A5024474598- Venous Thromboembolism Diagnosis and Management
- Blood Coagulation and Thrombosis Mechanisms
- Central Venous Catheters and Hemodialysis
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Cardiac Arrest and Resuscitation
- Traumatic Brain Injury and Neurovascular Disturbances
- Ultrasound in Clinical Applications
- Trauma and Emergency Care Studies
- Acute Myocardial Infarction Research
- Neonatal Health and Biochemistry
- Hemoglobinopathies and Related Disorders
- Heart Failure Treatment and Management
- Non-Invasive Vital Sign Monitoring
- Blood transfusion and management
- Heparin-Induced Thrombocytopenia and Thrombosis
- Cardiac, Anesthesia and Surgical Outcomes
- Hemodynamic Monitoring and Therapy
- Intensive Care Unit Cognitive Disorders
- Vascular Procedures and Complications
- Neonatal Respiratory Health Research
- Respiratory Support and Mechanisms
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Atrial Fibrillation Management and Outcomes
- Maternal and fetal healthcare
Children's Hospital of Wisconsin
2013-2022
Medical College of Wisconsin
2013-2022
Yale University
2021
Children's Hospital of Richmond at VCU
2021
Children's Hospital of Philadelphia
2018
University of Pennsylvania
2018
University of Utah
2018
Johns Hopkins University
2018
University of Michigan–Ann Arbor
2018
Kennedy Krieger Institute
2018
The purpose of our study was to describe children with life-threatening bleeding.We conducted a prospective observational bleeding events.Twenty-four childrens hospitals in the United States, Canada, and Italy participated.Children 0-17 years old who received greater than 40 mL/kg total blood products over 6 hours or were transfused under massive transfusion protocol included.Children compared according etiology: trauma, operative, medical.Patient characteristics, therapies administered,...
Background: Venous thromboembolism (VTE) causes major morbidity in adults after trauma, occurring up to 50% of patients without prophylaxis. The incidence VTE trauma is lower children. No study has measured the and risk factors for critically ill children trauma. Methods: Nested case-control children, younger than 18 years, admitted pediatric intensive care unit at a level I center. Three controls were selected each identified case. Results: Nine 144 developed (incidence 6.2%, 95% confidence...
SCCM Critical Care Medicine Explorations
BACKGROUND: Historically, 6% of critically ill children developed clinically apparent venous thromboembolism (VTE) after trauma at our Level I pediatric center. We hypothesized that implementation clinical guidelines for thrombosis prophylaxis incorporating both VTE risk and bleeding would reduce incidence without increased bleeding. METHODS: VTE, those only detected by guideline-directed screening, were prospectively identified all admitted to the intensive care unit during three time...
Objective Recent Pediatric Advanced Life Support (PALS) guidelines have deemphasized the use of advanced airways in short transport. It is unclear if guideline recommendations altered practice. We sought to determine a temporal change exists number prehospital pediatric trauma intubations since 2005 PALS update. Methods This an institutional review board–approved, retrospective, single-center study. Reviewed all activations where patients younger than 19 years were intubated at scene, en...
Although critically ill children are at increased risk for developing deep venous thrombosis, there few pediatric studies establishing the prevalence of thrombosis or efficacy thromboprophylaxis. We tested hypothesis that thromboprophylaxis is infrequently used in even those whom it indicated.Prospective multinational cross-sectional study over four dates 2012.Fifty-nine PICUs Australia, Canada, New Zealand, Portugal, Singapore, Spain, and United States.All patients less than 18 years old...
Despite the increasing incidence of venous thromboembolism (VTE) in hospitalized children, risks and benefits VTE prophylaxis, particularly for those after trauma, are unclear. The Pediatric Trauma Society Eastern Association Surgery convened a writing group to develop practice management guideline on prophylaxis this cohort children using Grading Recommendations Assessment, Development, Evaluation framework.A systematic review MEDLINE PubMed from January 1946 July 2015 was performed. search...
To identify factors associated with unplanned extubation in PICUs.A prospective, case-controlled multicenter study.Eleven Pediatric Intensive Care Units collaborating through the National Association of Children's Hospitals and Related Institutions PICU focus group.Patients events control patients without extubation.Unplanned were prospectively tracked for 1 year at 11 centers. When an occurred, up to four controls randomly identified other intubated unit. For each event control, data...
