21,515 results match your criteria ill children


Centrifugal and Roller Pumps in Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-Analysis of Clinical Outcomes.

ASAIO J 2021 May 25. Epub 2021 May 25.

Department of Cardiac Thoracic and Vascular Surgery, National University Heart Centre, Singapore.

Extracorporeal membrane oxygenation (ECMO) is an invaluable means of supporting critically ill children with refractory respiratory or cardiac failure. Controversy remains; however, whether roller or centrifugal pumps are superior, particularly in infants. We performed a comprehensive search on PubMed, Embase, and Scopus for studies comparing the use of centrifugal and roller pumps in the pediatric and neonatal population from 1973 until March 1, 2020. Read More

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The Child Health PSO at 10 Years: An Emerging Learning Network.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e449. Epub 2021 Jul 28.

Performance Measurement, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Ill.

Introduction: The 2005 Patient Safety and Quality Improvement Act, actualized as a Learning Network (LN), has enabled the Child Health Patient Safety Organization (PSO) to play a vital and novel role in improving the quality and safety of care. This article describes the Child Health PSO and proposes PSOs as a new construct for LNs.

Methods: A PSOs ability to affect patient care depends on member organizations' integration of PSO output into their individual Learning Healthcare Systems. Read More

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A Quality Improvement Approach to Influence Value-based Mucolytic Use in the PICU.

Pediatr Qual Saf 2021 Jul-Aug;6(4):e438. Epub 2021 Jul 28.

Division of Pediatric Critical Care Medicine, Department of Pediatrics, The Ohio State University College of Medicine, Nationwide Children's Hospital, Columbus, Ohio.

Introduction: High-cost medication administration, despite lacking evidence for use, results in poor healthcare value. This work aimed to reduce dornase-alfa utilization in critically ill mechanically ventilated children.

Methods: The project employed an observational pre-post design to develop a value-based clinical pathway to guide provider choice in mucolytic utilization in a quaternary pediatric intensive care unit. Read More

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Operating Within the Neonatal Intensive Care Unit: A Retrospective Analysis From a Tertiary Care Center.

Cureus 2021 Jun 30;13(6):e16077. Epub 2021 Jun 30.

Neonatology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND.

Background Despite ongoing advances in the field of neonatology, the survival outcomes among critically ill preterm surgical neonates remain unfavorable. Intrahospital transport is one of the major risk factors associated with early mortality (within 30 days) in these newborns. To overcome this, the approach of performing bedside surgeries is being followed. Read More

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Hemoperfusion with CytoSorb to Manage Multiorgan Dysfunction in the Spectrum of Hemophagocytic Lymphohistiocytosis Syndrome in Critically Ill Children.

Blood Purif 2021 Aug 3:1-8. Epub 2021 Aug 3.

Pediatric Emergency Department Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition characterized by a state of hyperinflammation. Blood purification techniques can blunt the inflammatory process with a rapidly relevant nonselective effect on the cytokine storm, thus potentially translating into survival benefit for these patients. In this cohort, we evaluated the impact of hemoadsorption with CytoSorb combined with continuous kidney replacement therapy used as adjunctive therapy in 6 critically ill children with multiple organ dysfunction due to HLH. Read More

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Effect of a Sedation and Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial.

JAMA 2021 08;326(5):401-410

Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, Ireland.

Importance: There is limited evidence on the optimal strategy for liberating infants and children from invasive mechanical ventilation in the pediatric intensive care unit.

Objective: To determine if a sedation and ventilator liberation protocol intervention reduces the duration of invasive mechanical ventilation in infants and children anticipated to require prolonged mechanical ventilation.

Design, Setting, And Participants: A pragmatic multicenter, stepped-wedge, cluster randomized clinical trial was conducted that included 17 hospital sites (18 pediatric intensive care units) in the UK sequentially randomized from usual care to the protocol intervention. Read More

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Parental Stress and Mental Health Symptoms in the NICU: Recognition and Interventions.

Neoreviews 2021 Aug;22(8):e496-e505

Division of Child Psychiatry, Stanford University School of Medicine, Palo Alto, CA.

Parental experiences in the NICU are often characterized by psychological stress and anxiety following the birth of a critically ill or premature infant. Such stress can have a negative impact on parents and their vulnerable infants during NICU hospitalization as well as after discharge. These infants are also at increased risk for adverse developmental, cognitive, academic, and mental health outcomes. Read More

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Risk Factors for Acute Kidney Injury in Critically Ill Neonates: A Systematic Review and Meta-Analysis.

Front Pediatr 2021 14;9:666507. Epub 2021 Jul 14.

Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.

