scholarly journals Nutritional support for children during critical illness: European Society of Pediatric and Neonatal Intensive Care (ESPNIC) metabolism, endocrine and nutrition section position statement and clinical recommendations

2020 ◽  
Vol 46 (3) ◽  
pp. 411-425 ◽  
Author(s):  
Lyvonne N. Tume ◽  
Frederic V. Valla ◽  
Koen Joosten ◽  
Corinne Jotterand Chaparro ◽  
Lynne Latten ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critical Illness ◽  
European Society ◽  
Nutritional Support ◽  
Neonatal Intensive Care ◽  
Position Statement ◽  
Clinical Recommendations

scholarly journals Recommendations for hemodynamic Monitoring for Critically Ill Children – Expert Consensus Statement issued by the Cardiovascular Dynamics Section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

2020 ◽  
Author(s):  
Yogen Singh ◽  
Javier Urbano Villaescusa ◽  
Eduardo M. da Cruz ◽  
Shane M Tibby ◽  
Gabriella Bottari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
European Society ◽  
Neonatal Intensive Care ◽  
Expert Consensus ◽  
Critically Ill Children ◽  
Evidence Based ◽  
Cardiovascular Dynamics ◽  
Hemodynamic Assessment

Abstract Background: Cardiovascular instability is common in critically-ill children. There is scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children.Methods: Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature - a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document.Results: Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement”, 20 “weak agreement” and 2 had “no agreement”. Six statements were considered as redundant after rephrasing of statements following first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus.Conclusions: These expert consensus-based recommendation may be used to guide clinical practice for hemodynamic monitoring in critically-ill children and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

scholarly journals Recommendations for hemodynamic monitoring for critically ill children—expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC)

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Yogen Singh ◽  
Javier Urbano Villaescusa ◽  
Eduardo M. da Cruz ◽  
Shane M. Tibby ◽  
Gabriella Bottari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Critically Ill ◽  
Hemodynamic Monitoring ◽  
European Society ◽  
Neonatal Intensive Care ◽  
Expert Consensus ◽  
Critically Ill Children ◽  
Evidence Based ◽  
Cardiovascular Dynamics ◽  
Hemodynamic Assessment

Abstract Background Cardiovascular instability is common in critically ill children. There is a scarcity of published high-quality studies to develop meaningful evidence-based hemodynamic monitoring guidelines and hence, with the exception of management of shock, currently there are no published guidelines for hemodynamic monitoring in children. The European Society of Paediatric and Neonatal Intensive Care (ESPNIC) Cardiovascular Dynamics section aimed to provide expert consensus recommendations on hemodynamic monitoring in critically ill children. Methods Creation of a panel of experts in cardiovascular hemodynamic assessment and hemodynamic monitoring and review of relevant literature—a literature search was performed, and recommendations were developed through discussions managed following a Quaker-based consensus technique and evaluating appropriateness using a modified blind RAND/UCLA voting method. The AGREE statement was followed to prepare this document. Results Of 100 suggested recommendations across 12 subgroups concerning hemodynamic monitoring in critically ill children, 72 reached “strong agreement,” 20 “weak agreement,” and 2 had “no agreement.” Six statements were considered as redundant after rephrasing of statements following the first round of voting. The agreed 72 recommendations were then coalesced into 36 detailing four key areas of hemodynamic monitoring in the main manuscript. Due to a lack of published evidence to develop evidence-based guidelines, most of the recommendations are based upon expert consensus. Conclusions These expert consensus-based recommendations may be used to guide clinical practice for hemodynamic monitoring in critically ill children, and they may serve as a basis for highlighting gaps in the knowledge base to guide further research in hemodynamic monitoring.

Rotational Thromboelastometry in Neonates Admitted to a Neonatal Intensive Care Unit: A Large Cross-sectional Study

2021 ◽  
Author(s):  
Andreas G. Tsantes ◽  
Rozeta Sokou ◽  
Aikaterini Konstantinidi ◽  
Georgios Ioakeimidis ◽  
Maria Lampridou ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Laboratory Data ◽  
Disease Onset ◽  
Rotational Thromboelastometry ◽  
Arterial Blood ◽  
Severity Scores

AbstractThe aim of the present study was to assess the coagulation profile in neonatal critical illness using rotational thromboelastometry (ROTEM), and to investigate its association with disease severity and its potential prognostic role in this clinical setting. Over a period of 67 months (July 2014–February 2020) 423 critically ill neonates with confirmed or suspected sepsis, perinatal hypoxia, or respiratory distress syndrome, hospitalized in our neonatal intensive care unit were included in the study. Demographic, clinical, and laboratory data were recorded on admission day and arterial blood was analyzed on ROTEM analyzer using the standard extrinsically activated rotational thromboelastometry assay (EXTEM). Neonatal illness severity scores (Modified NEOMOD [Neonatal Multiple Organ Dysfunction] and SNAPPE [Score for Neonatal Acute Physiology with Perinatal Extension]) were calculated at the same time as ROTEM analysis. Mortality during in-hospital stay was the main outcome measure. Multivariable analyses showed that a 10 mm decrease in EXTEM clot amplitude recorded at 10 minutes (A10) is significantly associated with a higher mortality (odds ratio [OR] = 1.69, 95% confidence interval [CI]: 1.33–2.08). Higher modified NEOMOD (OR = 1.36, 95% CI: 1.26–1.47) and higher SNAPPE scores (OR = 1.06, 95% CI: 1.04–1.08) were also associated with increased mortality. The CT and A10 variables demonstrated the best prognostic performance among the EXTEM parameters for mortality (area under the curve [AUC] = 0.78; 95% CI: 0.69–0.86 and AUC = 0.76; 95% CI: 0.66–0.85, respectively), showing an optimal cut-off CT ≥63 seconds and A10 ≤37 mm. Using optimal cut-off values of the EXTEM parameters for prediction of mortality, neonates with CT ≥63 seconds were 7.4 times more likely to die (OR = 7.40, 95% CI: 3.50–15.65), while neonates with A10 ≤37 mm were 5.8 times more likely to die (OR = 5.88, 95% CI: 2.94–12.50). An EXTEM hypocoagulable profile on disease onset was shown to be an independent risk factor for in-hospital mortality in neonatal critical illness.

A Muslim Neonatologist in a Canadian NICU

2019 ◽  
pp. 110-123
Author(s):  
Juzer M. Tyebkhan
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Critical Illness ◽  
Neonatal Intensive Care ◽  
High Stress ◽  
The United Kingdom ◽  
Spiritual Leader ◽  
Dawoodi Bohra ◽  
The Impact

What is the impact on a Muslim family of having a baby in the neonatal intensive care unit (NICU)? This chapter is written by a Muslim neonatologist, trained in the United Kingdom and Canada, who now works in a level III NICU in Edmonton, Canada. In addition to describing religious requirements and community traditions, the author suggests ways that these can be incorporated into the care of Muslim babies and families in our high-stress, technology-based NICUs. As a member of the Dawoodi Bohra sect (a subset of the Shi’a Muslim community), the author provides a brief background of the community’s spiritual heritage and their viewpoint on modern medical treatment. The living spiritual leader of the Dawoodi Bohras, the Da’i, is their source of authoritative decision making. The author explains how and why decision making in situations of critical illness is referred to the Da’i for His trusted advice.

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