National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (6)
- Antibiotics (1)
- Antimicrobial Stewardship (1)
- Behavioral Health (2)
- Brain Injury (1)
- Cardiovascular Conditions (1)
- Case Study (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- (-) Children/Adolescents (27)
- Communication (2)
- COVID-19 (3)
- (-) Critical Care (27)
- Diagnostic Safety and Quality (3)
- Education: Continuing Medical Education (1)
- Emergency Department (1)
- Healthcare-Associated Infections (HAIs) (1)
- Healthcare Cost and Utilization Project (HCUP) (1)
- Healthcare Costs (1)
- Hospitals (2)
- Infectious Diseases (1)
- Injuries and Wounds (1)
- Inpatient Care (1)
- Intensive Care Unit (ICU) (18)
- Medical Errors (2)
- Medication (1)
- Neurological Disorders (3)
- Outcomes (1)
- Patient Safety (7)
- Public Health (1)
- Quality Improvement (2)
- Quality of Care (2)
- Registries (4)
- Respiratory Conditions (4)
- Risk (2)
- Shared Decision Making (1)
- Simulation (3)
- Sleep Problems (1)
- Stroke (1)
- Teams (1)
- Training (2)
- Trauma (2)
- Urinary Tract Infection (UTI) (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedGeneslaw AS, Lu Y, Miles CH
Long-term increases in mental disorder diagnoses after invasive mechanical ventilation for severe childhood respiratory disease: a propensity matched observational cohort study.
They found that children without major comorbidity requiring invasive mechanical ventilation for severe respiratory illness had a 43% higher incidence of subsequent mental disorder diagnoses and a 67% higher incidence of psychotropic medication use. Both increases were substantially higher than in PICU patients with respiratory illness not necessitating invasive mechanical ventilation. They recommended further research to determine which factors related to invasive mechanical ventilation and severe respiratory illness are associated with abnormal neurodevelopment.
AHRQ-funded; HS022941.
Citation: Geneslaw AS, Lu Y, Miles CH .
Long-term increases in mental disorder diagnoses after invasive mechanical ventilation for severe childhood respiratory disease: a propensity matched observational cohort study.
Pediatr Crit Care Med 2021 Dec;22(12):1013-25. doi: 10.1097/pcc.0000000000002790..
Keywords: Children/Adolescents, Respiratory Conditions, Behavioral Health, Critical Care
Woods-Hill CZ, Koontz DW, Voskertchian A
Consensus recommendations for blood culture use in critically ill children using a modified Delphi approach.
Blood cultures are fundamental in evaluating for sepsis, but excessive cultures can lead to false-positive results and unnecessary antibiotics. The study objective was to create consensus recommendations focusing on when to safely avoid blood cultures in PICU patients. Using a modified Delphi process, the investigators created consensus recommendations on when to avoid blood cultures and prevent overuse in the PICU.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, Voskertchian A .
Consensus recommendations for blood culture use in critically ill children using a modified Delphi approach.
Pediatr Crit Care Med 2021 Sep;22(9):774-84. doi: 10.1097/pcc.0000000000002749..
Keywords: Children/Adolescents, Critical Care
Cifra CL, Custer JW, Singh H
Diagnostic errors in pediatric critical care: a systematic review.
This study is a systematic review on the prevalence, impact, and contributing factors related to diagnostic errors in the PICU. A database search was done for literature up through December 2019. Using specific criteria, 396 abstracts were screened, and 17 studies were included. Fifteen of 17 studies had an observational research design. Autopsy studies showed a 10-23% rate of missed major diagnosis with 5-16% of the errors having a potential adverse impact on survival and would have changed care management. Retrospective record review studies reported varying rates of diagnostic error from 8% in a general PICU population to 12% among unexpected critical admissions. About a quarter of those patients were discussed at PICU morbidity and mortality conferences. Most misdiagnosed conditions were cardiovascular, infectious, congenital, or neurologic. System, cognitive, and both system and cognitive factors were associated with diagnostic error but there is limited information on the impact of misdiagnosis.
AHRQ-funded; HS026965.
Citation: Cifra CL, Custer JW, Singh H .
