Articles: pediatrics.
-
Pediatr Crit Care Me · Jan 2025
Multicenter Study Observational StudyMechanical Thromboprophylaxis and Hospital-Acquired Venous Thromboembolism Among Critically Ill Adolescents: A U.S. Pediatric Health Information Systems Registry Study, 2016-2023.
To estimate the rate of mechanical thromboprophylaxis (mTP) prescription among critically ill adolescents using a multicenter administrative database and determine whether mTP prescription is inversely associated with hospital-acquired venous thromboembolism. ⋯ In the multicenter PHIS cohort, 2016-2023, the prescribing patterns for mTP among critically ill adolescents showed a low rate of mTP prescription (19.6%) that varied widely across institutions, decreased annually over the study period by 1.6%/year, and was not independently associated with HA-VTE risk reduction.
-
Case Reports
Prehospital whole blood administration for pediatric gastrointestinal hemorrhage: A case report.
The management of gastrointestinal (GI) hemorrhage in a prehospital setting presents significant challenges, particularly in arresting the hemorrhage and initiating resuscitation. This case report introduces a novel instance of prehospital whole blood transfusion to an 8-year-old male with severe lower GI hemorrhage, marking a shift in prehospital pediatric care. The patient, with no previous significant medical history, presented with acute rectal bleeding, severe hypotension (systolic/diastolic blood pressure [BP] 50/30 mmHg), and tachycardia (148 bpm). ⋯ Upon hospital admission, a Meckel's diverticulum was identified as the bleeding source, and it was successfully surgically resected. The patient's recovery was ultimately favorable, highlighting the importance of rapid, prehospital intervention and the potential role of whole blood transfusion in managing acute pediatric GI hemorrhage. This case supports the notion of advancing EMS protocols to include interventions historically reserved for the hospital setting that may significantly impact patient outcomes from the field.
-
Characterizing respiratory syncytial virus (RSV) infections before and during the COVID-19 pandemic.
Following the onset of the COVID-19 pandemic, RSV infections deviated from a previously reliable epidemiologic pattern of presentation. To investigate whether this change in RSV seasonality resulted in a change in frequency and severity of RSV infections, this single center retrospective study compares demographic and hospital factors during RSV seasons before and after the onset of the COVID-19 pandemic. ⋯ During the first three RSV seasons after the onset of the COVID-19 pandemic, our pediatric emergency departments saw more RSV positive patients than in the last three seasons beforehand. These patients were significantly older and less likely to be admitted, which may be partly due to increased respiratory viral testing during the pandemic. However, shorter LOS and decreased intubations despite increased respiratory support among admitted patients may indicate a paradigm shift in emergency department and inpatient management of severe RSV infections, perhaps encouraged by practice changes and resource limitations due to COVID-19. This information may better guide institutions in predicting resource needs after large-scale infectious disease outbreaks in the future.
-
Critical care clinics · Jan 2025
ReviewPediatric Post-Intensive Care Syndrome and Current Therapeutic Options.
Post-intensive care syndrome (PICS) impacts most pediatric critical care survivors. PICS spans physical, cognitive, emotional, and social health domains and is increasingly recognized in survivorship literature. Children pose unique challenges in identifying and treating PICS given the inherent population heterogeneity in pediatric samples with biological differences across ages and neurodevelopmental stages, unique disease pathophysiology, strong environmental influences on disease and recovery, and lack of standardized measurements to identify morbidities or track response to intervention. Emerging literature and the recent development of specialized multidisciplinary clinics highlight opportunities for intervention across PICS domains in inpatient and outpatient settings.