020 Apr-Jun;14(2):164-168. Epub 2020 Mar 5.

Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA.

Introduction: Anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, an autoimmune disorder resulting from antibodies directed against the NMDA (glutamate) receptor, is the second most frequent cause of immune-mediated encephalitis. To date, the information related to the anesthetic care of children with this disorder is limited to anecdotal reports.

Methods: We reviewed the anesthetic care of six patients with anti-NMDA receptor encephalitis who underwent 21 procedures at our institution from 2014 through 2019. Read More

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http://dx.doi.org/10.4103/sja.SJA_720_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7164460PMC

Predicting the outcome of respiratory disease in wheezing infants using tidal flow-volume loop shape.

Allergol Immunopathol (Madr) 2020 Apr 17. Epub 2020 Apr 17.

Paediatric Pulmonology Unit, Division of Pediatrics, Pontificia Universidad Católica de Chile, Santiago, Chile.

Introduction And Objectives: Wheezing (RW) infants with a positive asthma predictive index (API+) have a lower lung function as measured by forced expiratory techniques. Tidal flow-volume loops (TFVL) are easy to perform in infants, and sedation is not necessary.

Materials And Methods: A total of 216 wheezing infants were successfully measured, and 183 of them were followed for over a year. Read More

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http://dx.doi.org/10.1016/j.aller.2019.12.002DOI Listing

Neuroimaging young children and associations with neurocognitive development in a South African birth cohort study.

Neuroimage 2020 Apr 15;219:116846. Epub 2020 Apr 15.

Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Neuroscience Institute, University of Cape Town, South Africa.

Magnetic resonance imaging (MRI) is an indispensable tool for investigating brain development in young children and the neurobiological mechanisms underlying developmental risk and resilience. Sub-Saharan Africa has the highest proportion of children at risk of developmental delay worldwide, yet in this region there is very limited neuroimaging research focusing on the neurobiology of such impairment. Furthermore, paediatric MRI imaging is challenging in any setting due to motion sensitivity. Read More

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http://dx.doi.org/10.1016/j.neuroimage.2020.116846DOI Listing
April 2020
6.357 Impact Factor

Is Carbon Dioxide Insufflation During Endoscopy in Children as Safe and as Effective as we Think?

J Pediatr Gastroenterol Nutr 2020 Apr 14. Epub 2020 Apr 14.

Division of Pediatric Gastroenterology, Hepatology, Pancreatology and Nutrition, Stead Family Department of Pediatrics, University of Iowa, Iowa City, IA 52242 USA.

Objectives: Distension of the gastrointestinal lumen is crucial for visualization and advancement during endoscopic procedures. An increasing number of pediatric centers now use carbon dioxide (CO2) preferentially over air because many adult studies and a few pediatric studies have concluded that CO2 is better tolerated than air, especially for colonoscopy.

Aims: to determine if CO2 is as safe and as effective as air and if it reduces abdominal discomfort and distension in children undergoing upper endoscopy and colonoscopy. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002724DOI Listing

Same anesthesia ERCP and laparoscopic cholecystectomy in the Pediatric ERCP Database Initiative (PEDI) Experience.

J Pediatr Gastroenterol Nutr 2020 Apr 16. Epub 2020 Apr 16.

UT Southwestern Department of Pediatrics, Division of Pediatric Gastroenterology Children's Health-Children's Medical Center, Dallas, Texas.

Background: Successful combined Laparoscopic cholecystectomy and ERCP in the Same Session (LESS) has been reported in several studies in adult patients with choledocholithiasis.

Methods: This was a retrospective analysis of data collected prospectively in the Pediatric ERCP Database Initiative using REDCAP. Adverse events were recorded separately and were reviewed for this study. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002722DOI Listing

Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline.

Eur J Cancer 2020 May 14;131:53-67. Epub 2020 Apr 14.

University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Oncology/Hematology, Groningen, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.

Background: Children with cancer often undergo long treatment trajectories involving repeated needle procedures that potentially cause pain and distress. As part of a comprehensive effort to develop clinical practice guidelines (CPGs) to address pain prevention and management in children with cancer, we aimed to provide recommendations on the pharmacological and psychological management of procedure-related pain and distress.

Methods: Of the international inter-disciplinary CPG development panel (44 individuals), two working groups including 13 healthcare professionals focused on procedural pain and distress. Read More

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http://dx.doi.org/10.1016/j.ejca.2020.02.039DOI Listing

Determining a Bayesian predictive power stopping rule for futility in a non-inferiority trial with binary outcomes.

Contemp Clin Trials Commun 2020 Jun 8;18:100561. Epub 2020 Apr 8.

Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.

Background/aims: Non-inferiority trials investigate whether a novel intervention, which typically has other benefits (i.e., cheaper or safer), has similar clinical effectiveness to currently available treatments. Read More

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http://dx.doi.org/10.1016/j.conctc.2020.100561DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7153169PMC

Drug selection for sedation and general anesthesia in children undergoing ambulatory magnetic resonance imaging.

Authors:
Sung Mee Jung

Yeungnam Univ J Med 2020 Apr 17. Epub 2020 Apr 17.

Department of Anesthesiology and Pain Medicine, Yeungnam University College of Medicine, Daegu, Korea.

The demand for drug-induced sedation for magnetic resonance imaging (MRI) scans have substantially increased in response to increases in MRI utilization and growing interest in anxiety in children. Understanding the pharmacologic options for deep sedation and general anesthesia in an MRI environment is essential to achieve immobility for the successful completion of the procedure and ensure rapid and safe discharge of children undergoing ambulatory MRI. For painless diagnostic MRI, a single sedative/anesthetic agent without analgesia is safer than a combination of multiple sedatives. Read More

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http://dx.doi.org/10.12701/yujm.2020.00171DOI Listing

American Society of Hematology 2020 guidelines for sickle cell disease: prevention, diagnosis, and treatment of cerebrovascular disease in children and adults.

Blood Adv 2020 Apr;4(8):1554-1588

Evidence-Based Practice Center, Mayo Clinic, Rochester, MN.

Background: Central nervous system (CNS) complications are among the most common, devastating sequelae of sickle cell disease (SCD) occurring throughout the lifespan.

Objective: These evidence-based guidelines of the American Society of Hematology are intended to support the SCD community in decisions about prevention, diagnosis, and treatment of the most common neurological morbidities in SCD.

Methods: The Mayo Evidence-Based Practice Research Program supported the guideline development process, including updating or performing systematic evidence reviews. Read More

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http://dx.doi.org/10.1182/bloodadvances.2019001142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189278PMC