Diagnostic errors in pediatric critical care: a systematic review.
Pediatr Crit Care Med 2021 Aug;22(8):701-12. doi: 10.1097/pcc.0000000000002735..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Intensive Care Unit (ICU), Critical Care
Becker AE, Chiotos K, McGuire JL
Intracranial hypertension in multisystem inflammatory syndrome in children.
The authors presented 4 patients with multisystem inflammatory syndrome in children who had intracranial hypertension and discussed the unique management considerations when this occurs concurrently with significant myocardial dysfunction.
AHRQ-funded; HS026393.
Citation: Becker AE, Chiotos K, McGuire JL .
Intracranial hypertension in multisystem inflammatory syndrome in children.
J Pediatr 2021 Jun;233:263-67. doi: 10.1016/j.jpeds.2021.02.062..
Keywords: Children/Adolescents, COVID-19, Critical Care, Case Study
Cifra Cifra, CL Dukes, KC Ayres, et al.
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
This pilot study’s goal was to determine the feasibility of using focused ethnography to understand the relationship between referral communication and the diagnostic process for critically ill children. Findings showed that focused ethnography in the pediatric intensive care unit is feasible to investigate relationships between clinician referral communication and the diagnostic process for critically ill children.
AHRQ-funded; HS026965.
Citation: Cifra Cifra, CL Dukes, KC Ayres, et al..
Referral communication for pediatric intensive care unit admission and the diagnosis of critically ill children: a pilot ethnography.
J Crit Care 2021 Jun;63:246-49. doi: 10.1016/j.jcrc.2020.09.011..
Keywords: Children/Adolescents, Communication, Critical Care, Intensive Care Unit (ICU), Diagnostic Safety and Quality
Colman N, Newman JW, Nishisaki A
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
This single-center retrospective review discusses a translational simulation conducted to improve compliance with the National Emergency Airway Registry for Children (NEAR4KIDS) Airway Safety Quality Improvement (QI) bundle to improve the safety of tracheal intubations. The simulation was implemented between March and December 2018. Bundle adherence was assessed 12 months before simulation and 9 months after. Primary outcomes measures were compliance with the bundle and utilization of apneic oxygenation and secondary outcomes was the occurrence of adverse tracheal intubation-associated events. Preintervention bundle compliance was 66%, which increased to 93.7% after the simulation intervention. Adherence to apneic oxygenation was 27.9% before the intervention and increased to 77.9% after. There was no difference in the occurrence of tracheal intubation events.
AHRQ-funded; HS024511.
Citation: Colman N, Newman JW, Nishisaki A .
Translational simulation improves compliance with the NEAR4KIDS Airway Safety Bundle in a single-center PICU.
Pediatr Qual Saf 2021 May-Jun;6(3):e409. doi: 10.1097/pq9.0000000000000409..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Registries, Simulation, Patient Safety, Quality Improvement, Quality of Care
Nishisaki A, Lee A, Li S
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
The authors sought to evaluate the effect of a tracheal intubation safety bundle on adverse tracheal intubation-associated events across 15 PICUs. The safety bundle included a quarterly site benchmark performance reports and an airway safety checklist consisting of preprocedure risk factor, approach, and role planning, preprocedure bedside "time-out," and immediate postprocedure debriefing. The authors found that effective implementation of a quality-improvement bundle was associated with a decrease in the adverse tracheal intubation-associated event that was sustained for 24 months.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Nishisaki A, Lee A, Li S .
Sustained improvement in tracheal intubation safety across a 15-center quality-improvement collaborative: an interventional study from the national emergency airway registry for children investigators.
Crit Care Med 2021 Feb;49(2):250-60. doi: 10.1097/ccm.0000000000004725..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Patient Safety, Quality Improvement, Quality of Care
Balikai SC, Badheka A, Casey A
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
This paper describes the outcomes of pediatric intensive care unit (PICU) simulation training to safely perform endotracheal intubations in children with suspected or confirmed COVID-19. Confidence levels before and after training was measured using the Simulation Effectiveness Tool-Modified (SET-M, Likert scale 0-2). Fifty unique PICU staff members participated in 9 simulation sessions and mean confidences scores increased from 0.9 to 2.
