Pub Date : 2023-02-02eCollection Date: 2023-03-01DOI: 10.1055/s-0043-1761465
{"title":"Contributing Reviewers in 2022.","authors":"","doi":"10.1055/s-0043-1761465","DOIUrl":"10.1055/s-0043-1761465","url":null,"abstract":"","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"12 1","pages":"i-iv"},"PeriodicalIF":0.7,"publicationDate":"2023-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644530","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}
Pub Date : 2023-01-13eCollection Date: 2024-09-01DOI: 10.1055/s-0042-1760634
Michele E Smith, Meghan Gray, Patrick T Wilson
Continuous positive airway pressure (CPAP) is a form of noninvasive ventilation used to support pediatric patients with acute respiratory infections. Traditional CPAP interfaces have been associated with inadequate seal, mucocutaneous injury, and aerosolization of infectious particles. The helmet interface may be advantageous given its ability to create a complete seal, avoid skin breakdown, and decrease aerosolization of viruses. We aim to measure tolerability and safety in a pediatric population in the United States and ascertain feedback from parents and health care providers. We performed a prospective, open-label, single-armed feasibility study to assess tolerability and safety of helmet CPAP. Pediatric patients 1 month to 5 years of age admitted to the pediatric intensive care unit with pulmonary infections who were on CPAP for at least 2 hours were eligible. The primary outcome was percentage of patients tolerating helmet CPAP for 4 hours. Secondary measures included the rate of adverse events and change in vital signs. Qualitative feedback was obtained from families, nurses, and respiratory therapists. Five patients were enrolled and 100% tolerated helmet CPAP the full 4-hour study period. No adverse events or significant vital sign changes were observed. All family members preferred to continue the helmet interface, nursing staff noted it made cares easier, and respiratory therapists felt the set up was easy. Helmet CPAP in pediatric patients is well-tolerated, safe, and accepted by medical staff and families in the United States future randomized controlled trials measuring its effectiveness compared with traditional CPAP interfaces are needed.
{"title":"Acceptance and Tolerability of Helmet CPAP in Pediatric Bronchiolitis and Pneumonia: A Feasibility Study.","authors":"Michele E Smith, Meghan Gray, Patrick T Wilson","doi":"10.1055/s-0042-1760634","DOIUrl":"10.1055/s-0042-1760634","url":null,"abstract":"<p><p>Continuous positive airway pressure (CPAP) is a form of noninvasive ventilation used to support pediatric patients with acute respiratory infections. Traditional CPAP interfaces have been associated with inadequate seal, mucocutaneous injury, and aerosolization of infectious particles. The helmet interface may be advantageous given its ability to create a complete seal, avoid skin breakdown, and decrease aerosolization of viruses. We aim to measure tolerability and safety in a pediatric population in the United States and ascertain feedback from parents and health care providers. We performed a prospective, open-label, single-armed feasibility study to assess tolerability and safety of helmet CPAP. Pediatric patients 1 month to 5 years of age admitted to the pediatric intensive care unit with pulmonary infections who were on CPAP for at least 2 hours were eligible. The primary outcome was percentage of patients tolerating helmet CPAP for 4 hours. Secondary measures included the rate of adverse events and change in vital signs. Qualitative feedback was obtained from families, nurses, and respiratory therapists. Five patients were enrolled and 100% tolerated helmet CPAP the full 4-hour study period. No adverse events or significant vital sign changes were observed. All family members preferred to continue the helmet interface, nursing staff noted it made cares easier, and respiratory therapists felt the set up was easy. Helmet CPAP in pediatric patients is well-tolerated, safe, and accepted by medical staff and families in the United States future randomized controlled trials measuring its effectiveness compared with traditional CPAP interfaces are needed.</p>","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"13 1","pages":"296-302"},"PeriodicalIF":0.5,"publicationDate":"2023-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73090023","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}
Abstract The aim of this study was to determine the ability of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) to predict the severity of illness as assessed by two scoring systems, namely, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) and Pediatric Risk of Mortality-III (PRISM-III) and outcome. This was a retrospective cohort study wherein all critically ill children aged 1 month to 18 years admitted in the pediatric intensive care unit from January 2021 to October 2022 were included. Children with chronic systemic diseases and hematological illness were excluded from the study. Demographic details, diagnosis, PRISM-III-24 and PELOD-2 scores at admission, and outcome were retrieved from the hospital case records. NLR and PLR values were compared among high and normal PRISM-III and PELOD-2 groups as well as among survivors and nonsurvivors. A total of 325 patients with critical illness were included with a mean (standard deviation) age of 7(5) years and a male: female ratio of 3:2. The values of NLR were significantly higher among the patients with high PRISM-III (2.2 vs. 1.3, p -value = 0.006) and PELOD-2 (2 vs. 1.4, p -value = 0.015) groups compared with normal. The NLR and PLR were significantly higher among the nonsurvivors compared with the survivors (2.3 vs. 1.4, p -value = 0.013, and 59.4 vs. 27.3, p -value = 0.016 for NLR and PLR, respectively). The area under the receiver operating characteristics curve for NLR and PLR was 0.617 and 0.609, respectively. A high PLR, PRISM-III, and PELOD-2 were the factors found to be independently associated with mortality on multiple logistic regression analysis. Patients with high NLR are associated with more severe illness at admission. NLR and PLR are useful parameters to predict mortality.
