Pediatrics
-
Randomized Controlled Trial Multicenter Study Comparative Study
EMLA cream and nitrous oxide to alleviate pain induced by palivizumab (Synagis) intramuscular injections in infants and young children.
Palivizumab (Synagis [Abbot Laboratories, Kent, United Kingdom]) is recommended for the prevention of severe lower respiratory tract infections caused by respiratory syncytial virus in infants at high risk. These injections are very painful, and currently the use of analgesics is not systematic. The objective of this study was to compare the efficacy of EMLA with premixed 50% nitrous oxide/oxygen, used alone or combined with EMLA, for pain alleviation during palivizumab injections. ⋯ The administration of 50/50 nitrous oxide/oxygen to infants and young children is effective in decreasing the pain associated with palivizumab intramuscular injections. The combined nitrous oxide/oxygen plus EMLA cream was more effective than either EMLA cream or nitrous oxide/oxygen alone.
-
Our goals were to compare (1) single-channel amplitude-integrated electroencephalography alone, (2) 2-channel amplitude-integrated electroencephalography alone, and (3) amplitude-integrated electroencephalography plus 2-channel electroencephalography with simultaneous continuous conventional electroencephalography for seizure detection in term infants to check the accuracy of limited channels and compare the different modalities of bedside electroencephalography monitoring. ⋯ Limited-channel bedside electroencephalography combining amplitude-integrated electroencephalography with 2-channel electroencephalography, interpreted by experienced neonatal readers, detected the majority of electrical seizures in at-risk newborn infants.
-
The purpose of this work was to determine the excess charges, both overall and according to category, and lengths of stay attributable to adverse patient-care events during pediatric hospitalization. ⋯ Some adverse events experienced during pediatric hospitalization have the potential to increase lengths of stay and charges considerably, and pediatric-specific quality indicators are useful in calculating these effects.
-
The objective of this study was to determine the relationship between the frequency and total volume of intravascular volume administration and the development of intracranial hemorrhage during venoarterial extracorporeal membrane oxygenation. ⋯ The number and total volume of intravascular volume administration in the first 8 and 24 hours of venoarterial extracorporeal membrane oxygenation treatment are statistically significantly related to the development of intracranial hemorrhage.
-
Children with traumatic brain injuries often show impaired executive function (the ability to carry out goal-directed behavior). The Behavior Rating Inventory of Executive Function, a caregiver-report questionnaire, measures executive function in everyday activities. In this study, our goal was to use the Behavior Rating Inventory of Executive Function to document changes in children's executive function in the first year after traumatic brain injury and identify child, family, and injury variables associated with greater dysfunction. We predicted that children with traumatic brain injury would have more executive dysfunction than children hospitalized for orthopedic fractures and that more severe traumatic brain injury would predict greater dysfunction. Children's premorbid functioning and family characteristics were expected to moderate their executive function. ⋯ Between 18% and 38% of the children with traumatic brain injury had significant executive dysfunction in the first year after injury, with greater dysfunction reported for children with more severe traumatic brain injury. Our findings support previous reports that preinjury learning and behavior problems, limited family resources, and poor family functioning adversely affect executive function. These results suggest a need for more systematic screening for executive dysfunction after traumatic brain injury to increase recognition of cognitive disability and improve access to appropriate services.