Hospital pediatrics最新文献_第2页

Association of Prenatal Fentanyl Exposure With Neonatal Opioid Withdrawal Syndrome Severity. 产前芬太尼暴露与新生儿阿片类戒断综合征严重程度的关系

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008956

Baillee Cooper, Willa Molho, Elisha M Wachman

{"title":"Association of Prenatal Fentanyl Exposure With Neonatal Opioid Withdrawal Syndrome Severity.","authors":"Baillee Cooper, Willa Molho, Elisha M Wachman","doi":"10.1542/hpeds.2025-008956","DOIUrl":"10.1542/hpeds.2025-008956","url":null,"abstract":"Objective: Opioid use disorder (OUD) in pregnancy has increased substantially, with illicit fentanyl now the most common illicit opioid. Limited data exist on the impact of antenatal fentanyl exposure on neonatal opioid withdrawal syndrome (NOWS). We aimed to evaluate whether antenatal fentanyl exposure is associated with increased NOWS severity.Patients and methods: We conducted a retrospective cohort study of mother-infant dyads with OUD between 2017 and 2024. Fentanyl exposure was determined by urine toxicology during the pregnancy and on admission. Infants were monitored using the Eat, Sleep, Console tool and a standardized NOWS protocol. NOWS hospitalization outcomes were compared between the fentanyl-exposed and nonexposed groups with adjustment for breastfeeding, year of birth, and relevant co-exposures.Results: Among 504 dyads, 131 (26.0%) had fentanyl exposure. Maternal demographics were similar between groups, but fentanyl was associated with higher rates of polysubstance use. Fentanyl-exposed infants were more likely to receive pharmacologic NOWS treatment (61.1% vs 40.8%, P < .01), scheduled methadone dosing, secondary pharmacologic agents (15.4% vs 7.4%, P = .03), and feeding tubes (40.0% vs 24.5%, P < .001). Hospital length of stay (22.1 vs 13.3 days, P < .01) and opioid treatment duration (14.2 vs 9.4 days, P < .01) were longer in the fentanyl-exposed cohort. In adjusted regression models, fentanyl exposure remained independently associated with prolonged hospitalization (mean difference 5.1 days [95% CI 1.7-8.5]) and increased odds of pharmacologic treatment (adjusted odds ratio 2.1 [95% CI 1.2-3.8]).Conclusion: Antenatal fentanyl exposure is strongly associated with intensive pharmacologic management and extended hospitalization. These findings are suggestive of more severe NOWS.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"460-465"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Reduced Overnight Vital Signs Improve Sleep in Hospitalized Children: A Nonrandomized Interventional Trial. 减少住院儿童的夜间生命体征可改善睡眠：一项非随机介入试验。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008964

Leandra Bitterfeld, Abigail F Fraley, Katie Smith, Julianne Mathias, Brianna Peterson, Frank A Cipriano

{"title":"Reduced Overnight Vital Signs Improve Sleep in Hospitalized Children: A Nonrandomized Interventional Trial.","authors":"Leandra Bitterfeld, Abigail F Fraley, Katie Smith, Julianne Mathias, Brianna Peterson, Frank A Cipriano","doi":"10.1542/hpeds.2025-008964","DOIUrl":"10.1542/hpeds.2025-008964","url":null,"abstract":"Objective: This study sought to determine the change in sleep quality and duration among children hospitalized on acute care units when overnight vital signs (VS) monitoring is eliminated, compared with children who receive standard-of-care VS monitoring.Patients and methods: This is a nonrandomized controlled study among children hospitalized on medical-surgical units (n = 109). The study intervention involved forgoing VS measurement at 0000 and 0400. The primary outcome was actigraphy-measured total sleep time, with secondary outcomes of actigraphy-measured wake status at midnight and 0700; actigraphy-measured and self-reported nocturnal wake frequency and duration; and self-reported total sleep time, restfulness upon waking, and sleep disturbances.Results: Actigraphy total sleep time in the intervention group was 49.2 minutes longer than in the control group (P = .04). Sleep efficiency, wake after sleep onset, and wake episodes were not different. There was also no difference in the number of children asleep at midnight, but more children in the intervention group were asleep at 0700 than in the control group (77% vs 55%, P = .03). Self-reported restfulness and sleep disturbances were also superior in the intervention group. There were no unplanned pediatric intensive care unit (ICU)/cardiac ICU transfers, rapid response activations, code sepsis alerts, or code blue events.Conclusions: Forgoing overnight VS measurement among children hospitalized on medical-surgical units was associated with an increase in overnight sleep duration but did not decrease the overall number of nighttime interruptions or time awake during the night. VS measurement reduction was also safe and may be important for children to achieve adequate sleep in the hospital.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"376-383"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Responding to Gaza's Medical Crisis: The Role of US Hospitals. 应对加沙医疗危机：美国医院的作用。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008857