本研究的目的是确定中性粒细胞淋巴细胞比率(NLR)和血小板淋巴细胞比率(PLR)预测疾病严重程度的能力，通过两个评分系统评估，即儿科Logistic器官功能障碍-2 (PELOD-2)和儿科死亡风险- iii (PRISM-III)和结局。这是一项回顾性队列研究，纳入了2021年1月至2022年10月在儿科重症监护病房住院的所有1个月至18岁的危重患儿。患有慢性全身性疾病和血液系统疾病的儿童被排除在研究之外。从医院病例记录中检索患者的人口学细节、诊断、入院时PRISM-III-24和PELOD-2评分以及结果。比较PRISM-III和PELOD-2高和正常组以及幸存者和非幸存者的NLR和PLR值。共纳入325例危重患者，平均(标准差)年龄为7(5)岁，男女比例为3:2。高PRISM-III组(2.2 vs. 1.3, p值= 0.006)和PELOD-2组(2 vs. 1.4, p值= 0.015)NLR值明显高于正常组。非幸存者的NLR和PLR明显高于幸存者(NLR和PLR分别为2.3比1.4,p值= 0.013,59.4比27.3,p值= 0.016)。NLR和PLR的受试者工作特征曲线下面积分别为0.617和0.609。多重logistic回归分析发现，高PLR、PRISM-III和PELOD-2是与死亡率独立相关的因素。NLR高的患者入院时疾病更严重。NLR和PLR是预测死亡率的有用参数。
{"title":"Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio as Predictors of Disease Severity and Mortality in Critically Ill Children: A Retrospective Cohort Study","authors":"S. Shenoy, S. Patil","doi":"10.1055/s-0043-1768661","DOIUrl":"https://doi.org/10.1055/s-0043-1768661","url":null,"abstract":"Abstract The aim of this study was to determine the ability of neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) to predict the severity of illness as assessed by two scoring systems, namely, Pediatric Logistic Organ Dysfunction-2 (PELOD-2) and Pediatric Risk of Mortality-III (PRISM-III) and outcome. This was a retrospective cohort study wherein all critically ill children aged 1 month to 18 years admitted in the pediatric intensive care unit from January 2021 to October 2022 were included. Children with chronic systemic diseases and hematological illness were excluded from the study. Demographic details, diagnosis, PRISM-III-24 and PELOD-2 scores at admission, and outcome were retrieved from the hospital case records. NLR and PLR values were compared among high and normal PRISM-III and PELOD-2 groups as well as among survivors and nonsurvivors. A total of 325 patients with critical illness were included with a mean (standard deviation) age of 7(5) years and a male: female ratio of 3:2. The values of NLR were significantly higher among the patients with high PRISM-III (2.2 vs. 1.3, p -value = 0.006) and PELOD-2 (2 vs. 1.4, p -value = 0.015) groups compared with normal. The NLR and PLR were significantly higher among the nonsurvivors compared with the survivors (2.3 vs. 1.4, p -value = 0.013, and 59.4 vs. 27.3, p -value = 0.016 for NLR and PLR, respectively). The area under the receiver operating characteristics curve for NLR and PLR was 0.617 and 0.609, respectively. A high PLR, PRISM-III, and PELOD-2 were the factors found to be independently associated with mortality on multiple logistic regression analysis. Patients with high NLR are associated with more severe illness at admission. NLR and PLR are useful parameters to predict mortality.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"92 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80506431","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}
We read with interest the recently published article titled “ Inborn Errors of Metabolism in a Tertiary Pediatric Intensive Care Unit ” by Lipari et al 1 and want to make few important comments. Authors enrolled 65 cases of inborn errors of metabolism (IEMs) with 88 admission to a pediatric intensive care unit (PICU) in Portugal over a period 11 years (2009 – 2019) accounting for 2% of PICU admissions. The children with intoxication disorders, energy metabolism defects, complex molecules, and other disorders accounted for 35.4% ( n ¼ 23), 32.3% ( n ¼ 21), 26.2% ( n ¼ 17), and 6.1% ( n ¼ 4), respectively. The median age at admission to PICU was 3 years (range: 3 days – 21 years) and 70.4% ( n ¼ 62) admissions were for metabolic decompensation and 29.5% ( n ¼ 26) were elective/scheduled surgery/procedure admissions. The reasons for decompensation included infections (55.4%, n ¼ 36) and metabolic stress during neonatal period (18.7%, n ¼ 12). The common clinical presentations were respiratory failure (34.1%, 30/88) and neurological deterioration (29.5%, 26/88). The treatment included mechanical ventilation ( n ¼ 30), continuous venovenous hemodia fi ltration (CVVHDF) ( n ¼ 16), speci fi c nutritional management, and supportive care. The median duration of PICU stay was 3.6 days (range:
