Intensive care medicine. Paediatric and neonatal最新文献

{"title":"High-flow nasal oxygen in infants and children for early respiratory management of pneumonia-induced acute hypoxemic respiratory failure: the CENTURI randomized clinical trial","authors":"Sasidaran Kandasamy, R. Rameshkumar, Thangavelu Sangaralingam, N. Krishnamoorthy, N. C. G. Shankar, Vimalraj Vijayakumar, B. Sridharan","doi":"10.1007/s44253-024-00031-8","DOIUrl":"https://doi.org/10.1007/s44253-024-00031-8","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"52 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140356331","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":"Safety of primary nasotracheal intubation in the pediatric intensive care unit (PICU).","authors":"Laurence Ducharme-Crevier, Jamie Furlong-Dillard, Philipp Jung, Fabrizio Chiusolo, Matthew P Malone, Shashikanth Ambati, Simon J Parsons, Conrad Krawiec, Awni Al-Subu, Lee A Polikoff, Natalie Napolitano, Keiko M Tarquinio, Asha Shenoi, Andrea Talukdar, Palen P Mallory, John S Giuliano, Ryan K Breuer, Krista Kierys, Serena P Kelly, Makoto Motomura, Ron C Sanders, Ashley Freeman, Yuki Nagai, Lily B Glater-Welt, Joseph Wilson, Mervin Loi, Michelle Adu-Darko, Justine Shults, Vinay Nadkarni, Guillaume Emeriaud, Akira Nishisaki","doi":"10.1007/s44253-024-00035-4","DOIUrl":"10.1007/s44253-024-00035-4","url":null,"abstract":"<p><strong>Background: </strong>Nasal tracheal intubation (TI) represents a minority of all TI in the pediatric intensive care unit (PICU). The risks and benefits of nasal TI are not well quantified. As such, safety and descriptive data regarding this practice are warranted.</p><p><strong>Methods: </strong>We evaluated the association between TI route and safety outcomes in a prospectively collected quality improvement database (National Emergency Airway Registry for Children: NEAR4KIDS) from 2013 to 2020. The primary outcome was severe desaturation (SpO₂ > 20% from baseline) and/or severe adverse TI-associated events (TIAEs), using NEAR4KIDS definitions. To balance patient, provider, and practice covariates, we utilized propensity score (PS) matching to compare the outcomes of nasal vs. oral TI.</p><p><strong>Results: </strong>A total of 22,741 TIs [nasal 870 (3.8%), oral 21,871 (96.2%)] were reported from 60 PICUs. Infants were represented in higher proportion in the nasal TI than the oral TI (75.9%, vs 46.2%), as well as children with cardiac conditions (46.9% vs. 14.4%), both <i>p</i> < 0.001. Severe desaturation or severe TIAE occurred in 23.7% of nasal and 22.5% of oral TI (non-adjusted <i>p</i> = 0.408). With PS matching, the prevalence of severe desaturation and or severe adverse TIAEs was 23.6% of nasal vs. 19.8% of oral TI (absolute difference 3.8%, 95% confidence interval (CI): - 0.07, 7.7%), <i>p</i> = 0.055. First attempt success rate was 72.1% of nasal TI versus 69.2% of oral TI, <i>p</i> = 0.072. With PS matching, the success rate was not different between two groups (nasal 72.2% vs. oral 71.5%, <i>p</i> = 0.759).</p><p><strong>Conclusion: </strong>In this large international prospective cohort study, the risk of severe peri-intubation complications was not significantly higher. Nasal TI is used in a minority of TI in PICUs, with substantial differences in patient, provider, and practice compared to oral TI.A prospective multicenter trial may be warranted to address the potential selection bias and to confirm the safety of nasal TI.</p>","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"2 1","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10891187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974846","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}

{"title":"Evaluating associations between late intensive care admission and mortality, intensive care days, and organ dysfunctions: a secondary analysis of data from the EPOCH cluster randomized trial","authors":"Ari R. Joffe, Karen Dryden-Palmer, Leah Shadkowski, Helena Frndova, Vinay Nadkarni, George Tomlinson, Christopher Parshuram","doi":"10.1007/s44253-023-00019-w","DOIUrl":"https://doi.org/10.1007/s44253-023-00019-w","url":null,"abstract":"Abstract Purpose To determine whether late admission to pediatric intensive care (ICU) from hospital wards is associated with patient outcomes. Methods Secondary analysis of prospectively collected data from an international multicenter cluster-randomized trial. Clinical deterioration events with urgent ICU admission were defined as late if the Children’s Resuscitation Intensity Scale was > 2 (indicating critical care interventions started from 12 h pre- to 1 h post-urgent ICU admission). The association of late admission with primary outcomes (ICU and hospital mortality) was estimated using logistically generalized estimating equation models adjusted for PIM2 probability of death. Results There were 2979 clinical deterioration events in 2502 patients, including 620 (20.8%) late ICU admissions. ICU mortality of the last urgent ICU admission was 15.4% for late compared to 4.5% for non-late ICU admission (PIM-adjusted OR (95%CI) 1.63 (1.14, 2.33), p < 0.01). Hospital mortality was 19.7% in late compared to 6.0% for non-late urgent ICU admission (PIM-adjusted OR 1.56 (1.12, 2.16), p < 0.01). Late ICU admissions accounted for 20.9% of clinical deterioration events, and 90/179 (50.2.0%) of ICU and 103/222 (46.4%) of hospital deaths after clinical deterioration events. Secondary outcomes associated with late ICU admission included longer ICU stay (2.3 days, p = 0.02), more ventilation days (407/1000 ICU days, p < 0.0001), and more frequent treatment with dialysis, inhaled nitric oxide, and extracorporeal membrane oxygenation ( p < 0.01). Conclusion Late ICU admission from hospital wards