AHRQ-funded; HS026965.
Citation: Balikai SC, Badheka A, Casey A .
Simulation to train pediatric ICU teams in endotracheal intubation of patients with COVID-19.
Pediatr Qual Saf 2021 Jan-Feb;6(1):e373. doi: 10.1097/pq9.0000000000000373..
Keywords: Children/Adolescents, COVID-19, Intensive Care Unit (ICU), Critical Care, Simulation, Training, Public Health, Infectious Diseases
Branca A, Tellez D, Berkenbosch J
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Researchers evaluated the effect of the timing of the PICU fellow academic cycle on tracheal intubation-associated events in a retrospective cohort study of 37 PICUs participating in the National Emergency Airway Registry for Children.. They found that the New Trainee Effect in tracheal intubation safety outcomes was not observed in various types of PICUs. There was a significant improvement in pediatric critical care medicine fellows' first attempt success and a significant decline in tracheal intubation-associated event rates, indicating substantial skills acquisition throughout pediatric critical care medicine fellowship.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Branca A, Tellez D, Berkenbosch J .
The new trainee effect in tracheal intubation procedural safety across PICUs in North America: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2020 Dec;21(12):1042-50. doi: 10.1097/pcc.0000000000002480..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Patient Safety, Registries, Education: Continuing Medical Education, Training
Sosa T, Ferris S, Frese C
Comparing two proximal measures of unrecognized clinical deterioration in children.
Critical deterioration events (CDEs) and emergency transfers (ETs) are two proximal measures to cardiopulmonary arrest, and both aim to evaluate how systems recognize and respond to clinical deterioration in children. This retrospective observational study sought to (1) characterize CDEs and ETs by timing, overlap, and intervention category, and (2) evaluate the performance of the watcher identification system and the pediatric early warning score (PEWS) to identify patients who experience these events.
AHRQ-funded; HS023827.
Citation: Sosa T, Ferris S, Frese C .
Comparing two proximal measures of unrecognized clinical deterioration in children.
J Hosp Med 2020 Nov;15(11):673-76. doi: 10.12788/jhm.3515..
Keywords: Children/Adolescents, Cardiovascular Conditions, Critical Care, Inpatient Care
Emeriaud G, Napolitano N, Polikoff P
Impact of failure of noninvasive ventilation on the safety of pediatric tracheal intubation.
This prospective multicenter cohort study’s objective was to assess whether noninvasive ventilation failure in critically ill children was associated with severe tracheal intubation-associated events and severe oxygen desaturation during tracheal intubation. Data from the National Emergency Airway Registry for Children was used to examine data from thirteen PICUs (in 12 institutions) in the United States and Canada. The study included 956 tracheal intubation encounters, with 424 (44%) occurring after noninvasive ventilation failure with a median of 13 hours of noninvasive ventilation. The failure group included more infants (47% vs 33%) and patients with a respiratory diagnosis (56% vs 30%). Noninvasive ventilation failure was not associated with severe tracheal intubation-associated events without noninvasive ventilation but was associated with severe desaturation (15% vs 9%) without noninvasive ventilation.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Emeriaud G, Napolitano N, Polikoff P .
Impact of failure of noninvasive ventilation on the safety of pediatric tracheal intubation.
Crit Care Med 2020 Oct;48(10):1503-12. doi: 10.1097/ccm.0000000000004500..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Patient Safety, Adverse Events
Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Tracheal intubation by respiratory therapists (RTs) is a well-established practice that has been described primarily in adult and neonatal patients. However, minimal data exist regarding RTs' intubation performance in pediatric ICUs. The purpose of this study was to describe the current landscape of intubations performed by RTs in pediatric ICUs. The investigators found that RTs infrequently intubated in pediatric ICUs, with success rates similar to other providers but higher adverse event rates. RTs were more likely to use video laryngoscopy than other providers.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Miller Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA Miller AG, Napolitano N, Turner DA, Miller AG, Napolitano N, Turner DA .
Respiratory therapist intubation practice in pediatric ICUs: a multicenter registry study.
Respir Care 2020 Oct;65(10):1534-40. doi: 10.4187/respcare.07667..
