Pediatr Crit Care Me
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Pediatr Crit Care Me · Apr 2016
Optimal Chest Compression Position for Patients With a Single Ventricle During Cardiopulmonary Resuscitation.
Few studies have examined cardiopulmonary resuscitation for patients with congenital heart disease, although they are at a high risk of cardiac arrest. Therefore, this study investigated the optimal chest compression position in patients with a single ventricle while providing them with basic life support. ⋯ The optimal compression position in patients with a single ventricle is approximately 5-25% of the lower sternum. The optimal compression level for patients with a single ventricle is lower than that suggested in current guidelines for the normal population.
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Acute kidney injury is an independent risk factor for morbidity and mortality in critically ill children in the PICU. Neonates are a particularly vulnerable subgroup regarding acute kidney injury. The objectives were to define the prevalence of acute kidney injury to assess independent risk factors, for the development of acute kidney injury, and to determine the impact of acute kidney injury on outcomes in critically ill neonates without history of cardiac surgery. ⋯ Acute kidney injury is common in neonates not requiring cardiac surgery and is associated with increased morbidity and mortality. Age, bacteremia, and maximum sodium concentration are independently associated with the development of acute kidney injury in this population.
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Pediatr Crit Care Me · Apr 2016
Can Monitoring Fetal Intestinal Inflammation Using Heart Rate Variability Analysis Signal Incipient Necrotizing Enterocolitis of the Neonate?
Necrotizing enterocolitis of the neonate is an acute inflammatory intestinal disease that can cause necrosis and sepsis. Chorioamnionitis is a risk factor of necrotizing enterocolitis. The gut represents the biggest vagus-innervated organ. Vagal activity can be measured via fetal heart rate variability. We hypothesized that fetal heart rate variability can detect fetuses with incipient gut inflammation. ⋯ We identified a unique subset of fetal heart rate variability measures reflecting 1.5 days ahead of time the levels of macrophage activation and increased leakiness in terminal ileum. We propose that such subset of fetal heart rate variability measures reflects brain-gut communication via the vagus nerve. Detecting such noninvasively obtainable organ-specific fetal heart rate variability signature of inflammation would alarm neonatologists about neonates at risk of developing necrotizing enterocolitis and sepsis. Clinical validation studies are required.
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Pediatr Crit Care Me · Apr 2016
Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients.
To evaluate the correlation of a Pediatric Early Warning Score with unplanned transfer to the PICU in hospitalized oncology and hematopoietic stem cell transplant patients. ⋯ We demonstrate that our institution's Pediatric Early Warning Score is highly correlated with the need for unplanned PICU transfer in hospitalized oncology and hematopoietic stem cell transplant patients. Furthermore, we found an association between higher scores and PICU mortality. This is the first validation of a Pediatric Early Warning Score specific to the pediatric oncology and hematopoietic stem cell transplant populations, and supports the use of Pediatric Early Warning Scores as a method of early identification of clinical deterioration in this high-risk population.