Acute kidney injury (AKI) is recognized as an independent risk factor for mortality and long-term poor prognosis in neonates. The objective of the study was to identify the risk factors for AKI in critically ill neonates to provide an important basis for follow-up research studies and early prevention. The PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, WanFang Med, SinoMed, and VIP Data were searched for studies of risk factors in critically ill neonates. Read More

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The accuracy of the pediatric assessment triangle in assessing triage of critically ill patients in emergency pediatric department.

Int Emerg Nurs 2021 Jul 29;58:101041. Epub 2021 Jul 29.

Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China. Electronic address:

Background: The Pediatric Assessment Triangle (PAT) is a rapid evaluation tool that establishes a child's clinical status and his or her category of illness in order to direct initial management priorities. However, only few studies have examined its accuracy in assessing triage of critically ill patients in the emergency pediatric department (EPD) in China.

Objective: To quantitatively validate the accuracy in assessing critically ill medical children and nurses' acceptance of PAT in the EPD. Read More

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Parent and Adolescent Perspectives on the Impact of COVID on the Care of Seriously Ill Children.

J Pain Symptom Manage 2021 Jul 29. Epub 2021 Jul 29.

Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute. Boston, Massachusetts; Department of Pediatrics, Boston Children's Hospital. Boston, Massachusetts. Electronic address:

Context: Few studies have explored the impact of the Coronavirus Pandemic (COVID-19) on the care of seriously ill children which may be especially affected due to the child's vulnerability, complexity of care, and high reliance on hospital-based care.

Objective: To explore parental and adolescent perspectives on the impact of COVID-19 on care of seriously children.

Methods: We recruited a convenience sample of families of seriously ill children between September and December 2020. Read More

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Excessive and pathological Internet use - Risk-behavior or psychopathology?

Addict Behav 2021 Jul 9;123:107045. Epub 2021 Jul 9.

National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institutet, Stockholm, Sweden.

Pathological Internet use (but only with respect to gaming) is classified as mental disorder in the ICD-11. However, there is a large group of adolescents showing excessive Internet use, which may rather be considered adolescent risk-behavior. The aim was to test whether pathological and excessive Internet use should be considered as "psychopathology" or "risk-behavior". Read More

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Acute kidney injury in critically Ill children and young adults with suspected SARS-CoV2 infection.

Pediatr Res 2021 Jul 30. Epub 2021 Jul 30.

Center for Acute Care Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Background: We aimed to study the association of suspected versus confirmed infection with the novel SARS-CoV2 virus with the prevalence of acute kidney injury (AKI) in critically ill children.

Methods: Sequential point-prevalence study of children and young adults aged 7 days to 25 years admitted to intensive care units under investigation for SARS-CoV2 infection. AKI was staged in the first 14 days of enrollment using KDIGO creatinine-based staging. Read More

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Family Group Conferences as a Shared Decision-Making Strategy in Adults Mental Health Work.

Authors:
Shulamit Ramon

Front Psychiatry 2021 13;12:663288. Epub 2021 Jul 13.

Department of Allied Health, Midwifery and Social Work, University of Hertfordshire, Hatfield, United Kingdom.

Family Group conferences (FGC) provide a system by which a client and their family reach jointly key intervention decisions, from a number of options proposed by professionals. The system originated in child protection social work. Conceptually FGC is based on the assumption that the family is potentially a supportive social system for an individual with a variety of difficulties, including mental ill health. Read More

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Human autoinflammatory disease reveals ELF4 as a transcriptional regulator of inflammation.

Nat Immunol 2021 Jul 29. Epub 2021 Jul 29.

Immunobiology Department, Yale University School of Medicine, New Haven, CT, USA.

Transcription factors specialized to limit the destructive potential of inflammatory immune cells remain ill-defined. We discovered loss-of-function variants in the X-linked ETS transcription factor gene ELF4 in multiple unrelated male patients with early onset mucosal autoinflammation and inflammatory bowel disease (IBD) characteristics, including fevers and ulcers that responded to interleukin-1 (IL-1), tumor necrosis factor or IL-12p40 blockade. Using cells from patients and newly generated mouse models, we uncovered ELF4-mutant macrophages having hyperinflammatory responses to a range of innate stimuli. Read More

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Association between the use of balanced fluids and outcomes in critically ill children: a before and after study.

Crit Care 2021 Jul 29;25(1):266. Epub 2021 Jul 29.

Division of Critical Care, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave., Chicago, IL, 60611, USA.

Background: Hyperchloremia and chloride load have been associated with worse clinical outcomes in critically ill patients. We sought to evaluate the electrolyte profile and clinical outcomes associated with a unit-wide transition from saline to balanced fluids for resuscitation and maintenance fluids in a pediatric intensive care unit (PICU).

Methods: A before and after analysis of all patients admitted to the PICU in a large, urban, academic hospital between August 2018 and March 2020. Read More

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Role of laboratory biomarkers in assessing the severity of COVID-19 disease. A cross-sectional study.