Keywords: Children/Adolescents, Respiratory Conditions, Intensive Care Unit (ICU), Registries, Critical Care
Daigle CH, Fiadjoe JE, Laverriere EK
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
This study looked at the epidemiology, risk factors, and clinical implications of difficult bag-mask ventilation among critically ill children. The prevalence and risk factors are described as well as its association with adverse tracheal intubation-associated events and oxygen desaturation in PICU patients. This retrospective review used observational data collected from a multicenter tracheal intubation database (National Emergency Airway Registry for Children) from January 2013 to December 2018 from 46 international PICUs. Difficult bag-mask ventilation was reported in 9.5% of 15,810 patients undergoing tracheal intubation with bag-mask ventilation. Difficult bag-mask ventilation was more commonly reported with increasing age, those with a primary respiratory diagnosis/indication for tracheal intubation, presence of difficulty airway features, more experienced provider level, and tracheal intubations without use of neuromuscular blockade. Specific intubation-associated or oxygen desaturation events occurred in 40.2% of patients with reported difficult bag-mask ventilation versus 19.8% in patients without difficult bag-mask ventilation.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Daigle CH, Fiadjoe JE, Laverriere EK .
Difficult bag-mask ventilation in critically ill children is independently associated with adverse events.
Crit Care Med 2020 Sep;48(9):e744-e52. doi: 10.1097/ccm.0000000000004425..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Adverse Events, Risk
Morgan RW, Kienzle M, Sen AI
Pediatric resuscitation practices during the coronavirus disease 2019 pandemic.
This multi-institutional survey asked U.S. pediatric intensive care units (PICUs) on practices regarding inpatient resuscitation practices during the 2019 coronavirus pandemic. Out of 130 institutions surveyed, 60% responded. Forty-eight centers had admitted pediatric coronavirus disease patients, with 33% reporting code team activation for patients with suspected/confirmed coronavirus disease. Eighty-six percent of respondents had implemented changes to inpatient emergency response systems, including: limited number of personnel entering patient rooms, limited resident involvement, and new or refined team roles. Most institutions are using enhanced personal protective equipment (PPE) and 23% have PPE policies dependent on the performance of aerosol generating procedures. Most institutions do not have policies regarding limitations of resuscitation efforts in coronavirus disease pediatric patients.
AHRQ-funded; HS026975.
Citation: Morgan RW, Kienzle M, Sen AI .
Pediatric resuscitation practices during the coronavirus disease 2019 pandemic.
Pediatr Crit Care Med 2020 Sep;21(9):e651-e60. doi: 10.1097/pcc.0000000000002512..
Keywords: Children/Adolescents, COVID-19, Intensive Care Unit (ICU), Critical Care
Rozenfeld RA, Nannicelli AP, Brown AR
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
The objective of this study was to assess health-care teams' verbal communication, an observable teamwork behavior, during simulations involving pediatric emergency airway management and intubation. The investigators found that no uniform statement was identified to declare an airway emergency among the care teams. Preintubation medication dosages were not consistently included in intubation medication orders, and frequently, there were multiple requests to obtain medications.
AHRQ-funded; HS017909.
Citation: Rozenfeld RA, Nannicelli AP, Brown AR .
Verbal communication during airway management and emergent endotracheal intubation: observations of team behavior among multi-institutional pediatric intensive care unit in situ simulations.
J Patient Saf 2020 Sep;16(3):e114-e19. doi: 10.1097/pts.0000000000000272..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Teams, Communication, Simulation
Hartman ME, Williams CN, Hall TA
Post-intensive-care syndrome for the pediatric neurologist.
The investigators are working to create awareness and help mitigate post-intensive-care syndrome in pediatric patients who had experienced primary neurological injury and also help their parents and siblings. In this paper they review current knowledge regarding post-intensive-care syndrome in pediatrics and its risk factors. They describe their experience establishing Pediatric Neurocritical Care Recovery Programs at two large academic centers. They also provide a battery of validated tests to identify and manage the different aspects of post-intensive-care syndrome in pediatrics.
AHRQ-funded; HS022981.
Citation: Hartman ME, Williams CN, Hall TA .