Sabreen Akhter

引用次数: 0

Postoperative Fever in Children Hospitalized After Surgery: Incidence and Risk Factors. 手术后住院儿童的术后发热：发病率和危险因素。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008660

Peter J Hong, Lynne Ferrari, Steven Staffa, Ben Reis, Maria Osipovich, Jonathan D Hron, Jay G Berry

{"title":"Postoperative Fever in Children Hospitalized After Surgery: Incidence and Risk Factors.","authors":"Peter J Hong, Lynne Ferrari, Steven Staffa, Ben Reis, Maria Osipovich, Jonathan D Hron, Jay G Berry","doi":"10.1542/hpeds.2025-008660","DOIUrl":"10.1542/hpeds.2025-008660","url":null,"abstract":"Background and objectives: Pediatricians increasingly engage in medical cotreatment of pediatric patients undergoing surgical procedures. Understanding the natural history of postoperative fever (PoF) is paramount. We assessed the incidence of PoF by surgical procedure as well as patient- and procedure-level risk factors among children hospitalized after surgery.Methods: This study is a retrospective analysis of inpatient surgical admissions at a children's hospital from January 1, 2016 to December 31, 2023. PoF was defined as a body temperature of 38.0 °C or higher within 7 days after surgery. Mixed-effects logistic regression was used to assess risk factors for PoF, including number of chronic conditions, weight Z score, operative duration, and demographics.Results: Of 35 030 hospitalizations, 20.3% of patients had PoF. Of encounters with PoF, the median peak temperature was 38.4 °C (IQR: 38.1-38.9), occurring at a median of 26.7 hours postoperatively (IQR: 10.9-52.2). PoF rate by procedure domain ranged from 8.1% for ophthalmologic to 35.2% for cardiovascular. In a multivariable analysis, controlling for procedure type, the highest adjusted odds ratios (aOR) for PoF occurred with an operative duration of 6 or more hours vs less than 2 hours (aOR: 2.72 [95% CI, 2.44-3.04]), patients aged 1 year to 4 years vs 16 years to 21 years at procedure (aOR: 2.09 [95%, CI 1.87-2.34]), weight Z scores of less than -2 vs more than 2 (aOR: 1.46 [95% CI, 1.24-1.72]), and 9 or more vs 0 to 1 body systems affected by chronic condition (aOR: 1.29 [95% CI, 1.13-1.49]).Conclusions: PoF occurred in 1 in 5 cases, with the rate varying substantially by procedure. Longer operative time, younger age at procedure, lower weight Z score, and greater number of chronic conditions were positively associated with PoF.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"357-365"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147676443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Do Chronic Conditions Increase Risk for Postoperative Fevers? 评论-术后住院儿童的术后发热：发病率和危险因素。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-009174

Mirna Giordano, Katarzyna M Stoj, Moises Auron, David Rappaport

引用次数: 0

Inflammatory Markers and the Youngest Febrile Infants. 炎症标志物与最小发热婴儿。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-009191

Kenneth B Roberts, Robert H Pantell

引用次数: 0

Hospitalists' Practices and Barriers to Health-Literate Communication in Pediatric Inpatient Care. 儿科住院护理中医院医师的实践与健康素养沟通障碍。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008574

Prabi Rajbhandari, Jonathan VanGeest, Daniel H Grossoehme, Michael J Oravec, Alexander F Glick

{"title":"Hospitalists' Practices and Barriers to Health-Literate Communication in Pediatric Inpatient Care.","authors":"Prabi Rajbhandari, Jonathan VanGeest, Daniel H Grossoehme, Michael J Oravec, Alexander F Glick","doi":"10.1542/hpeds.2025-008574","DOIUrl":"10.1542/hpeds.2025-008574","url":null,"abstract":"Objective: Health literacy is a critical determinant of health care outcomes, particularly in pediatric inpatient care, where hospitalists play a pivotal role. However, hospitalists often face challenges in effectively addressing health literacy with patients and caregivers. This study evaluated pediatric hospitalists' attitudes, practices, perceived effectiveness of commonly used communication techniques, and barriers to health-literate communication.Methods: We conducted a multicenter, cross-sectional survey through the Pediatric Research in Inpatient Settings (PRIS) network from July to September 2024. The survey assessed awareness, communication practices, and barriers to health-literate communication using Likert scales and predefined options. Data were analyzed using descriptive statistics.Results: A total of 55 out of 100 (55%) PRIS site leads responded. Among respondents, 67% were unaware of the universal precautions approach for health literacy, although those aware reported using it regularly (72%). All agreed that health literacy is either \"extremely important\" (67%) or \"very important\" (33%) in inpatient care. The most-frequently employed communication technique was using simple language (98%). Hospitalists viewed simple language (96%) and teach-back (87%) as the most effective strategies. Time constraints (95%), lack of patient-education materials in languages other than English (89%), and volume and complexity of information to be covered (87%) were identified as major barriers for health-literate communication.Conclusions: Pediatric hospitalists recognize the importance of health literacy, but several barriers impact consistent use of health literacy-informed communication strategies. Future work should examine the impact of organizational health literacy approaches and incorporating additional formal communication training for hospitalists.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e328-e333"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Deimplementing Overnight Vital Sign Monitoring in Pediatrics: Progress, Pitfalls, and the Path Forward. 儿科夜间生命体征监测的取消：进展、缺陷和前进的道路。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-009126

