SOJ Pediatrics and Clinical Neonatology最新文献

Liver Transplantation in Children and Impact of Intra-operative Goal Directed Therapies on Postoperative Outcome 儿童肝移植及术中定向治疗对术后预后的影响

SOJ Pediatrics and Clinical Neonatology Pub Date : 2021-07-23 DOI: 10.21203/RS.3.RS-744584/V1

C. Kumba

{"title":"Liver Transplantation in Children and Impact of Intra-operative Goal Directed Therapies on Postoperative Outcome","authors":"C. Kumba","doi":"10.21203/RS.3.RS-744584/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-744584/V1","url":null,"abstract":"\u0000 Background: Liver transplantation is a hemorrhagic surgery with high postoperative complication rates in terms of organ dysfunction and infections. We conducted a retrospective observational monocentric study that had the objectives of determining predictors of postoperative outcome in children. In the initial cohort, 19 children underwent liver transplantation. A description of the postoperative outcomes of these patients was undertaken.Objective: To describe intraoperative and postoperative outcomes in children undergoing liver transplantation and to propose intraoperative management implementation measures for postoperative outcome improvement.Methods: Secondary analysis of liver transplanted patients included in the initial study.Results: There were 19 patients who underwent liver transplantation with a median age of 31[2-154] months. Five patients had re-operations (26.3%). Fourteen (73.7%) had intraoperative and/or postoperative complications. Five (26.3%) had intraoperative hemorrhagic shock. One (5.3%) had postoperative respiratory failure, one (5.3%) had postoperative multiple organ failure, two (10.5%) had postoperative neurologic failure and five (26.3%) had cardio-circulatory failure. One (5.3%) had postoperative pulmonary sepsis, five (26.3%) had postoperative abdominal sepsis, and six (31.6%) had postoperative septicemia. Intra-operative transfusion rate was 100%. In-hospital mortality rate was 10.5% (two patients).Conclusion:There were multiple postoperative adverse outcome predictors. Optimal intraoperative patient management with transfusion guided by point-of-care viscoelastic devices and goal-directed fluid and hemodynamic therapy with validated parameters and tools in children is a possible pathway to upgrade postoperative evolution in pediatric liver transplantation.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128140306","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: 6

Hemoglobin Levels and Postoperative Outcome in Pediatric Surgical Patients 儿科外科患者血红蛋白水平与术后预后

SOJ Pediatrics and Clinical Neonatology Pub Date : 2021-06-30 DOI: 10.21203/rs.3.rs-669069/v1

C. Kumba

{"title":"Hemoglobin Levels and Postoperative Outcome in Pediatric Surgical Patients","authors":"C. Kumba","doi":"10.21203/rs.3.rs-669069/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-669069/v1","url":null,"abstract":"\u0000 Background: Postoperative outcome in children is multifactorial. Among the reported predictors of postoperative outcome, preoperative anemia has been related to adverse outcome in children. A secondary analysis was undertaken to determine the correlation between hemoglobin levels and postoperative outcome in children included in a cohort of an observational pediatric study published previously since this analysis has not been done.Objective: To determine the correlation between preoperative, intra-operative, postoperative hemoglobin levels and postoperative outcome in children in neurosurgery, abdominal and orthopedic surgery.Methods: Secondary analysis of a sub-cohort of 252 pediatric surgical patients with a median age of 62 months [12.50-144.00].Results: Preoperative hemoglobin levels were negatively correlated to length of stay in the intensive care unit (LOSICU) (p=0.002), to length of hospital stay (LOS) (p<0.0001), to the number of patients with intra-operative and/or postoperative complications (p<0.0001) and to re-surgery (p<0001). Low preoperative hemoglobin levels below 6 g/dL were correlated to higher postoperative LOSICU and LOS.Intra-operative hemoglobin levels were negatively correlated to LOS (p<0.0001) and to the number of patients with intra-operative and/or postoperative complications (p=0.004). Low intra-operative hemoglobin levels below 5 g/dL were correlated to higher LOS. Postoperative hemoglobin levels were positively correlated to LMV (p=0.002).Conclusion: Hemoglobin levels are among other multifactorial predictors of postoperative outcome in pediatric surgical patients emphasizing the importance of a global patient blood management implementation program to improve outcome in surgical children.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116385866","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: 2