Post-intensive-care syndrome for the pediatric neurologist.
Pediatr Neurol 2020 Jul;108:47-53. doi: 10.1016/j.pediatrneurol.2020.02.003..
Keywords: Children/Adolescents, Neurological Disorders, Intensive Care Unit (ICU), Critical Care, Risk
Conway JA, Kharayat P, Sanders RC
Ketamine use for tracheal intubation in critically ill children is associated with a lower occurrence of adverse hemodynamic events.
Tracheal intubation in critically ill children with shock poses a risk of hemodynamic compromise. Ketamine has been considered the drug of choice for induction in these patients, but limited data exist. In this study, the authors investigated whether the administration of ketamine for tracheal intubation in critically ill children with or without shock was associated with fewer adverse hemodynamic events compared with other induction agents. They also investigated if there was a dose dependence for any association between ketamine use and adverse hemodynamic events.
AHRQ-funded; HS021583; HS022464; HS024511.
Citation: Conway JA, Kharayat P, Sanders RC .
Ketamine use for tracheal intubation in critically ill children is associated with a lower occurrence of adverse hemodynamic events.
Crit Care Med 2020 Jun;48(6):e489-e97. doi: 10.1097/ccm.0000000000004314..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Medication
Cifra CL, Ten Eyck P, Dawson JD
Factors associated with diagnostic error on admission to a PICU: a pilot study.
This pilot retrospective cohort study examined errors in pediatric ICUs (PICUs) for children during the first 12 hours after PICU admission. A structured tool (Safer Dx) was used to identify diagnostic error in an academic tertiary institution. Out of 50 patients, 4 (8%) had diagnostic errors. The errors were in diagnoses of chronic ear infection, intracranial pressure (two cases), and Bartonella encephalitis. This pilot study will be expanded into a larger and more definitive multicenter study.
AHRQ-funded; HS022087.
Citation: Cifra CL, Ten Eyck P, Dawson JD .
Factors associated with diagnostic error on admission to a PICU: a pilot study.
Pediatr Crit Care Med 2020 May;21(5):e311-e15. doi: 10.1097/pcc.0000000000002257..
Keywords: Children/Adolescents, Diagnostic Safety and Quality, Medical Errors, Adverse Events, Patient Safety, Critical Care, Intensive Care Unit (ICU), Hospitals
Balmaks R, Whitfill TM, Ziemele B
Pediatric readiness in the emergency department and its association with patient outcomes in critical care: a prospective cohort study.
The purpose of this study was to assess the quality of pediatric acute care and pediatric readiness and to determine their association with patient outcomes using a patient registry. Studying all Latvian Emergency Departments and the national PICU, researchers’ findings showed that a higher weighted pediatric readiness score was associated significantly with lower length of stay in both the PICU and hospital and lower 6-month mortality. Pediatric readiness in the emergency department was associated with patient outcomes in this population of pediatric patients transferred to the national PICU.
AHRQ-funded; HS020286.
Citation: Balmaks R, Whitfill TM, Ziemele B .
Pediatric readiness in the emergency department and its association with patient outcomes in critical care: a prospective cohort study.
Pediatr Crit Care Med 2020 May;21(5):e213-e20. doi: 10.1097/pcc.0000000000002255..
Keywords: Children/Adolescents, Emergency Department, Critical Care, Intensive Care Unit (ICU), Outcomes
Williams CN, Hartman ME, McEvoy CT
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. In this prospective cohort study, the investigators aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances. The investigators concluded that over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. They indicated that many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep.
AHRQ-funded; HS022981.
Citation: Williams CN, Hartman ME, McEvoy CT .
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Pediatr Neurol 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010..
Keywords: Children/Adolescents, Brain Injury, Critical Care, Sleep Problems, Trauma, Injuries and Wounds, Neurological Disorders
Woods-Hill CZ, Koontz DW, King AF
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Sending blood cultures in children at low risk of bacteremia can contribute to a cascade of unnecessary antibiotic exposure, adverse effects, and increased costs. In this study, the investigators aimed to describe practice variation, clinician beliefs, and attitudes about blood culture testing in critically ill children. They concluded that there is variation in blood culture practices in the pediatric ICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia.