J Family Med Prim Care 2021 Jun 2;10(6):2209-2215. Epub 2021 Jul 2.

Department of Clinical Biochemistry, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.

Background: Corona virus disease 2019 (Covid-19) has high infectivity and mortality rate. Covid-19 patients can suddenly deteriorate and develop life threatening complications. Hence, there is a need to identify laboratory biomarkers in order to categorize high risk patients. Read More

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Association between secondhand marijuana smoke and respiratory infections in children.

Pediatr Res 2021 Jul 29. Epub 2021 Jul 29.

Children's Hospital Colorado, University of Colorado Denver Anschutz Medical Campus, Aurora, CO, USA.

Background: Little is known about the effects of secondhand marijuana smoke on children. We aimed to determine caregiver marijuana use prevalence and evaluate any association between secondhand marijuana smoke, childhood emergency department (ED) or urgent care (UC) visitation, and several tobacco-related illnesses: otitis media, viral respiratory infections (VRIs), and asthma exacerbations.

Methods: This study was a cross-sectional, convenience sample survey of 1500 subjects presenting to a pediatric ED. Read More

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A Randomized Controlled Trial Comparing the Success of Mineral Trioxide Aggregate and Ferric Sulfate as Pulpotomy Medicaments for Primary Molars.

J Dent Child (Chic) 2021 May;88(2):120-128

Dr. Alapati is an associate professor, Department of Endodontics, all in the College of Dentistry, University of Illinois at Chicago, Chicago, Ill., USA.

To evaluate and compare the clinical and radiographic performance of a new type of mineral trioxide aggregate (MTA, NuSmile NeoMTA) and ferric sulfate (FS) as pulpotomy medicaments for primary molars over 12 months.
Fifty participants (25 per group) were enrolled, according to specific inclusion criteria. Each participant received a single primary molar pulpotomy either with MTA or FS, depending on random digit table method allocation. Read More

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Geographic Distribution of Pediatric Dentists and Community Characteristics of Their Locations in Florida.

J Dent Child (Chic) 2021 May;88(2):101-107

Dr. Tomar is a professor and an associate dean for Prevention and Public Health Sciences, College of Dentistry, University of Illinois Chicago, Chicago, Ill., USA;, Email:

To describe the geographic distribution of pediatric dentists (PDs) in Florida and the sociodemographic characteristics of communities in which they are located compared with communities without a PD.
The ratio of PDs to children for each county in Florida and the distribution of PDs in Florida counties at the census tract (CT) level were calculated. Each CT was categorized as having or not having PDs to examine the geographic distribution of PDs, and the sociodemographic differences between CTs with and without a PD were tested by using -tests. Read More

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Time to achieve delivery of nutrition targets is associated with clinical outcomes in critically ill children.

Am J Clin Nutr 2021 Jul 28. Epub 2021 Jul 28.

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

Background: Optimal nutrition in critically ill children involves a complex interplay between the doses, route, and timing of macronutrient delivery.

Objectives: We aimed to examine the association between the time to achieve delivery of 60% of the prescribed energy and protein targets and clinical outcomes in mechanically ventilated children.

Methods: We conducted a prospective, observational cohort study of mechanically ventilated children admitted to pediatric intensive care units (PICUs) worldwide. Read More

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Frequency and Causes of Delirium in Pediatric Intensive Care Unit: A Prospective Observational Study.

Indian J Crit Care Med 2021 Jun;25(6):715-719

Department of Pediatric Intensive Care, Cukurova University Medicine Faculty, Adana, Turkey.

Background: The number of studies evaluating delirium and its frequency in critically ill infants, children, and adolescents is increasing day by day. The primary objective of this study was to evaluate all patients hospitalized in our pediatric intensive care unit (PICU) in terms of pediatric delirium, to determine the frequency and risk factors of pediatric delirium.

Patients And Methods: The patients included in this study had been hospitalized in the PICU between November 1, 2018, and August 31, 2019, and were followed up for more than 48 hours. Read More

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Delirium in Pediatric Intensive Care Unit: Frequency, Causes, and Interventions.

Authors:
Sandeep Dhingra

Indian J Crit Care Med 2021 Jun;25(6):620-621

Department of Pediatrics, Command Hospital, Panchkula, Haryana, India.

Delirium is an acute neurologic dysfunction characterized by fluctuating alteration in awareness, attention, and cognition and is a result of an underlying medical condition or its treatment. It is associated with increased morbidity and mortality in the intensive care setting and may lead to long-term cognitive impairment in survivors. Pediatric delirium (PD) occurs in as many as 25% of critically ill children. Read More

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Adapting the Community-based Health Planning and Services (CHPS) to engage poor urban communities in Ghana: protocol for a participatory action research study.