{"title":"Inborn Errors of Metabolism in Pediatric Intensive Care Unit: Much More to Understand.","authors":"Puspraj Awasthi, Suresh Kumar Angurana","doi":"10.1055/s-0041-1731022","DOIUrl":"https://doi.org/10.1055/s-0041-1731022","url":null,"abstract":"We read with interest the recently published article titled “ Inborn Errors of Metabolism in a Tertiary Pediatric Intensive Care Unit ” by Lipari et al 1 and want to make few important comments. Authors enrolled 65 cases of inborn errors of metabolism (IEMs) with 88 admission to a pediatric intensive care unit (PICU) in Portugal over a period 11 years (2009 – 2019) accounting for 2% of PICU admissions. The children with intoxication disorders, energy metabolism defects, complex molecules, and other disorders accounted for 35.4% ( n ¼ 23), 32.3% ( n ¼ 21), 26.2% ( n ¼ 17), and 6.1% ( n ¼ 4), respectively. The median age at admission to PICU was 3 years (range: 3 days – 21 years) and 70.4% ( n ¼ 62) admissions were for metabolic decompensation and 29.5% ( n ¼ 26) were elective/scheduled surgery/procedure admissions. The reasons for decompensation included infections (55.4%, n ¼ 36) and metabolic stress during neonatal period (18.7%, n ¼ 12). The common clinical presentations were respiratory failure (34.1%, 30/88) and neurological deterioration (29.5%, 26/88). The treatment included mechanical ventilation ( n ¼ 30), continuous venovenous hemodia fi ltration (CVVHDF) ( n ¼ 16), speci fi c nutritional management, and supportive care. The median duration of PICU stay was 3.6 days (range:","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"11 4","pages":"355-358"},"PeriodicalIF":0.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9649296/pdf/10-1055-s-0041-1731022.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965902","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}
R. Troch, Alexandra Lazzara, Flora N. Yazigi, Carly E. Blatt, Avery W. Zierk, B. Chalk, L. Prichett, Sofia Perazzo, K. Rais-Bahrami, R. Boss
Abstract Pediatric chronic critical illness (PCCI) is characterized by prolonged and recurrent hospitalizations, multiorgan conditions, and use of medical technology. Our prior work explored the mismatch between intensive care unit (ICU) acute care models and the chronic needs of patients with PCCI. The objective of this study was to examine whether the number and frequency of treatment weans in ICU care were associated with clinical setbacks and/or length of stay for patients with PCCI. A retrospective chart review of the electronic medical record for 300 pediatric patients with PCCI was performed at the neonatal intensive care unit, pediatric intensive care unit, and cardiac intensive care unit of two urban children's hospitals. Daily patient care data related to weans and setbacks were collected for each ICU day. Data were analyzed using multilevel mixed multiple logistic regression analysis and a multilevel mixed Poisson regression. The patient-week level adjusted regression analysis revealed a strong correlation between weans and setbacks: three or more weekly weans yielded an odds ratio of 3.35 (95% confidence interval [CI] = 2.06–5.44) of having one or more weekly setback. There was also a correlation between weans and length of stay, three or more weekly weans were associated with an incidence rate ratio of 1.09 (95% CI = 1.06–1.12). Long-stay pediatric ICU patients had more clinical setbacks and longer hospitalizations if they had more than two treatment weans per week. This suggests that patients with PCCI may benefit from a slower pace of care than is traditionally used in the ICU. Future research to explore the causative nature of the correlation is needed to improve the care of such challenging patients.