Major Abdominal Surgery, Neurosurgery, Orthopedic Surgery in Children aged between 10 and 18 years and Postoperative Outcome 10 - 18岁儿童的腹部外科、神经外科、骨科手术和术后结果

SOJ Pediatrics and Clinical Neonatology Pub Date : 2021-06-29 DOI: 10.21203/rs.3.rs-666955/v1

C. Kumba

{"title":"Major Abdominal Surgery, Neurosurgery, Orthopedic Surgery in Children aged between 10 and 18 years and Postoperative Outcome","authors":"C. Kumba","doi":"10.21203/rs.3.rs-666955/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-666955/v1","url":null,"abstract":"\u0000 BackgroundIn a previously conducted monocentric retrospective study, predictors of postoperative outcome in children included American Society of Anesthesiologists score, transfusion, emergency interventions, surgery and age. A study has been undertaken to describe postoperative outcome in patients aged between 10 and 18 years included in the initial study in abdominal surgery, neurosurgery and orthopedics.AimsTo describe postoperative outcome in children aged between 10 and 18 years.MethodsSecondary analysis of postoperative outcome in children aged between 10 and 18 years included retrospectively in the initial study of 594 patients. The study was approved by the Ethics Committee.ResultsThere were 221 children with a mean age of 165.5±24.3 months in abdominal surgery, neurosurgery and orthopedics.16.3% patients had intra-operative or postoperative complications. Intra-operatively, 3.2%had hemorrhagic shock, 0.45% anaphylaxis and 0.45% respiratory failure. Postoperatively,3.2% had neurologic failure, 2.3% respiratory failure, 0.45% cardio-circulatory failure, 0.45%endocrinal failure, 0.45% had hepatic failure, 0.45% multiple organ failure, and 0.45% had renal failure. In-hospital mortality rate was 0.45%.ConclusionThese results emphasize the importance of optimizing intra-operative management in critically ill patients in major surgery with goal directed therapies in order to improve postoperative outcome.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"776 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124668554","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: 3

Heart Rate Variability (HRV) is Extubation Failure Predictor in Pediatrics? 心率变异性(HRV)是儿科拔管失败的预测因子?

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2022.02.000517

Dias Cm

{"title":"Heart Rate Variability (HRV) is Extubation Failure Predictor in Pediatrics?","authors":"Dias Cm","doi":"10.53902/sojpcn.2022.02.000517","DOIUrl":"https://doi.org/10.53902/sojpcn.2022.02.000517","url":null,"abstract":"Background: Heart rate variability (HRV) is an indicator of autonomic activity in the regulation of circulation and changes have been associated with several pathological conditions. Aims: The aim of the study was to acess the HRV as a predictor of extubation failure in pediatrics. Methods: In this prospective observational pilot study, we included all consecutive patients from 1 month to 18 years of age who were admitted to the PICU in the ICr-HCFMUSP, São Paulo - Brazil. They were submitted to the spontaneous breathing test (SBT) and evaluated by HRV by the time and frequency domain variables derived from the Polar V800 equipment and the Kubios HRV Standart® program. Results: A total of 36 patients [age 17 (2-216) months; male/female: 20/16; PIM2 3.9 (0.3-45.5); CRP (C-reactive protein) 20.2 (0.1-327); time of mechanical ventilation 5.0 (1.0-64.0) days] were included the study. The main diagnoses were 17 patients with lung diseases, 06 liver diseases, 08 neurological diseases, 03 sepsis/ septic shock, 01 nephropatic and 01 gastric disease. The data analyzed on HRV described in Table 3. Conclusions: From the data analyzed, it can be concluded that the analysis of heart rate variability was not a predictor of success/failure of tracheal extubation for the pediatric sample studied.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125123421","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

