中国小儿急救医学最新文献

{"title":"Cardiac arrest outcomes in children with preexisting neurobehavioral impairment","authors":"方伯梁, 钱素云","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.11.101","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.11.101","url":null,"abstract":"目的 \u0000了解纳入两项关于目标体温控制的平行随机临床研究之一的已存在神经行为损害儿童的存活情况及3个月，12个月时神经行为预后。 \u0000 \u0000 \u0000设计 \u0000二次分析儿童心脏骤停后治疗性低体温(therapeutic hypothermia after pediatric cardiac arrest，THAPCA)院内及院外试验数据。 \u0000 \u0000 \u0000场所 \u0000美国，加拿大及英国的41家PICU。 \u0000 \u0000 \u0000对象 \u0000共纳入84例患儿[59例院内心跳骤停(in-hospital cardiac arrest，IH-CA)，25例院外心跳骤停(out-of-hospital cardiac arrest，OH-CA)]，男49例，女35例，平均年龄4.6岁(标准差5.36)，均在CA前已存在神经行为损害[Vineland适应性行为量表第2版(Vineland Adaptive Behavior Scales-Second Edition，VABS-Ⅱ)综合评分<70]。所有患儿均需胸外按压≥2 min，昏迷且循环恢复后需要机械通气。 \u0000 \u0000 \u0000干预 \u0000采用VABS-Ⅱ评估基线(反应CA前状态)，CA后3个月、12个月神经行为功能，随后进行现场认知评估。VABS-Ⅱ评分100±15，分值越高功能越佳。分析结果评估存活情况，VABS-Ⅱ改变及认知功能。 \u0000 \u0000 \u0000测量方法与主要结果 \u000028/84(33%)存活至12个月[IH-CA为19/59 (32%)，OH-CA为9/25 (36%)]。IH-CA组存活率显著低于THAPCA组内CA前无神经行为损害患儿。25例存活患儿VABS-Ⅱ降低≤15分[IH-CA为18/59 (31%)，OH-CA为7/25 (28%)]。CA后3个月，平均VABS-Ⅱ评分显著降低(P<0.05)。12个月时OH-CA患儿VABS-Ⅱ降低(P<0.05)，IH-CA无降低；43% (12/28)评分无变化或改善。 \u0000 \u0000 \u0000结论 \u0000本研究证实了将此部分人群纳入临床神经保护研究的可行性，实用性及面临的挑战。既往存在神经行为损害的儿童中，1/3存活至12个月且神经行为预后差异显著。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"877-877"},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41608058","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}

{"title":"Imaging features of adenovirus pneumonia in children","authors":"Yan Wang, Yun Peng","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.002","url":null,"abstract":"The detailed and advanced chest radiographic features of adenovirus pneumonia in children was described.The most frequently dominant imaging pattern adenovirus pneumonia in children was bilateral fused patchy parenchymal opacities or consolidation with a peribronchovascular distribution and bilateral lung hyperinflation.Severe adenovirus pneumonia may be associated with complications and sequela such as bronchiolitis obliterans.Presence of dominant consolidation findings during the early stage in adenovirus pneumonia may be a noteworthy finding for differentiating this condition from other types of viral pneumonia.A better understanding of the typical radiographic findings of adenoviral pneumonia in children may help physicians identify infections at an earlier stage and elucidate the natural course of the disease. \u0000 \u0000 \u0000Key words: \u0000Children; Pneumonia; Adenoviruses; Radiographic","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"725-728"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42013124","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}

{"title":"Early recognition and treatment of adenovirus pneumonia complicated with bronchiolitis obliterans","authors":"H. Fan, G. Lu, J. Tao","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.006","url":null,"abstract":"Adenovirus pneumonia is a common infectious disease of the respiratory tract in children, and severe cases developed post-infectious bronchiolitis obliterans (PIBO), which is chronic airflow obstruction syndrome caused by small airway inflammatory injury.The major clinical manifestations of PIBO are persistent cough, wheezing and dyspnea after acute stage of adenovirus pneumonia, and nowadays there is no specific treatment.PIBO has a prolonged course and very poor prognosis without early intervention, and it influences patients on health and life seriously.The article reviewed the early recognition and the therapeutic progress of adenovirus pneumonia complicated with PIBO. \u0000 \u0000 \u0000Key words: \u0000Adenovirus; Bronchiolitis obliterans; Recognition; Treatment","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"742-745"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49514297","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}