儿童慢性危重症(PCCI)的特点是长期和反复住院，多器官疾病和使用医疗技术。我们之前的工作探讨了重症监护病房(ICU)急性护理模式与PCCI患者的慢性需求之间的不匹配。本研究的目的是研究ICU护理中的治疗次数和频率是否与PCCI患者的临床挫折和/或住院时间有关。对两家城市儿童医院的新生儿重症监护室、儿科重症监护室和心脏重症监护室的300名PCCI儿科患者的电子病历进行回顾性图表审查。每天收集与断奶和挫折相关的患者日常护理数据。数据分析采用多水平混合多元逻辑回归分析和多水平混合泊松回归。患者-周水平调整的回归分析显示，体重和挫折之间存在很强的相关性:三次或更多的每周体重产生一个或更多的每周挫折的比值比为3.35(95%可信区间[CI] = 2.06-5.44)。妊娠期与住院时间也有相关性，每周妊娠3次或更多与1.09的发病率比相关(95% CI = 1.06-1.12)。长期住院的儿科ICU患者如果每周接受两次以上的治疗，则会有更多的临床挫折和更长的住院时间。这表明PCCI患者可能受益于较慢的护理速度，而不是传统的ICU治疗。未来的研究需要探索相关性的因果性质，以改善对这些具有挑战性的患者的护理。
{"title":"Slow and Steady: Optimizing Intensive Care Unit Treatment Weans for Children with Chronic Critical Illness","authors":"R. Troch, Alexandra Lazzara, Flora N. Yazigi, Carly E. Blatt, Avery W. Zierk, B. Chalk, L. Prichett, Sofia Perazzo, K. Rais-Bahrami, R. Boss","doi":"10.1055/s-0043-1763256","DOIUrl":"https://doi.org/10.1055/s-0043-1763256","url":null,"abstract":"Abstract Pediatric chronic critical illness (PCCI) is characterized by prolonged and recurrent hospitalizations, multiorgan conditions, and use of medical technology. Our prior work explored the mismatch between intensive care unit (ICU) acute care models and the chronic needs of patients with PCCI. The objective of this study was to examine whether the number and frequency of treatment weans in ICU care were associated with clinical setbacks and/or length of stay for patients with PCCI. A retrospective chart review of the electronic medical record for 300 pediatric patients with PCCI was performed at the neonatal intensive care unit, pediatric intensive care unit, and cardiac intensive care unit of two urban children's hospitals. Daily patient care data related to weans and setbacks were collected for each ICU day. Data were analyzed using multilevel mixed multiple logistic regression analysis and a multilevel mixed Poisson regression. The patient-week level adjusted regression analysis revealed a strong correlation between weans and setbacks: three or more weekly weans yielded an odds ratio of 3.35 (95% confidence interval [CI] = 2.06–5.44) of having one or more weekly setback. There was also a correlation between weans and length of stay, three or more weekly weans were associated with an incidence rate ratio of 1.09 (95% CI = 1.06–1.12). Long-stay pediatric ICU patients had more clinical setbacks and longer hospitalizations if they had more than two treatment weans per week. This suggests that patients with PCCI may benefit from a slower pace of care than is traditionally used in the ICU. Future research to explore the causative nature of the correlation is needed to improve the care of such challenging patients.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"47 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77080282","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}
F. Savorgnan, S. Flores, Rohit S. Loomba, Sebastián Acosta
Abstract The aim of the study was to evaluate the hemodynamic and oximetric changes in patients with parallel circulation (Norwood, hybrid, and BT-shunted) after sodium bicarbonate bolus administration. This study was a retrospective analysis of physiologic data. To eliminate confounders, sodium bicarbonate boluses concurrently administered with normal saline, 5% albumin, epinephrine boluses, blood transfusions, change in vasoactive inotropic score or mechanical circulatory support were excluded. Blood pressure, arterial oxygen saturation, heart rate (HR), and cerebral and renal near infrared spectroscopy were continuously recorded from 1-hour pre to 1-hour post each intervention. Out of 429 boluses, 293 boluses met the inclusion criteria. Measurements show an increase in blood pressure ( p = 0.01) and HR ( p < 0.01), and a decrease in pulmonary-to-systemic flow ratio ( p = 0.02) and renal oxygen extraction ratio (rOER) ( p = 0.04) at some point during the first hour postbolus. The arterial oxygen saturation increased, and the rOER decreased for those patients with pre-bolus pH < 7.20 and/or pre-bolus serum bicarbonate level < 18 mEq/L, according to linear regression models ( p < 0.05). Sodium bicarbonate was associated with improvement of hemodynamic and oximetric parameters in this cohort, particularly for those patients with pH < 7.20 and/or serum bicarbonate level < 18 mEq/L. This finding is consistent with an increase in cardiac output due to the removal of the acidotic negative inotropic effect by the sodium bicarbonate.