BMJ Open 2021 07 27;11(7):e049564. Epub 2021 Jul 27.

Department of Health Sciences, University of York, York, UK.

Introduction: With rapid urbanisation in low-income and middle-income countries, health systems are struggling to meet the needs of their growing populations. Community-based Health Planning and Services (CHPS) in Ghana have been effective in improving maternal and child health in rural areas; however, implementation in urban areas has proven challenging. This study aims to engage key stakeholders in urban communities to understand how the CHPS model can be adapted to reach poor urban communities. Read More

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Differential DNA methylation by early versus late parenteral nutrition in the PICU: a biological basis for its impact on emotional and behavioral problems documented 4 years later.

Clin Epigenetics 2021 Jul 27;13(1):146. Epub 2021 Jul 27.

Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Herestraat 49, 3000, Leuven, Belgium.

Background: The PEPaNIC multicenter randomized controlled trial (RCT) has shown that early administration of supplemental parenteral nutrition (early-PN) as compared with withholding PN for 1 week (late-PN) induced long-term internalizing, externalizing and total emotional/behavioral problems in critically ill children, as observed 4 years later. Early-PN was further shown to alter the methylation status of 37 CpG-sites in leukocyte DNA between admission and discharge from the pediatric intensive care unit (PICU). In a preplanned subanalysis of the PEPaNIC trial, we now investigated whether the altered methylation of these CpG-sites could statistically explain the negative impact of early-PN on emotion/behavior documented 4 years after PICU admission. Read More

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Out-of-Hospital COVID-19 Deaths: Consequences for Quality of Medical Care and Accuracy of Cause of Death Coding.

Am J Public Health 2021 07;111(S2):S101-S106

Elizabeth B. Pathak, Rebecca B. Garcia, and Janelle M. Menard are with the Women's Institute for Independent Social Enquiry, Olney, MD. Jason L. Salemi is with the College of Public Health, University of South Florida, Tampa.

To examine age and temporal trends in the proportion of COVID-19 deaths occurring out of hospital or in the emergency department and the proportion of all noninjury deaths assigned ill-defined causes in 2020. We analyzed newly released (March 2021) provisional COVID-19 death tabulations for the entire United States. Children (younger than 18 years) were most likely (30. Read More

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Healthier Minds in Fitter Bodies: A Systematic Review and Meta-Analysis of the Association between Physical Fitness and Mental Health in Youth.

Sports Med 2021 Jul 27. Epub 2021 Jul 27.

PROFITH 'PROmoting FITness and Health Through Physical Activity' Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.

Background: Physical fitness is an important marker of current and future health status, yet the association between physical fitness and indicators of mental health in youth has not been systematically reviewed and meta-analyzed.

Objective: The aim of this work was to systematically review and meta-analyze the association between physical fitness components (i.e. Read More

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Individualized precision dosing approaches to optimize antimicrobial therapy in pediatric populations.

Expert Rev Clin Pharmacol 2021 Jul 27. Epub 2021 Jul 27.

University of Queensland Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.

Introduction: : Severe infections continue to impose a major burden on critically ill children and mortality rates remain stagnant. Outcomes rely on accurate and timely delivery of antimicrobials achieving target concentrations in infected tissue. Yet, developmental aspects, disease-related variables, and host factors may severely alter antimicrobial pharmacokinetics in pediatrics. Read More

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Play interventions for paediatric patients in hospital: a scoping review.

BMJ Open 2021 07 26;11(7):e051957. Epub 2021 Jul 26.

Children's Hospital Copenhagen and Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark.

Objective: Play is a non-invasive, safe and inexpensive intervention that can help paediatric patients and their families manage difficult aspects of being ill or hospitalised. Although play has existed in hospitals for decades, research on hospital play interventions is scarce. This review aimed to categorise and synthesise the last 20 years of research on hospital play interventions. Read More

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Socioeconomic inequalities in co-morbidity of overweight, obesity and mental ill-health from adolescence to mid-adulthood in two national birth cohort studies.

Lancet Reg Health Eur 2021 Jul;6:100106

MRC Unit for Lifelong Health and Ageing at UCL, 1-19 Torrington Place, WC1E 7HB London, United Kingdom.

Aim: To examine socioeconomic inequalities in comorbidity risk for overweight (including obesity) and mental ill-health in two national cohorts. We investigated independent effects of childhood and adulthood socioeconomic disadvantage on comorbidity from childhood to mid-adulthood, and differences by sex and cohort.

Methods: Data were from 1958 National Child Development Study (NCDS58) and 1970 British Cohort Study (BCS70) [total N=30,868, 51% males] assessed at ages 10, 16, 23/26, 34 and 42 years. Read More

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