Hypophosphatemia and its clinical implications in critically ill children: A retrospective study

2012 ◽  
Vol 27 (5) ◽  
pp. 474-479 ◽  
Author(s):  
Omer Kilic ◽  
Demet Demirkol ◽  
Raif Ucsel ◽  
Agop Citak ◽  
Metin Karabocuoglu
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Clinical Implications

scholarly journals 2 Systemic glucocorticoids and bradycardia in critically ill children: a retrospective study

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e1-e1
Author(s):  
Camille Maltais-Bilodeau ◽  
Maryse Frenette ◽  
Geneviève Morissette ◽  
Dennis Bailey ◽  
Karine Cloutier ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Heart Rate ◽  
Intensive Care ◽  
Retrospective Study ◽  
Critically Ill ◽  
Medical Staff ◽  
Pediatric Population ◽  
Critically Ill Children ◽  
Rate Variation ◽  
The Impact

Abstract Background Glucocorticoids are widely used in the pediatric population. They are associated with numerous side effects including repercussions on the cardiovascular system. The impact on heart rate is not well known, but bradycardia has been reported, mostly with high doses. Objectives We described the occurrence of bradycardias and the variation of heart rate in critically ill children receiving glucocorticoids. Design/Methods We conducted a retrospective study including 1 month old to 18 year old children admitted to the Pediatric Intensive Care Unit between 2014 and 2017, who received a glucocorticoid dose equivalent to 1 to 15 mg/kg/day of prednisone. We collected data on exposition to glucocorticoids, heart rate before, during and after the exposition, and interventions from the medical staff in response to bradycardia. The primary outcome was the occurrence of bradycardia and the secondary outcomes were the magnitude of heart rate variation and the clinical management of bradycardias. Results We included 92 admissions (85 patients). The median dose of glucocorticoid used was 2.80 mg/kg/day of prednisone (2.08—3.80). We found 70 cases (76%) with at least one bradycardia. Before treatment, all patients had a mean heart rate higher than the 5th percentile for age. During exposition to glucocorticoids, 8 patients (10%, n = 83) had a median heart rate ≤ 5th percentile. We noted 46 cases of bradycardia (50%) that led to an intervention from the medical staff, but no patient had a major event associated to bradycardia. We found a significant association between bradycardia and age (estimate -0.136, 95% CI -0.207—-0.065, p < 0.001), glucocorticoid dose (estimate 4.820, 95% CI 2.048—7.592, p < 0.001) and intravenous administration (estimate 8.709, 95% CI 1.893—15.524, p = 0.012). Conclusion In our study, most children hospitalized at the intensive care unit receiving standard doses of glucocorticoid experienced bradycardia. The majority of episodes led to an intervention from the medical staff. Presence of bradycardia was associated with younger age, higher dose and IV administration of glucocorticoids.

Prevalence, risk factors and clinical implications of hypophosphatemia in critically ill children on oral and enteral nutrition

2020 ◽  
Vol 40 ◽  
pp. 633
Author(s):  
A.M.M. Springer ◽  
T.D.R. Hortencio ◽  
E.C. Melro ◽  
T.H. de Souza ◽  
R.J.N. Nogueira
Keyword(s):  
Risk Factors ◽  
Enteral Nutrition ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Clinical Implications

scholarly journals Infections with Carbapenem-Resistant Gram-Negative Bacteria are a Serious Problem Among Critically Ill Children: A Single-Centre Retrospective Study

Pathogens ◽  
2019 ◽  
Vol 8 (2) ◽  
pp. 69 ◽  
Author(s):  
Fatih Aygun ◽  
Fatma Deniz Aygun ◽  
Fatih Varol ◽  
Cansu Durak ◽  
Haluk Çokuğraş ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Bacterial Infections ◽  
Invasive Mechanical Ventilation ◽  
Critically Ill Children ◽  
Resistant Bacteria ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Culture Positive

Children in paediatric intensive care units (PICUs) are vulnerable to infections because invasive devices are frequently used during their admission. We aimed to determine the prevalence, associated factors, and prognosis of infections in our PICU. This retrospective study evaluated culture results from 477 paediatric patients who were treated in the PICU between January 2014 and March 2019. Ninety patients (18.9%) had bacterial infections, with gram-negative bacteria being the predominant infectious agents. Culture-positive patients were younger than culture-negative patients, and age was related to mortality and various clinical factors. Culture-positive bacterial infections in the PICU were associated with increased use of invasive mechanical ventilation (odds ratio(OR); 2.254), red blood cell (RBC) transfusions (OR:2.624), and inotropic drugs (OR:2.262). Carbapenem resistance was found in approximately one-third of gram-negative bacteria, and was most common in tracheal aspirate specimens and cases involving Klebsiella spp. Total parenteral nutrition was a significant risk factor (OR:5.870). Positive blood culture results were associated with poorer patient survival than other culture results. These findings indicate that infections, especially those involving carbapenem-resistant bacteria, are an important issue when treating critically ill children.