{"title":"Hemodynamic and Oximetric Response to Sodium Bicarbonate Boluses in Children with Single Ventricle Parallel Circulation: A Retrospective, Single-Center Study","authors":"F. Savorgnan, S. Flores, Rohit S. Loomba, Sebastián Acosta","doi":"10.1055/s-0043-1762911","DOIUrl":"https://doi.org/10.1055/s-0043-1762911","url":null,"abstract":"Abstract The aim of the study was to evaluate the hemodynamic and oximetric changes in patients with parallel circulation (Norwood, hybrid, and BT-shunted) after sodium bicarbonate bolus administration. This study was a retrospective analysis of physiologic data. To eliminate confounders, sodium bicarbonate boluses concurrently administered with normal saline, 5% albumin, epinephrine boluses, blood transfusions, change in vasoactive inotropic score or mechanical circulatory support were excluded. Blood pressure, arterial oxygen saturation, heart rate (HR), and cerebral and renal near infrared spectroscopy were continuously recorded from 1-hour pre to 1-hour post each intervention. Out of 429 boluses, 293 boluses met the inclusion criteria. Measurements show an increase in blood pressure ( p = 0.01) and HR ( p < 0.01), and a decrease in pulmonary-to-systemic flow ratio ( p = 0.02) and renal oxygen extraction ratio (rOER) ( p = 0.04) at some point during the first hour postbolus. The arterial oxygen saturation increased, and the rOER decreased for those patients with pre-bolus pH < 7.20 and/or pre-bolus serum bicarbonate level < 18 mEq/L, according to linear regression models ( p < 0.05). Sodium bicarbonate was associated with improvement of hemodynamic and oximetric parameters in this cohort, particularly for those patients with pH < 7.20 and/or serum bicarbonate level < 18 mEq/L. This finding is consistent with an increase in cardiac output due to the removal of the acidotic negative inotropic effect by the sodium bicarbonate.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"2 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88469738","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}
Pub Date : 2022-11-21eCollection Date: 2023-03-01DOI: 10.1055/s-0042-1758746
Hüseyin Çaksen
One-hundred and twenty-four thousand prophets came from the first Prophet Adam (Alayhi As-Salam [AS]), the first man, to the last Prophet Muhammad (Salla Allahu Alayhi Wa Sallam [SAW]).1 The Prophet Isa (AS) is one of the five greatest (ulul-azm) prophets. The others are Nuh (AS), Ibrahim (AS), Musa (AS), and Muhammad (SAW).2 Jesus (Isa) is the prophet who is mentioned as Isa, Ibn Maryam, and Messiah in the Quran, who is given the Bible, who is reported to give the good news of Muhammad (SAW), who is described as “a spirit and word from Allah,” but who is emphasized as a servant. Isa (AS) performed many miracles, such as resurrecting the dead by Allah’s leave. He resurrects Lazarus, who was dead 4 days ago.3 The prophets’ miracles were mentioned in the Quran, so that people imitate these miracles and make similar ones. Herein, we discussed the Prophet Isa’s (AS) the miracle of “bringing the dead into life” from the Islamic perspective to emphasize that Isa (AS) addressed today’s intensivists with this miracle. The All-Wise Quran sends the prophets to man’s communities as leaders and vanguards of spiritual and moral progress. Similarly, it gives all of them several wonders and makes them the masters and foremen in regard to mankind’s material progress, and commands men to follow them absolutely. Thus, just as by speaking of the spiritual and moral perfections of the prophets, it is encouraging people to benefit from them, so too in discussing their miracles it is inferring encouragement to achieve similar things and to imitate them. It may even be said that like spiritual and moral attainments, material attainments and wonders were first given to mankind as a gift by the hand of miracles.1 The Quran says about Isa’s (AS) miracles as follows: “I (Isa) heal those born blind, and the lepers, and I (Isa) bring the dead into life, by Allah’s leave.”4,5Nursi1 interpreted this ayat as follows: Just as the Quran explicitly urges man to follow Isa’s (AS) high morals, so it allusively encourages him toward the elevated art and dominical medicine of which Isawas the master. The ayat indicates the following: “Remedies may be found for even themost chronic ills. Inwhich case, Oman!, O calamity-afflicted sons of Adem (AS)! Don’t despair! Whatever the ill, its cure is possible. Search for it and you will find it. It is even possible to give a temporary tinge of life to death.”And in meaning Almighty Allah is saying through the figurative tongue of this ayat: “Oman! I gave two gifts to one of My servants who abandoned the world for Me. One was the remedy for spiritual ills, and the other the cure for physical sicknesses. Moribund hearts were raised to life through the light of guidance, and sick people who were as though dead found health through his breath and cure. You too may find the cure for every ill in the pharmacy of My wisdom. Work to find it! If you seek, you will certainly find.” Thus, this ayat traces the limit that is far ahead of man’s present progr
