Journal of paediatrics and child health最新文献

{"title":"Paediatric Central Venous Access Devices: An Evidence and Gap Map of Global Research.","authors":"Tricia M Kleidon, Sabrina de Souza, Patrícia Kuerten Rocha, Elouise Comber, Jacqueline Cunninghame, Areum Hyun, Jefferson Wildes da Silva Moura, Amanda J Ullman, Mari Takashima","doi":"10.1111/jpc.70391","DOIUrl":"https://doi.org/10.1111/jpc.70391","url":null,"abstract":"<p><strong>Context: </strong>Central venous access devices (CVADs) are essential in paediatric care but pose significant risks. Synthesising existing evidence is needed to guide safe, effective, and equitable practice amid evolving interventions and complex management needs.</p><p><strong>Objective: </strong>To develop an evidence and gap map (EGM) to identify, categorise, and visualise paediatric evidence on interventions aimed at improving CVAD outcomes.</p><p><strong>Data sources: </strong>Following Campbell Collaboration guidance, systematic searches were conducted in PubMed, CINAHL, Scopus, and CENTRAL (date limits: 2014 to 30 June 2024).</p><p><strong>Study selection: </strong>Eligible studies included patients (0-18 years) evaluating an intervention to improve CVAD outcomes, including randomised and non-randomised trials, implementation studies, and systematic reviews.</p><p><strong>Data extraction: </strong>Two reviewers independently screened and extracted data on CVAD type, intervention, setting, outcomes, and study design. Data were descriptively analysed and visualised in Tableau.</p><p><strong>Results: </strong>Of 952 studies in the broader EGM, 151 were paediatric-specific. Most were conducted in high-income countries (72%) and high-acuity settings, including critical care (41.9%) and oncology (38.5%). CVAD type was unspecified in 80.1% of studies. Systematic reviews (22.5%) and randomised controlled trials (28.5%) were available, though 40.4% of studies were before-and-after studies without controls. Common interventions addressed infection prevention, insertion technologies, and flushing. Clinical outcomes, particularly bloodstream infection (27.8%), dominated reporting, while patient-reported, economic, and device removal outcomes were rarely reported (< 2%).</p><p><strong>Limitations: </strong>Only studies from the last 10 years and English-language databases were included. No formal quality appraisal was conducted.</p><p><strong>Conclusions: </strong>Significant evidence gaps exist. Future research should prioritise rigorous, paediatric-specific studies across diverse settings and outcome domains.</p><p><strong>Trial registration: </strong>Open Science Framework (OSF) q6gcr: https://osf.io/q6gcr/overview.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Enteral Nutrition After Paediatric Ostomy Closure (EPOC): A Protocol for a Multicentre, Prospective Randomised Controlled Trial.","authors":"Joyce Ly, James Cope, Nicholas Olsen, Soundappan S V Soundappan, Susan Adams","doi":"10.1111/jpc.70368","DOIUrl":"https://doi.org/10.1111/jpc.70368","url":null,"abstract":"<p><strong>Aims: </strong>This is the study protocol of an ongoing prospective randomised controlled trial (RCT) designed to assess the safety and efficacy of early enteral nutrition after elective enterostomy closure in children, written in accordance with the SPIRIT guidelines.</p><p><strong>Materials and methods: </strong>This is a multicentre, RCT that will be conducted in two Australian tertiary paediatric hospitals with a planned sample size of 68. Children that meet the inclusion criteria aged between 3 months and 16 years (inclusive) undergoing an elective enterostomy closure will be invited to participate. To assign treatment group, stratified permutated block randomisation will be used, with block sizes of four and six, and strata including: age group (3 months-< 6 years, 6-≤ 16 years); stoma type (ileostomy, colostomy); and hospital (Sydney Children's Hospital, Randwick, The Children's Hospital at Westmead). The control group will commence feeds on return of bowel function or when nasogastric tube aspirates are non-bilious. The intervention group will be offered feeds within 24 h of admission to the recovery room. The primary outcome is the length of stay, measured in hours. Secondary outcomes include time to oral feeds, time to first spontaneous passage of stool, highest post-operative pain score, complications, analgesia use and parent satisfaction. Data analyses will use an intention-to-treat principle. Length of stay, time to feeds and passing of stool will be analysed using restricted mean survival time. Other secondary outcomes will be analysed using regression models.