Articles: pediatrics.
-
The Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAIAI). Little is known about the risk for IAIAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAIAI when either one or two PECARN intraabdominal injury rule variables are positive. ⋯ Few children with blunt torso trauma and one or two PECARN predictor variables present have IAIAI. Those with GCS score <14, however, are at highest risk for IAIAI.
-
Combined medicine-pediatrics training was formally established in 1967 by the American Board of Pediatrics and the American Board of Internal Medicine. More than 8000 physicians have completed dual training. Their career choices are not well-described. ⋯ Medicine-pediatrics physicians pursue diverse career paths and make important contributions to the healthcare workforce.
-
J Pain Symptom Manage · Jan 2025
Association of Palliative Care Timing with End-of-Life Quality in Children with Heart Disease.
Children with heart disease are at risk for early mortality and parents often perceive suffering at end-of-life (EOL). Involvement of pediatric palliative care (PPC) is a proposed quality measure at the EOL in children with cancer, and early PPC involvement is associated with other quality measures. The impact of early PPC involvement on EOL quality is unknown in children with heart disease. ⋯ Our findings may indicate that quality indicators extrapolated from pediatric oncology do not apply to children with heart disease, as they have notably different disease trajectories and intervention options. We recommend defining high-quality EOL care indicators for children with heart disease as a priority.
-
J. Cardiothorac. Vasc. Anesth. · Jan 2025
ReviewRegional Analgesia in Pediatric Cardiothoracic Surgery: A Bayesian Network Meta-Analysis.
Various regional analgesia techniques are used to reduce postoperative pain in pediatric patients undergoing cardiothoracic surgeries. This study aimed to determine the relative efficacy of regional analgesic interventions. PubMed, EMBASE, Web of Science, and Cochrane databases were searched to identify all randomized controlled studies evaluating the effects of regional block after cardiothoracic surgery. ⋯ The incidence of postoperative nausea and vomiting was the lowest in the epidural anesthesia group, followed by the transversus thoracis muscle plane block group. Regional anesthesia revealed significant opioid-sparing effects following pediatric cardiothoracic surgery. However, indirect comparisons are limited because of the heterogeneity of previous studies, and direct comparisons are needed to establish the relative efficacies of different blocks.