{"title":"The Prophet Isa's (Alayhi As-Salam) Miracle of \"Bringing the Dead into Life\": A Message to Intensivists.","authors":"Hüseyin Çaksen","doi":"10.1055/s-0042-1758746","DOIUrl":"10.1055/s-0042-1758746","url":null,"abstract":"One-hundred and twenty-four thousand prophets came from the first Prophet Adam (Alayhi As-Salam [AS]), the first man, to the last Prophet Muhammad (Salla Allahu Alayhi Wa Sallam [SAW]).1 The Prophet Isa (AS) is one of the five greatest (ulul-azm) prophets. The others are Nuh (AS), Ibrahim (AS), Musa (AS), and Muhammad (SAW).2 Jesus (Isa) is the prophet who is mentioned as Isa, Ibn Maryam, and Messiah in the Quran, who is given the Bible, who is reported to give the good news of Muhammad (SAW), who is described as “a spirit and word from Allah,” but who is emphasized as a servant. Isa (AS) performed many miracles, such as resurrecting the dead by Allah’s leave. He resurrects Lazarus, who was dead 4 days ago.3 The prophets’ miracles were mentioned in the Quran, so that people imitate these miracles and make similar ones. Herein, we discussed the Prophet Isa’s (AS) the miracle of “bringing the dead into life” from the Islamic perspective to emphasize that Isa (AS) addressed today’s intensivists with this miracle. The All-Wise Quran sends the prophets to man’s communities as leaders and vanguards of spiritual and moral progress. Similarly, it gives all of them several wonders and makes them the masters and foremen in regard to mankind’s material progress, and commands men to follow them absolutely. Thus, just as by speaking of the spiritual and moral perfections of the prophets, it is encouraging people to benefit from them, so too in discussing their miracles it is inferring encouragement to achieve similar things and to imitate them. It may even be said that like spiritual and moral attainments, material attainments and wonders were first given to mankind as a gift by the hand of miracles.1 The Quran says about Isa’s (AS) miracles as follows: “I (Isa) heal those born blind, and the lepers, and I (Isa) bring the dead into life, by Allah’s leave.”4,5Nursi1 interpreted this ayat as follows: Just as the Quran explicitly urges man to follow Isa’s (AS) high morals, so it allusively encourages him toward the elevated art and dominical medicine of which Isawas the master. The ayat indicates the following: “Remedies may be found for even themost chronic ills. Inwhich case, Oman!, O calamity-afflicted sons of Adem (AS)! Don’t despair! Whatever the ill, its cure is possible. Search for it and you will find it. It is even possible to give a temporary tinge of life to death.”And in meaning Almighty Allah is saying through the figurative tongue of this ayat: “Oman! I gave two gifts to one of My servants who abandoned the world for Me. One was the remedy for spiritual ills, and the other the cure for physical sicknesses. Moribund hearts were raised to life through the light of guidance, and sick people who were as though dead found health through his breath and cure. You too may find the cure for every ill in the pharmacy of My wisdom. Work to find it! If you seek, you will certainly find.” Thus, this ayat traces the limit that is far ahead of man’s present progr","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"12 1","pages":"1-2"},"PeriodicalIF":0.7,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644531","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}
D. Khera, Nisha Toteja, Simranjeet Singh, Siyaram Didel, Kuldeep Singh, A. Chugh, Surjit Singh
Objectives Biomarkers in sepsis are an arena of avid research as they can facilitate timely diagnosis and help reduce mortality. Presepsin is a promising candidate with good diagnostic performance reported in adult and neonatal studies. However, there is no clear consensus about its utility in the pediatric age group. This study aimed to synthesize scientific evidence regarding the diagnostic and prognostic performance of presepsin in pediatric sepsis. Data Sources A systematic literature search was conducted in MEDLINE/PubMed, Cochrane Central Register of Clinical Trials, Google Scholar, and Scopus to identify relevant studies reporting the diagnostic and prognostic accuracy of presepsin. Study Selection Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we retrieved all controlled trials and observational studies on presepsin as a biomarker in children aged <19 years with sepsis. Data Extraction Two authors independently performed study screening, data extraction, and quality assessment of the included studies. Data Synthesis Among the 267 citations identified, a total of nine relevant studies were included in the final analysis. The pooled diagnostic sensitivity and specificity of presepsin were 0.99 (95% confidence interval [CI]; 0.97–1.00) and 0.88 (95% CI; 0.83–0.92), respectively, with a diagnostic odds ratio (DOR) of 28.15 (95% CI; 0.74–1065.67) and area under the curve (AUC) in summary receiver operating curve of 0.89. Prognostic accuracy for presepsin had a sensitivity of 0.64 (95% CI; 0.35–1.0), specificity of 0.62 (95% CI; 0.44–0.87), and DOR of 3.3 (95% CI; 0.20–53.43). For procalcitonin, the pooled sensitivity for diagnostic accuracy was 0.97 (95% CI; 0.94–1.00), specificity was 0.76 (95% CI; 0.69–0.82), DOR was 10.53 (95% CI; 5.31–20.88), and AUC was 0.81. Conclusion Presepsin has good diagnostic accuracy with high sensitivity and specificity. Its prognostic accuracy in predicting mortality is low.