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation for Bleeding Disorders in Suspected Non-Accidental Intracranial Haemorrhage.","authors":"Petrisse E Seeley, Paul Monagle, Lydia Garside, Susan Russell, Meredith Wiggins, Dhriti Chandru Bhavnani, Nadira Pratisto, Dimitra Tzioumi","doi":"10.1111/jpc.70400","DOIUrl":"https://doi.org/10.1111/jpc.70400","url":null,"abstract":"<p><strong>Background: </strong>Abusive head trauma is the most common cause of death in children suffering non-accidental injury (NAI). Intracranial haemorrhage can (rarely) be caused by inherited bleeding disorders. Evaluation of children with suspected NAI and intracranial bleeding involves diagnosis or exclusion of a bleeding disorder; however, there is a paucity of evidence to guide haematological evaluation in these patients.</p><p><strong>Objectives: </strong>To determine the prevalence of inherited bleeding disorders in children with intracranial haemorrhage suspected of NAI and determine which tests have the highest diagnostic yield.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of children referred to the Child Protection Unit at Sydney Children's Hospital, Australia, between 2011 and 2020 with intracranial haemorrhage. Descriptive analyses of the data were completed.</p><p><strong>Results: </strong>A total of 120 children were included in the cohort. Eighty-seven (73%) had a baseline coagulation screen (FBC, PT and APTT) performed with initial pathology testing within 72 h of presentation. Three children (2.5%) were identified to have an underlying inherited bleeding disorder, all of whom (100%) had a prolonged APTT on initial testing.</p><p><strong>Conclusion: </strong>An extensive array of haematological investigations was performed, but with a lack of consistency. Three patients were identified to have an inherited bleeding disorder, including haemophilia A, haemophilia B and von Willebrand disease, two of whom were confirmed NAI regardless. All three had abnormal APTT on the initial coagulation screen. We propose initial haematological screening with FBC, PT/APTT/fibrinogen only, unless bleeding risk factors are identified. If an abnormality is detected, subsequent factor levels and further haematological investigations are recommended.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Australia's Thriving Kids Initiative Needs Clearer Measurement Language to Succeed.","authors":"Suzanne H Long, Christine Imms","doi":"10.1111/jpc.70395","DOIUrl":"https://doi.org/10.1111/jpc.70395","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Apprenticeship.","authors":"Mick O'Keeffe","doi":"10.1111/jpc.70379","DOIUrl":"https://doi.org/10.1111/jpc.70379","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness and Management of Paediatric Delirium: Differences Among Clinical Disciplines.","authors":"Gizem Durcan, Başak Günal, Pınar Coşkun, Mesut Yavuz","doi":"10.1111/jpc.70396","DOIUrl":"https://doi.org/10.1111/jpc.70396","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this study was to evaluate the knowledge of child and adolescent psychiatrists (CAP) and other physicians working with paediatric patients (paediatrics and paediatric surgery) on delirium.</p><p><strong>Methods: </strong>To measure the level of knowledge about delirium, participants were asked to complete an online questionnaire consisting of 17 statements developed by paediatric delirium experts at Johns Hopkins Hospital, which were asked to be evaluated as true/false.</p><p><strong>Results: </strong>Of the 249 physicians who participated in the study, 57% (n = 141) were in the CAP group and 43% (n = 108) were in the other doctor group. The median total number of correct answers to the questions was significantly higher in the CAP group (15 [14, 15]) than in the other doctor group (14 [12-15]). The most significant knowledge gap relates to delirium treatment, with 68% of paediatric and paediatric surgery physicians believing that benzodiazepines are frequently recommended for delirium treatment.</p><p><strong>Conclusions: </strong>It was found that physicians working with children may have misinformation about the risk factors, diagnosis and management of delirium and that there may be differences between specialties. Recalling missing information about delirium and correcting misconceptions will be of great importance in the prevention and treatment of delirium.