scholarly journals Retrospective study on 48-h fluid balance and outcome in mechanically ventilated critically ill children

2020 ◽  
Vol 7 (4) ◽  
pp. 174
Author(s):  
Ramachandran Rameshkumar ◽  
Namita Ravikumar ◽  
Ponnarmeni Satheesh ◽  
Subramanian Mahadevan
Keyword(s):  
Retrospective Study ◽  
Critically Ill ◽  
Fluid Balance ◽  
Critically Ill Children ◽  
Mechanically Ventilated

Acute Kidney Injury in Critically Ill Children Admitted to the PICU for Diabetic Ketoacidosis. A Retrospective Study

2019 ◽  
Vol 20 (1) ◽  
pp. e10-e14 ◽  
Author(s):  
Avichai Weissbach ◽  
Noy Zur ◽  
Eytan Kaplan ◽  
Gili Kadmon ◽  
Yulia Gendler ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Retrospective Study ◽  
Diabetic Ketoacidosis ◽  
Critically Ill ◽  
Kidney Injury ◽  
Critically Ill Children

Incidence, risk factors, and outcome of transfusion-related acute lung injury in critically ill children: A retrospective study

2015 ◽  
Vol 30 (1) ◽  
pp. 55-59 ◽  
Author(s):  
Hilde D. Mulder ◽  
Quinten J.J. Augustijn ◽  
Job B. van Woensel ◽  
Albert P. Bos ◽  
Nicole P. Juffermans ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Lung Injury ◽  
Retrospective Study ◽  
Lung Injury ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Incidence Risk

scholarly journals Clinical Characteristics and Laboratory Abnormalities of Hospitalized and Critically Ill Children with Coronavirus Disease 2019: A Retrospective Study from Saudi Arabia

2021 ◽  
Vol Volume 14 ◽  
pp. 1949-1958
Author(s):  
Ali Alsuheel Asseri ◽  
Ibrahim Alzaydani ◽  
Ahmed Al-Jarie ◽  
Ahmed Albishri ◽  
Abdullah Alsabaani ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Retrospective Study ◽  
Critically Ill ◽  
Clinical Characteristics ◽  
Critically Ill Children

An Exploratory Retrospective Study of Factors Affecting Energy Expenditure in Critically Ill Children

2019 ◽  
Vol 44 (3) ◽  
pp. 507-515
Author(s):  
Haifa Mtaweh ◽  
Christiana Garros ◽  
Allison Ashkin ◽  
Lori Tuira ◽  
Johane P. Allard ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Energy Expenditure ◽  
Critically Ill ◽  
Critically Ill Children ◽  
Factors Affecting

scholarly journals The Developing Balance of Thrombosis and Hemorrhage in Pediatric Surgery: Clinical Implications of Age-Related Changes in Hemostasis

2020 ◽  
Vol 26 ◽  
pp. 107602962092909
Author(s):  
Meredith A. Achey ◽  
Uttara P. Nag ◽  
Victoria L. Robinson ◽  
Christopher R. Reed ◽  
Gowthami M. Arepally ◽  
...  
Keyword(s):  
Critically Ill ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Organ Transplant ◽  
Clinical Problem ◽  
Critically Ill Children ◽  
Future Research ◽  
Clinical Implications ◽  
Solid Organ ◽  
Age Related

Bleeding and thrombosis in critically ill infants and children is a vexing clinical problem. Despite the relatively low incidence of bleeding and thrombosis in the overall pediatric population relative to adults, these critically ill children face unique challenges to hemostasis due to extreme physiologic derangements, exposure of blood to foreign surfaces and membranes, and major vascular endothelial injury or disruption. Caring for pediatric patients on extracorporeal support, recovering from solid organ transplant or invasive surgery, and after major trauma is often complicated by major bleeding or clotting events. As our ability to care for the youngest and sickest of these children increases, the gaps in our understanding of the clinical implications of developmental hemostasis have become increasingly important. We review the current understanding of the development and function of the hemostatic system, including the complex and overlapping interactions of coagulation proteins, platelets, fibrinolysis, and immune mediators from the neonatal period through early childhood and to young adulthood. We then examine scenarios in which our ability to effectively measure and treat coagulation derangements in pediatric patients is limited. In these clinical situations, adult therapies are often extrapolated for use in children without taking age-related differences in pediatric hemostasis into account, leaving clinicians confused and impacting patient outcomes. We discuss the limitations of current coagulation testing in pediatric patients before turning to emerging ideas in the measurement and management of pediatric bleeding and thrombosis. Finally, we highlight opportunities for future research which take into account this developing balance of bleeding and thrombosis in our youngest patients.

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