{"title":"The Role of Presepsin as a Biomarker of Sepsis in Children: A Systemic Review and Meta-Analysis","authors":"D. Khera, Nisha Toteja, Simranjeet Singh, Siyaram Didel, Kuldeep Singh, A. Chugh, Surjit Singh","doi":"10.1055/s-0042-1758479","DOIUrl":"https://doi.org/10.1055/s-0042-1758479","url":null,"abstract":"\u0000 Objectives Biomarkers in sepsis are an arena of avid research as they can facilitate timely diagnosis and help reduce mortality. Presepsin is a promising candidate with good diagnostic performance reported in adult and neonatal studies. However, there is no clear consensus about its utility in the pediatric age group. This study aimed to synthesize scientific evidence regarding the diagnostic and prognostic performance of presepsin in pediatric sepsis.\u0000 Data Sources A systematic literature search was conducted in MEDLINE/PubMed, Cochrane Central Register of Clinical Trials, Google Scholar, and Scopus to identify relevant studies reporting the diagnostic and prognostic accuracy of presepsin.\u0000 Study Selection Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we retrieved all controlled trials and observational studies on presepsin as a biomarker in children aged <19 years with sepsis.\u0000 Data Extraction Two authors independently performed study screening, data extraction, and quality assessment of the included studies.\u0000 Data Synthesis Among the 267 citations identified, a total of nine relevant studies were included in the final analysis. The pooled diagnostic sensitivity and specificity of presepsin were 0.99 (95% confidence interval [CI]; 0.97–1.00) and 0.88 (95% CI; 0.83–0.92), respectively, with a diagnostic odds ratio (DOR) of 28.15 (95% CI; 0.74–1065.67) and area under the curve (AUC) in summary receiver operating curve of 0.89. Prognostic accuracy for presepsin had a sensitivity of 0.64 (95% CI; 0.35–1.0), specificity of 0.62 (95% CI; 0.44–0.87), and DOR of 3.3 (95% CI; 0.20–53.43). For procalcitonin, the pooled sensitivity for diagnostic accuracy was 0.97 (95% CI; 0.94–1.00), specificity was 0.76 (95% CI; 0.69–0.82), DOR was 10.53 (95% CI; 5.31–20.88), and AUC was 0.81.\u0000 Conclusion Presepsin has good diagnostic accuracy with high sensitivity and specificity. Its prognostic accuracy in predicting mortality is low.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"13 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73231636","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}
Z. Karakaya, Merve Boyraz, Seyma Koksal Atis, Servet Yuce, M. Duyu
Abstract The objective of this study was to identify the characteristics of nonsurvivors in a pediatric intensive care unit (PICU) in Turkey. This is a retrospective analysis of patients who died in a tertiary PICU over a 6-year period from 2016 to 2021. Data were drawn from electronic medical records and resuscitation notes. Mode of death was categorized as failed cardiopulmonary resuscitation (F-CPR) or brain death. Among the 161 deaths, 136 nonsurvivors were included and 30.1% were younger than 1 year. Severe pneumonia, respiratory failure, and acute respiratory distress syndrome (ARDS) (31.6%) were the most common primary diagnoses. The most common mode of death was F-CPR (86.8%). More than half of the subjects had been admitted from pediatric emergency departments (58.1%), and more than half (53.7%) had died within 7 days in the PICU. Patients admitted from pediatric emergency departments had the lowest frequency of comorbidities ( p < 0.001). Severe pneumonia, respiratory failure, and ARDS diagnoses were significantly more frequent in those who died after 7 days ( p < 0.001), whereas septicemia, shock, and multiple organ dysfunction were more common among those who died within the first day of PICU admission ( p < 0.001). It may be important to note that patients referred from wards are highly likely to have comorbidities, while those referred from pediatric emergency departments may be relatively younger. Additionally, patients with septicemia, shock, or multiple organ dysfunction were more likely to die earlier (within 7 days), especially compared with those with severe pneumonia, respiratory failure, or ARDS.