AHRQ-funded; HS025642.
Citation: Woods-Hill CZ, Koontz DW, King AF .
Practices, perceptions, and attitudes in the evaluation of critically ill children for bacteremia: a national survey.
Pediatr Crit Care Med 2020 Jan;21(1):e23-e29. doi: 10.1097/pcc.0000000000002176..
Keywords: Children/Adolescents, Critical Care, Antimicrobial Stewardship, Antibiotics, Adverse Drug Events (ADE), Adverse Events, Patient Safety, Intensive Care Unit (ICU), Shared Decision Making
Williams CN, Piantino J, McEvoy C
The burden of pediatric neurocritical care in the United States.
This article attempts to quantify the burden of pediatric neurocritical care (PNCC) by developing national estimates of disease incidence, evaluating use of critical care interventions (CCI), and examining hospital outcomes. The Kids Inpatient Database (KID) was analyzed to evaluate cohorts with the following conditions: traumatic brain injury, neuro-infection, or inflammatory diseases; status epilepticus; stroke; hypoxic ischemic injury after cardiac arrest; or spinal cord injury.
AHRQ-funded; HS022981.
Citation: Williams CN, Piantino J, McEvoy C .
The burden of pediatric neurocritical care in the United States.
Pediatr Neurol 2018 Dec;89:31-38. doi: 10.1016/j.pediatrneurol.2018.07.013..
Keywords: Children/Adolescents, Critical Care, Healthcare Costs, Healthcare Cost and Utilization Project (HCUP), Neurological Disorders, Stroke, Trauma
Sobotka SA, Peters S, Pinto NP
Neurodevelopmental disorders in the PICU population.
Attention deficit hyperactivity disorder (ADHD), affecting 11% of children and adolescents, increases risk for injury and may predispose children to illness. However, the prevalence of ADHD and other developmental disorders in the pediatric intensive care unit (PICU) has not been previously studied. In this study, the investigators performed a single-center, prospective cohort study of children aged 6 to 12 years who were hospitalized in the PICU from May through August 2016.
AHRQ-funded; HS023007.
Citation: Sobotka SA, Peters S, Pinto NP .
Neurodevelopmental disorders in the PICU population.
Clin Pediatr 2018 Jul;57(8):913-19. doi: 10.1177/0009922817737080..
Keywords: Children/Adolescents, Intensive Care Unit (ICU), Critical Care, Behavioral Health
Kojima T, Harwayne-Gidansky I, Shenoi AN
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
The objective of this retrospective cohort study was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in pediatric intensive care unit (PICU). The investigators found that cricoid pressure during induction and mask ventilation before tracheal intubation in the current ICU practice was not associated with a lower regurgitation rate after adjusting for previously reported confounders.
AHRQ-funded; HS024511.
Citation: Kojima T, Harwayne-Gidansky I, Shenoi AN .
Cricoid pressure during induction for tracheal intubation in critically ill children: a report from National Emergency Airway Registry for Children.
Pediatr Crit Care Med 2018 Jun;19(6):528-37. doi: 10.1097/pcc.0000000000001531.
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Keywords: Children/Adolescents, Critical Care, Children/Adolescents, Registries, Respiratory Conditions
Kojima T, Laverriere EK, Owen EB
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
In this retrospective observational study, the objective was to evaluate the association between external laryngeal manipulation use and initial tracheal intubation attempt success in pediatric ICUs. The investigators found that external laryngeal manipulation during direct laryngoscopy was associated with lower initial tracheal intubation attempt success in critically ill children, even after adjusting for underlying differences in patient factors and provider levels. They asserted that the indiscriminate use of external laryngeal manipulation cannot be recommended.
AHRQ-funded; HS024511.
Citation: Kojima T, Laverriere EK, Owen EB .
Clinical impact of external laryngeal manipulation during laryngoscopy on tracheal intubation success in critically ill children.
Pediatr Crit Care Med 2018 Feb;19(2):106-14. doi: 10.1097/pcc.0000000000001373..
Keywords: Children/Adolescents, Critical Care, Intensive Care Unit (ICU), Children/Adolescents, Respiratory Conditions