{"title":"Epidemiological investigation of adenovirus pneumonia in children in Hunan province","authors":"Qin Liu, Leyun Xie, Bing Zhang, L. Zhong, Tian Yu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.008","url":null,"abstract":"Objective \u0000To investigate the detection results and epidemiological characteristics of human adenovirus (HAdV) among children with community acquired pneumonia (CAP) in Hunan province. \u0000 \u0000 \u0000Methods \u0000A descriptive retrospective survey was conducted to investigate the clinical epidemiological data of 33 056 children with CAP admitted to the Children′s Medical Center of Hunan People′s Hospital from May 1st, 2014 to April 30th, 2019.The seasonal distribution and demographic characteristics of HAdV infection were analyzed. \u0000 \u0000 \u0000Results \u0000(1) A total of 33 056 children with CAP were included in this study.A total of 3 770 children with HAdV positive were detected, with a total detection rate of 11.40% (3 770/33 056). From May 2014 to April 2019, the detection rates of adenovirus in different years were 13.76%, 8.57%, 7.94%, 9.53%, 12.36% and 24.75% respectively.Adenovirus detection rate reached its peak in 2019.(2) The detection rate of HAdV among male children were higher than that among female children (χ2= 6.374, P=0.012). Among 3 770 children with HAdV infection, 3 036 (80.53%) were from 6 months to 5 years old.The detection rate of adenovirus were different in different age groups.The highest detection rate was 16.65% in 3 to 5 years old group (χ2=526.494, P<0.001). Among children with severe pneumonia, the detection rate of adenovirus was 18.43% (415/2 252). The detection rate of adenovirus was the highest in the age group of 6 months to 1 years, and the difference was statistically significant(χ2=71.485, P<0.001). (3) The detection rate of adenovirus was the lowest in autumn, and the other three seasons were all high- incidence seasons (χ2= 268.744, P<0.001). (4) The hospitalization days of adenovirus pneumonia were longer than those of non-adenovirus pneumonia (Z=-10.419, P<0.001). \u0000 \u0000 \u0000Conclusion \u0000The prevalence of HAdV infection is related to age, season and sex.The susceptibility of adenovirus varies with severity of pneumonia.We should be vigilant against the outbreak of adenovirus infection characterized by years. \u0000 \u0000 \u0000Key words: \u0000Community acquired pneumonia; Adenovirus; Children; Epidemiology","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"752-757"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43576158","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}

{"title":"Current status and challenges of diagnosis and treatment of adenovirus pneumonia in children","authors":"Suyun Qian","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.001","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.001","url":null,"abstract":"儿童是腺病毒肺炎的易感人群，重症患儿并发症多、病死率高且存活者容易遗留后遗症。目前缺乏特效抗腺病毒药物，临床以综合治疗为主，诸多治疗方法的疗效和时机尚存在争议。早识别，早诊断，合理综合治疗，防治并发症仍是现阶段降低其病死率、致残率的关键措施。","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"721-724"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43447969","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}

{"title":"Severe adenovirus infection damage to the blood system","authors":"Xiaoxu Ren","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.003","url":null,"abstract":"Severe adenovirus pneumonia and disseminated adenovirus infection can cause damage to the blood system.Those damages included coagulopathy, hemolytic phagocytosis, acquired hemophagocytic lymphohistiocytosis, leukocyte abnormalities.All of the above injuries are related to the uncontrolled immune inflammatory response to adenovirus infection.Direct injury caused by adenovirus infection and immune inflammation are the main injury mechanisms. \u0000 \u0000 \u0000Key words: \u0000Adenovirus infection; Coagulopathy; Acquired hemophagocytic lymphohistiocytosis; Immune inflammation","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"729-733"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42895078","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}

{"title":"Analysis of respiratory pathogens for children respiratory tract infection by capillary electrophoresis-based multiplex PCR","authors":"Liu Yuqi, Yanzhi Huang, Liwei Sun, Hongbo Jiang, Yuling Tian, Tingyu Meng, Yan Ma, H. Yan, Yanling Zhao, Yi-la Ma","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.010","url":null,"abstract":"Objective \u0000To investigate the effect of capillary electrophoresis-based multiplex PCR (CEMP) in detecting pathogens for children respiratory tract infection, and to provide scientific basis for clinical diagnosis and treatment rapidly and accurately. \u0000 \u0000 \u0000Methods \u0000The cases were defined according to the national monitoring program of febrile respiratory syndrome during the 12th Five-Year Plan, and the samples were collected from nasopharyngeal swabs, bronchoalveolar lavage fluid and sputum of children with respiratory tract infection hospitalized in Changchun Children′s Hospital from January 2017 to February 2018.Multiplex PCR amplification was performed by one-step method, then PCR products were separated by DNA length size with capillary electrophoresis and pathogens were analyzed by \"Genemapper software\" software.Detecting pathogens included Influenza A virus (InfA), Human Adenovirus (HADV), Boca virus (Boca), Human Rhinovirus (HRV), Novel InfA-09H1 (InfA-09H1) and Seasonal Influenza virus H3N2 (InfA-H3N2), Parainfluenza virus (HPIV), Human metapneumonia virus (HMPV), Influenza B virus (InfB), Mycoplasma pneumoniae (Mp), Chlamydia pneumoniae (CP), Human Coronavirus (HCOV), Human Respiratory Syncytial virus (HRSV). \u0000 \u0000 \u0000Results \u0000The effective detection rate of the CEMP assay was 95.71%.The positive detection rate of respiratory tract pathogens was 62.84% and the mixed infection rate was 9.61%.The mixed infection was mainly InfA and HRSV.The highest three positive rates were named InfA, HRSV and Mp.The positive rate of HRSV was significantly higher in the 0-3 age group than that in older group.Different pathogens were detected in different age groups, and the high-occurrence season of respiratory tract infection with virus was from December to March of the next year.InfA-09H1 was the main prevalent influenza virus in January, February and March 2017, InfA-H3N2 was the main prevalent influenza virus in November and December 2017, and the outbreak of InfB was happened in Changchun in late 2017 and early 2018.HRSV was detected only in the coldest season in Changchun from November to March of the next year.Different pathogens were detected in different respiratory infection.HRSV was the main pathogen detected in pneumonia; InfA-03H2 and HPIV were the main pathogens detected in acute bronchitis; HRV and InfA were the main pathogens detected in upper respiratory tract infection. \u0000 \u0000 \u0000Conclusion \u0000CEMP is an efficient, rapid and accurate method for the detection of pathogens in patients with respiratory tract infections, and it will have a broad application prospect to develop reagents suitable for clinical diagnosis. \u0000 \u0000 \u0000Key words: \u0000Capillary electrophoresis; Respiratory tract infection; Respiratory pathogen; Multiplex PCR","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"764-770"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69967776","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}