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catheter-Associated Urinary Tract Infections in Children: An Evidence-Informed Narrative Review of Diagnosis, Management and Prevention.","authors":"Simon P Paget, Robert McCusker, Suzanne Simpson, Melissa Short, Angela Berkhout","doi":"10.1111/jpc.70394","DOIUrl":"https://doi.org/10.1111/jpc.70394","url":null,"abstract":"<p><p>Catheter-associated urinary tract infections (CAUTI) are a common healthcare-associated infection in children and a major contributor to increased morbidity, prolonged hospital stays and higher healthcare costs. This narrative review uses an evidence-informed approach highlighting recent paediatric literature (2000-2025) to provide an overview of epidemiology, pathophysiology, management and prevention of CAUTI in children. Two populations are considered: children requiring short-term catheterisation (typically peri-procedural or during hospitalisation) and those requiring long-term (continuous/intermittent) catheterisation for conditions such as neurogenic bladder and/or children who have had surgery for urogenital abnormalities. Diagnosis of CAUTI can be challenging due to the high prevalence of asymptomatic bacteriuria (particularly in long-term catheterisation), non-specific symptoms and the lack of specificity of bedside tests. Prevention strategies, including judicious catheter use, adherence to aseptic technique, staff training, and implementation of CAUTI bundles, have been shown to substantially reduce the incidence of hospital CAUTI. For children with long-term catheterisation, evidence on optimal approaches to reduce risk of CAUTI remains limited, highlighting the need for further research and tailored guidelines.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Neonatal Hypernatraemia Caused by Congenital Nephrogenic Diabetes Insipidus.","authors":"Özlem Yüksel Aksoy, Aylin Kilinç Uğurlu, Şerife Suna Oğuz, Sare Gülfem Özlü, Burcu Yazicioğlu, Mihriban Inözü, Fatma Şemsa Çayci, Umut Selda Bayrakci","doi":"10.1111/jpc.70392","DOIUrl":"https://doi.org/10.1111/jpc.70392","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Propofol-Related Infusion Syndrome in Paediatrics-Cautious Consideration or Considered Caution? Case Report.","authors":"Michael A Stokes, Mark A J Dexter, Stephen Jacobe, Jonathan R Egan, Cindy G Berrueta Rodriguez, Ashfaque Quadir","doi":"10.1111/jpc.70393","DOIUrl":"https://doi.org/10.1111/jpc.70393","url":null,"abstract":"","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biosensor Compared With Standard Care to Identify Extravasation Injuries in Paediatric Intensive Care: A Randomised Controlled Trial.","authors":"Craig A McBride, Sarfaraz Rahiman, Melanie Kennedy, Luregn J Schlapbach, Jessica A Schults, Tricia M Kleidon, Thim Baveas, Rebecca Paterson, Joshua Byrnes, Robert S Ware, Amanda J Ullman","doi":"10.1111/jpc.70378","DOIUrl":"https://doi.org/10.1111/jpc.70378","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate whether, in children treated in paediatric intensive care units (PICU) with peripheral venous access devices (PVADs) receiving intermediate- or high-risk peripheral intravenous medications, the use of a tissue-infiltration biosensor (ivWatch), compared to standard care, reduces extravasation injuries.</p><p><strong>Methods: </strong>A superiority, parallel group randomised controlled trial conducted in a single Queensland quaternary hospital PICU from September 2020 to July 2022. Children with PVADs inserted in the distal half of the limb and receiving intermediate- to high-risk infusates for ≥ 24 h were randomly allocated in a 1:1 ratio to biosensor (ivWatch monitor applied within 10-15 mm of the PVAD tip) plus standard clinical observation, or standard observation alone. Primary outcome was extravasation severity on the 4-point Cincinnati Children's Hospital Medical Centre Extravasation Harm Scale. Injuries were compared between treatment groups using ordinal logistic regression.</p><p><strong>Results: </strong>A total of 175 children were enrolled, 88 to biosensor and 87 to standard care. Extravasation severity was similar between groups, with no, mild and moderate injury occurring in 56 (69%), 25 (30%) and 2 (2%) participants in the biosensor group and 61 (70%), 24 (28%) and 2 (2%) in the standard care group (proportional odds ratio = 1.13; 95% CI: 0.59, 2.15, p = 0.71). No statistically significant between-group differences in extravasation severity, volume, treatment sequelae, PVADs used or dwell time were observed. The biosensor was acceptable to nurses.</p><p><strong>Conclusions: </strong>In this PICU population, biosensor monitoring in addition to standard care did not significantly reduce extravasation injuries. The technology was acceptable to bedside nursing staff.</p><p><strong>Trial registration: </strong>ACTRN12620000317998.</p>","PeriodicalId":16648,"journal":{"name":"Journal of paediatrics and child health","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}