Maternal and Neonatal Idiopathic Thrombocytopenic Purpura 产妇和新生儿特发性血小板减少性紫癜

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2020.01.000504

Kendall Steadmon

引用次数: 0

Lower IGFBP-1 Plasma Levels in Mothers of Autistic Children 自闭症儿童母亲血浆IGFBP-1水平较低

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2022.02.000516

A.J. Russo

引用次数: 0

Research Involving Children and Adolescents in Situations of Violence: Ethical Aspects to be Considered 涉及儿童和青少年在暴力情况下的研究:伦理方面要考虑

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2022.02.000514

V. Platt

引用次数: 0

Monitoring Of Regional Oxygen Saturation in Very Low Birth Weight Newborns Using Infrared Spectroscopy: Case Series 用红外光谱监测极低出生体重新生儿的局部氧饱和度:病例系列

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2022.02.000519

C. Johnston

引用次数: 0

Acute Kidney Injury in Children 儿童急性肾损伤

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2021.01.000507

N. Bresolin

{"title":"Acute Kidney Injury in Children","authors":"N. Bresolin","doi":"10.53902/sojpcn.2021.01.000507","DOIUrl":"https://doi.org/10.53902/sojpcn.2021.01.000507","url":null,"abstract":"Recent literature data has shown that acute kidney injury (AKI) is a common occurrence in critically ill children and that it is associated with high rates of morbidity and mortality, even after adjusting for other risk factors. In addition, it can result in long-term sequelae translated by the development of arterial hypertension, microalbuminuria and chronic renal dysfunction. High degree of suspicion, early diagnosis based on the recognition of patients at risk and the use of new criteria for the diagnosis and classification of AKI and, whenever possible, using the new biomarkers can positively alter the prognosis of these patients. Although there is still no specific treatment for AKI, it is recommended to focus on the immediate institution of preventive measures in order to maintain renal hemodynamics, early treatment of septic patients, elimination of exogenous nephrotoxins, recognition and management of patients with AKI secondary to high levels of endotoxins, control and normalization of volume after the initial phase of fluid resuscitation, sufficient nutritional support, and recognition and treatment of the underlying causes are necessary. Patients that fail with conservative care will need renal replacement therapy.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115455743","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

Various Aspects of Nursing as A Science and Its Impact on Nursing 护理作为一门科学的各个方面及其对护理的影响

SOJ Pediatrics and Clinical Neonatology Pub Date : 1900-01-01 DOI: 10.53902/sojpcn.2022.02.000518

Melissa A Rice RN

{"title":"Various Aspects of Nursing as A Science and Its Impact on Nursing","authors":"Melissa A Rice RN","doi":"10.53902/sojpcn.2022.02.000518","DOIUrl":"https://doi.org/10.53902/sojpcn.2022.02.000518","url":null,"abstract":"This paper explores the various aspects of nursing as a science and its impact on nursing since its conception. A review of three major peer reviewed articles1-3 was completed and defined nursing as a science founded on empiric knowledge or scientific knowledge and expanded by nursing theory through the four ways of knowing or epistemology in nursing, nursing conceptual frameworks through nursing theorists, and evidence-based practice (EBP) models for care Chinn and Kramer4 to support nursing practice through educational program development. Key concepts included: interactive training programs, team resuscitation programs, minimum length of time and work hours for new nurse orientation programs, a formalized new graduate nurse program to increase transition scores for new graduate nurse programs. Nursing as a science truly became known and recognized in the 1950’s and expanded in the 1990’s through the introduction of EBP Chinn and Kramer.4 Through use of empiric knowledge, scientific research, application of nursing theory, and nurses training program development nursing as a profession can advance and meet future challenges of a changing and challenging healthcare system.","PeriodicalId":408443,"journal":{"name":"SOJ Pediatrics and Clinical Neonatology","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130736680","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