{"title":"Application of blood purification in children with severe adenoviral disease","authors":"Yun Cui","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.004","url":null,"abstract":"Severe hypoxia respiratory failure or acute respiratory distress syndrome, acute renal injury, liver function disorder, and multiple organ dysfunction syndrome caused by severe adenoviral disease have high mortality.Blood purification have become more widely available for acute renal injury, fluid overload, hyperlactacidemia, inflammatory reaction, coagulopathy and so on.The methods include renal replacement therapy(RRT) and therapeutic plasma exchange, usually combined with extracorporeal membrane oxygenation (ECMO). The appropriate blood purification strategy has not been available.Based on experience of RRT in acute renal injury, liver dysfunction, currently continuous renal replacement therapy/RRT technologies are reasonable used by personalized decision-making. \u0000 \u0000 \u0000Key words: \u0000Continuous renal replacement therapy; Therapeutic plasma exchange; Adenoviral disease; Adenoviral pneumonia; Critically ill; Children","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"734-737"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45105963","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}

{"title":"Application of ECMO in the treatment of severe adenovirus pneumonia","authors":"Zi-hao Yang","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.005","url":null,"abstract":"Adenovirus is one of the common pathogens causing respiratory tract infection in children, which can cause severe pneumonia.Severe adenovirus pneumonia has an acute onset, rapid progress, and many complications, but there is no specific treatment and the mortality rate is high.Mechanical ventilation is an important means of respiratory support for the treatment of severe adenoviral pneumonia, and ventilator-associated lung injury is an inevitable drawback of mechanical ventilation.ECMO can replace and support cardiopulmonary function for a long time, reduce the occurrence of such damage, and improve oxygenation.When patients with severe adenovirus pneumonia develop respiratory failure or ARDS, and conventional treatment fails to improve hypoxemia, or accompanied by air leakage and other complications, ECMO treatment should be considered.However, there are few relevant studies in China, and further experience needs to be accumulated in the selection of respiratory support modes, intervention opportunities and management points of ECMO respiratory support for severe adenovirus pneumonia. \u0000 \u0000 \u0000Key words: \u0000Extracorporeal membrane oxygenation; Severe adenovirus pneumonia; Respiratory support","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"738-741"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44699624","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}

{"title":"Current status of Acinetobacter baumannii infection and antibiotic selection in children","authors":"Caifang Xu","doi":"10.3760/CMA.J.ISSN.1673-4912.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1673-4912.2019.10.011","url":null,"abstract":"Acinetobacter baumannii is an important pathogen of clinical infection in critically ill patients.The clinical detection rate of Acinetobacter baumannii is increasing and the drug resistance is becoming more and more serious.The selection of antibiotics to antibiotic-resistant Acinetobacter baumannii is very limited, particularly in children with the special age and physiological characteristics, which aggravates the clinical burden.This article reviewed the status of Acinetobacter baumannii infection, especially on different diseases including pneumonia, bloodstream infections, intracranial infections and antibiotics using. \u0000 \u0000 \u0000Key words: \u0000Acinetobacter baumannii; Drug resistance; Children; Antibiotics","PeriodicalId":68901,"journal":{"name":"中国小儿急救医学","volume":"26 1","pages":"771-776"},"PeriodicalIF":0.0,"publicationDate":"2019-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48503058","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}