was associated with higher ICU and hospital mortality, greater use of ICU technologies, and longer ICU stays. How to prevent late ICU admission and its consequences requires further study.","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"261 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135633977","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":"Distribution and trajectory of vital signs from high-frequency continuous monitoring during pediatric critical care transport","authors":"Zhiqiang Huo, John Booth, Thomas Monks, Philip Knight, Liam Watson, Mark Peters, Christina Pagel, Padmanabhan Ramnarayan, Kezhi Li","doi":"10.1007/s44253-023-00018-x","DOIUrl":"https://doi.org/10.1007/s44253-023-00018-x","url":null,"abstract":"Abstract Objective To describe comprehensively the distribution and progression of high-frequency continuous vital signs monitoring data for children during critical care transport and explore associations with patient age, diagnosis, and severity of illness. Design Retrospective cohort study using prospectively collected vital signs monitoring data linked to patient demographic and transport data. Setting A regional pediatric critical care transport team based in London, England. Patients Critically ill children (age ≤ 18 years) transported by the Children’s Acute Transport Service (CATS) at Great Ormond Street Hospital (GOSH) between January 2016 and May 2021 with available high-frequency vital signs monitoring data. Interventions None. Main results Numeric values of heart rate (HR), blood pressure (BP), respiratory rate (RR), oxygen saturations (SpO 2 ), and end-tidal carbon dioxide in ventilated children (etCO 2 ) were extracted at a frequency of one value per second totalling over 40 million data points. Age-varying vital signs (HR, BP, and RR) were standardized using Z scores. The distribution of vital signs measured in the first 10 min of monitoring during transport, and their progression through the transport, were analyzed by age group, diagnosis group and severity of illness group. A complete dataset comprising linked vital signs, patient and transport data was extracted from 1711 patients (27.7% of all transported patients). The study cohort consisted predominantly of infants (median age of 6 months, IQR 0–51), and respiratory illness (36.0%) was the most frequent diagnosis group. Most patients were invasively ventilated (70.7%). The Infection group had the highest average (+ 2.5) and range (− 5 to + 9) of HR Z scores, particularly in septic children. Infants and pre-school children demonstrated a greater reduction in the HR Z score from the beginning to the end of transport compared to older children. Conclusions Marked differences in the distribution and progression of vital signs between age groups, diagnosis groups, and severity of illness groups were observed by analyzing the high-frequency data collected during paediatric critical care transport.","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135537500","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":"Use of bi-caval cannulae for veno-venous ECMO in neonates and children","authors":"J. Awad, A. Numa, H. Ravindranathan, Peter Grant, A. Lahanas, Puneet Singh, K. Swil, Victoria Ward, Gary Williams","doi":"10.1007/s44253-023-00017-y","DOIUrl":"https://doi.org/10.1007/s44253-023-00017-y","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"138 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90451502","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":"Inflammatory and coagulant responses after acute respiratory failure in children of different body habitus","authors":"Shan L. Ward, H. Flori, M. Dahmer, H. Weeks, A. Sapru, M. Quasney, M. Curley, Kathleen D. Liu, M. Matthay","doi":"10.1007/s44253-023-00015-0","DOIUrl":"https://doi.org/10.1007/s44253-023-00015-0","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74937182","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":"Edema description in pediatric critical care: terms, patterns, and clinical characteristics","authors":"M. Gaetani, E. See, Saravanan Satkumaran, B. Gelbart","doi":"10.1007/s44253-023-00016-z","DOIUrl":"https://doi.org/10.1007/s44253-023-00016-z","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82654625","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":"A combined rapid clinical and lung ultrasound score for predicting bronchiolitis severity","authors":"A. Camporesi, R. Morello, A. Guzzardella, Ugo Maria Pierucci, F. Izzo, C. De Rose, D. Buonsenso","doi":"10.1007/s44253-023-00012-3","DOIUrl":"https://doi.org/10.1007/s44253-023-00012-3","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"32 3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85766329","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":"Furosemide and acute kidney injury: is Batman the cause of evil?","authors":"Z. Ricci, Akash Deep","doi":"10.1007/s44253-023-00014-1","DOIUrl":"https://doi.org/10.1007/s44253-023-00014-1","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"336 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80644978","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":"Physiological effects of standard oxygen therapy, high-flow nasal cannula, and helmet CPAP in acute bronchiolitis: a randomized cross-over study","authors":"G. Chidini, T. Mauri, G. Conti, S. S. Catenacci, T. Marchesi, Giada Dona, M. Figini, G. Babini, E. Calderini","doi":"10.1007/s44253-023-00013-2","DOIUrl":"https://doi.org/10.1007/s44253-023-00013-2","url":null,"abstract":"","PeriodicalId":73402,"journal":{"name":"Intensive care medicine. Paediatric and neonatal","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88974647","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}