Pediatric emergency care
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Pediatric emergency care · Apr 2024
Multicenter StudyCharacteristics of Transport of Ill Pediatric Patients in the Emergency Department: A Latin America Multicenter Prospective Study.
The aim was to describe the characteristics of the transport system of critically ill pediatric patients in the emergency departments (EDs) in Latin America (LA). ⋯ In LA, there is great variability in personnel training, equipment for pediatric transport, team composition, and characterization of critical care transport systems. Continued efforts to improve conditions in our countries may help reduce patient morbidity and mortality.
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Pediatric emergency care · Mar 2024
Multicenter StudyA Descriptive Analysis: Infants Presenting to the Pediatric Emergency Department With a Brief Resolved Unexplained Event.
Infants presenting to pediatric emergency departments (EDs) after a choking episode, cyanotic event, or irregular breathing pattern are often diagnosed with a brief, resolved, unexplained event (BRUE). Social determinants of health may affect these patients; therefore, we aimed to define population demographics and determine significant demographic predictors between 2 cohorts-infants presenting with BRUE, and those admitted to the intensive care unit. ⋯ Black race and Medicaid insurance predicted admission in this patient population, but demographics did not play a role in intensive care unit admission overall. Social determinants of health and demographics therefore appeared to play a role in admission for patients presenting to the ED. Future research could evaluate the effect of focused interventions, such as providing additional resources to socially at-risk families through community outreach, on admission rates of patients with these specific at-risk demographics.
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Pediatric emergency care · Feb 2024
Multicenter StudyElevated High-Sensitivity Troponin and NT-proBNP Values in Febrile Children.
The COVID-19 pandemic and subsequent rise of multisystem inflammatory syndrome in children have raised interest in high-sensitivity troponin (hs-TnT) and N-terminal probrain natriuretic peptide (NT-proBNP) because these have been found to be elevated in many cases of multisystem inflammatory syndrome in children. Our aim was to study hs-TnT and NT-proBNP concentrations in febrile children not affected by COVID-19. ⋯ Concentrations of hs-TnT and NT-proBNP are often elevated in febrile children with different causes of fever. Concentrations were higher in children admitted to the PICU than in children attending the ED, and seem to reflect disease severity rather than the underlying cause of fever.
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Pediatric emergency care · Sep 2023
Multicenter StudyValidity of the Adrogué-Madias Formula for the Management of Acute Dysnatremias in Critically Ill Children: A Prospective Multicenter Analysis.
Current conventional formulas do not predict the expected changes in serum sodium after administration of various fluids to correct serum sodium abnormalities. The Adrogué-Madias formula is currently the preferred and widely used fluid prescription for adult patients with dysnatremias, but its therapeutic efficacy has not been validated in pediatric patients. ⋯ This study demonstrates that the use of the Adrogué-Madias quantitative formula allows to calculate the appropriate rate of administration of various fluids. The calculated fluid administration resulted in the subsequent actual laboratory values and clinical changes.
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Pediatric emergency care · Aug 2023
Multicenter StudyPredicting Delayed Shock in Multisystem Inflammatory Disease in Children: A Multicenter Analysis From the New York City Tri-State Region.
Patients with multisystem inflammatory disease in children (MIS-C) are at risk of developing shock. Our objectives were to determine independent predictors associated with development of delayed shock (≥3 hours from emergency department [ED] arrival) in patients with MIS-C and to derive a model predicting those at low risk for delayed shock. ⋯ Serum CRP, lymphocyte percent, and platelet count differentiated children at higher and lower risk for developing delayed shock. Use of these data can stratify the risk of progression to shock in patients with MIS-C, providing situational awareness and helping guide their level of care.