{"title":"Descriptive and Clinical Characteristics of Nonsurvivors in a Tertiary Pediatric Intensive Care Unit in Turkey: 6 Years of Experience","authors":"Z. Karakaya, Merve Boyraz, Seyma Koksal Atis, Servet Yuce, M. Duyu","doi":"10.1055/s-0043-1764330","DOIUrl":"https://doi.org/10.1055/s-0043-1764330","url":null,"abstract":"Abstract The objective of this study was to identify the characteristics of nonsurvivors in a pediatric intensive care unit (PICU) in Turkey. This is a retrospective analysis of patients who died in a tertiary PICU over a 6-year period from 2016 to 2021. Data were drawn from electronic medical records and resuscitation notes. Mode of death was categorized as failed cardiopulmonary resuscitation (F-CPR) or brain death. Among the 161 deaths, 136 nonsurvivors were included and 30.1% were younger than 1 year. Severe pneumonia, respiratory failure, and acute respiratory distress syndrome (ARDS) (31.6%) were the most common primary diagnoses. The most common mode of death was F-CPR (86.8%). More than half of the subjects had been admitted from pediatric emergency departments (58.1%), and more than half (53.7%) had died within 7 days in the PICU. Patients admitted from pediatric emergency departments had the lowest frequency of comorbidities ( p < 0.001). Severe pneumonia, respiratory failure, and ARDS diagnoses were significantly more frequent in those who died after 7 days ( p < 0.001), whereas septicemia, shock, and multiple organ dysfunction were more common among those who died within the first day of PICU admission ( p < 0.001). It may be important to note that patients referred from wards are highly likely to have comorbidities, while those referred from pediatric emergency departments may be relatively younger. Additionally, patients with septicemia, shock, or multiple organ dysfunction were more likely to die earlier (within 7 days), especially compared with those with severe pneumonia, respiratory failure, or ARDS.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"30 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74070403","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}
Nithiya Selvam, N. Parameswaran, R. Ananthakrishnan
Abstract Our objective was to evaluate the role of optic nerve sheath diameter measurement by orbital ultrasound in monitoring children with nontraumatic coma and increased intracranial pressure (ICP). A single-center prospective observational study was conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital in Puducherry, India. Children admitted to the PICU with features of raised ICP were enrolled. Baseline characteristics and raised ICP characteristics were recorded. Optic nerve sheath diameter (ONSD) measurements were taken in all children in the supine position using bedside ultrasound with a 12 MHz linear probe. The probe was initially placed in the axial plane, and measurements were taken at a distance of 3 mm posterior to the site at which the optic nerve enters the globe. Measurements were recorded sequentially 8th hourly till ICP features got resolved or the patient died. Along with each measurement, clinical parameters were recorded. The ONSD measurements were compared with clinical features. We also recruited children admitted to the PICU for other conditions without features of raised ICP as controls. We compared ONSD measurements of cases with controls. In total, 185 children were recruited, of which 81 had features of raised ICP and 104 were without increased ICP. The ONSD measurements in children with raised ICP were significantly higher as compared with those without ICP. Among children with raised ICP, there was a negative correlation between ONSD and Glasgow Coma Scale scores ( r = −0.739, p ≤ 0.0001). In children with raised ICP, there was a significant difference in ONSD at different intervals, demonstrating a falling trend from admission to 32nd-hour readings. ONSD measurements were higher in children with clinical signs of increased ICP compared with controls, thereby suggesting that this noninvasive measure may be helpful in the neuromonitoring of children with neurologic insults.
{"title":"Role of Orbital Ultrasound in the Monitoring of Children with Raised Intracranial Pressure—Prospective Observational Study Conducted in Tertiary Care Centre","authors":"Nithiya Selvam, N. Parameswaran, R. Ananthakrishnan","doi":"10.1055/s-0042-1760395","DOIUrl":"https://doi.org/10.1055/s-0042-1760395","url":null,"abstract":"Abstract Our objective was to evaluate the role of optic nerve sheath diameter measurement by orbital ultrasound in monitoring children with nontraumatic coma and increased intracranial pressure (ICP). A single-center prospective observational study was conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital in Puducherry, India. Children admitted to the PICU with features of raised ICP were enrolled. Baseline characteristics and raised ICP characteristics were recorded. Optic nerve sheath diameter (ONSD) measurements were taken in all children in the supine position using bedside ultrasound with a 12 MHz linear probe. The probe was initially placed in the axial plane, and measurements were taken at a distance of 3 mm posterior to the site at which the optic nerve enters the globe. Measurements were recorded sequentially 8th hourly till ICP features got resolved or the patient died. Along with each measurement, clinical parameters were recorded. The ONSD measurements were compared with clinical features. We also recruited children admitted to the PICU for other conditions without features of raised ICP as controls. We compared ONSD measurements of cases with controls. In total, 185 children were recruited, of which 81 had features of raised ICP and 104 were without increased ICP. The ONSD measurements in children with raised ICP were significantly higher as compared with those without ICP. Among children with raised ICP, there was a negative correlation between ONSD and Glasgow Coma Scale scores ( r = −0.739, p ≤ 0.0001). In children with raised ICP, there was a significant difference in ONSD at different intervals, demonstrating a falling trend from admission to 32nd-hour readings. ONSD measurements were higher in children with clinical signs of increased ICP compared with controls, thereby suggesting that this noninvasive measure may be helpful in the neuromonitoring of children with neurologic insults.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":"31 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72933172","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号