Jessica Jones, Lauren M McDaniel

引用次数: 0

Dental Surgeries in Hospitals and Surgery Centers for Children With Developmental Disabilities. 在医院和手术中心为有发育障碍的儿童进行牙科手术。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008912

Katherine M Rancaño, Xiaoxi Zhao, Elizabeth Munnich, Christopher Whaley, Jessica Y Lee, Ashley M Kranz

{"title":"Dental Surgeries in Hospitals and Surgery Centers for Children With Developmental Disabilities.","authors":"Katherine M Rancaño, Xiaoxi Zhao, Elizabeth Munnich, Christopher Whaley, Jessica Y Lee, Ashley M Kranz","doi":"10.1542/hpeds.2025-008912","DOIUrl":"10.1542/hpeds.2025-008912","url":null,"abstract":"Background and objective: Children with intellectual disabilities and related conditions (IDRC) and autism often require dental treatment in surgical settings. Studies of older adults suggest that ambulatory surgery centers (ASCs) can reduce costs without reducing quality, but it is unknown whether this is true for children with autism and IDRC and dental surgeries. This study compared outcomes among children with IDRC and autism receiving dental caries-related surgeries at ASCs and hospital outpatient departments (HOPDs).Methods: This cross-sectional analysis used Medicaid data from 29 states (2016-2020) to examine 17 552 outpatient dental surgeries in ASCs and HOPDs for children with IDRC or autism. Regression models were used to examine whether outcomes varied by setting of care (ASC vs HOPD). The following outcomes were included: days from diagnosis to surgery, Medicaid payment, emergency department (ED) visits, and hospitalization after surgery.Results: Multivariate regression results indicate time from diagnosis to surgery was, on average, 8.7 days sooner for a child with autism and 13.2 days sooner for a child with IDRC if furnished in an ASC compared with a HOPD (P < .001 for both). Average Medicaid payment was $419 and $363 less in an ASC than HOPD for a child with autism (P = .003) or IDRC (P = .02), respectively. The likelihood of an ED visit or hospitalization was lower in an ASC than HOPD for a child with IDRC (P < .001), but not autism (P > .05).Conclusions: Increasing use of ASCs for dental care may increase timely receipt of care and lower Medicaid costs without increasing adverse outcomes for children with autism and IDRC.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"419-426"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Research Consenting Practices in Critically Ill Children: A Scoping Review. 危重儿童的研究同意实践：范围综述。

IF 2.1

Hospital pediatrics Pub Date : 2026-05-01 DOI: 10.1542/hpeds.2025-008915

Sarah B Kandil, Madhuradhar Chegondi, Melissa C Funaro, E Vincent S Faustino

{"title":"Research Consenting Practices in Critically Ill Children: A Scoping Review.","authors":"Sarah B Kandil, Madhuradhar Chegondi, Melissa C Funaro, E Vincent S Faustino","doi":"10.1542/hpeds.2025-008915","DOIUrl":"10.1542/hpeds.2025-008915","url":null,"abstract":"Clinical trials are critical for advancing care in critically ill children, yet enrollment remains challenging because of surrogate decision-making, narrow recruitment windows, and caregiver stress. To evaluate strategies aimed at improving enrollment, particularly around consent, in clinical trials involving critically ill children, we conducted a scoping review of literature through December 2024. Studies involving children aged less than 18 years in critical care settings that described factors targeting consent were included. Nonhuman, hypothetical, and non-health care setting studies were excluded. Two reviewers independently screened studies, resolving conflicts through discussion. Of 2770 studies screened, 26 met the inclusion criteria. Study designs varied and included randomized controlled trials, observational studies, and qualitative research. The populations targeted included neonatal (12), pediatric (12), cardiac (1), and mixed critical care units (1). Six themes emerged as barriers to consent: family/social dynamics, emotional/psychological stress, limited understanding of clinical trials, logistical issues, clinical concerns, and study design. Facilitators included parental preferences, communication approaches, increased awareness, family motivation, and recruitment strategies. Alternative consent models, such as deferred consent, and multicenter designs were associated with improved enrollment. Co-enrollment and telesimulation had limited impact. Although few studies have directly focused on improving consent, strategies shown to enhance overall enrollment should be incorporated into future pediatric critical care trials.","PeriodicalId":38180,"journal":{"name":"Hospital pediatrics","volume":" ","pages":"e365-e380"},"PeriodicalIF":2.1,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0