ObjectivesOne essential requirement of trustworthy guidelines is that they should be based on systematic reviews the best available evidence. The GRADE Working Group has provided guidance for evaluating certainty evidence several domains. However, many clinical questions, published may limited, too indirect or simply not exist. In this brief report (GRADE notes), we describe our method developing evidence-based recommendations when publisheddirect was lacking.Study Design and SettingWhen...
Objective: The aim of this study was to measure the change cerebral and somatic regional oxygen saturation (rSO2) using near-infrared spectroscopic (NIRS) monitoring during volume resuscitation dehydrated children. Methods: This prospective, observational enrolled 17 moderately children presenting emergency department in a tertiary care pediatric hospital. Pulse oximetry 2-site rSO2 forehead flank NIRS probes were monitored continuously intravenous rehydration. Results: Prehydration...
The purpose of our study is to compare the rate central line-associated blood stream infections and venous thromboembolism in catheters versus peripherally inserted hospitalized children. There a growing body literature adults describing an increased thromboembolisms similar rates infection associated with catheters. It not known if differs between Based on current adult literature, we hypothesize that for will be similar, higher catheters.This cohort using retrospective review medical...
Prior criteria for organ dysfunction in critically ill children were based mainly on expert opinion. We convened the Pediatric Organ Dysfunction Information Update Mandate (PODIUM) panel to summarize data characterizing single and multiple derive contemporary pediatric dysfunction. The was composed of 88 members representing 47 institutions 7 countries. conducted systematic reviews literature evidence-based neurologic, cardiovascular, respiratory, gastrointestinal, acute liver, renal,...
Central venous access devices, including peripherally inserted central catheters and catheters, are often needed in critically ill patients, but also associated with complications, central-line bloodstream infections thromboembolism. We compared different device types these complications the PICU.Multicenter, cohort study.One hundred forty-eight participating Virtual PICU Systems, LLC, hospital sites.Pediatric patients placed from January 1, 2010, to December 31, 2015.None.Patient variables...
OBJECTIVES: We obtained preliminary evidence on the efficacy of early prophylaxis risk central venous catheter-associated deep thrombosis and its effect thrombin generation in critically ill children. DESIGN: Bayesian phase 2b randomized clinical trial. SETTING: Seven PICUs. PATIENTS: Children less than 18 years old with a newly inserted catheter at low bleeding. Intervention: Enoxaparin adjusted to anti-Xa level 0.2–0.5 international units/mL started 24 hours after insertion (enoxaparin...
Abstract Background Outcomes for patients with oncologic disease and/or after hematopoietic stem cell transplant (HSCT) requiring intensive care unit admission have improved, but indications and outcomes extracorporeal membrane oxygenation (ECMO) support in this population are poorly characterized. Procedure We analyzed data from consecutive < 18 years HSCT reported to a pediatric ECMO registry by nine centers the United States between 2011 2018. Results identified HSCT, 415 controls...
Hanson, Sheila J. MD, MS; Faustino, E. Vincent S. MHS; Mahajerin, Arash MSCr; O'Brien, Sarah H. MD; Streck, Christian Thompson, A. Jill PharmD; Petrillo, Toni M. Petty, John K. MD Author Information
Abstract Background While previous studies have described the use of blood components in subsets children, such as critically ill, little is known about transfusion practices hospitalized children across all departments and diagnostic categories. We sought to describe utilization red cell, platelet, plasma, cryoprecipitate transfusions hospital settings categories a large cohort children. Study Design Methods The public datasets from 11 US academic community hospitals that participated...
Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE has not been standardized injured pediatric patients. Our institution identified factors potentially with high risk of critically children that led prospective implementation guidelines. We hypothesize the guidelines are accurate predicting at VTE.Data were prospectively collected on from August 2010 2015. was indicated...
OBJECTIVES: To describe blood component usage in transfused children with congenital heart disease undergoing cardiopulmonary bypass surgery across perioperative settings and diagnostic categories. DESIGN: Datasets from U.S. hospitals participating the National Heart, Lung, Blood Institute Recipient Epidemiology Donor Evaluation Study-III were analyzed. SETTING: Inpatient admissions three 2013 to 2016. PATIENTS: Transfused single ventricular, biventricular surgery, extracorporeal membrane...
Objectives: To demonstrate that low-molecular-weight heparin (enoxaparin) can be used in critically ill pediatric patients to achieve target anti-factor Xa concentrations and determine appropriate dosing corrected for age illness severity. Design: Retrospective cohort study. Setting: Single tertiary level PICU. Patients: One hundred ninety-two children 1 day through 18 years admitted PICU undergoing every 12-hour enoxaparin therapy with at least one concentration obtained. Patients receiving...