Pediatrics
-
Multicenter Study Comparative Study
Skin conductance versus the modified COMFORT sedation score as a measure of discomfort in artificially ventilated children.
We wanted to use skin conductance as a measure of increased stress in artificially ventilated children. The aim was to examine how changes in skin conductance, arterial blood pressure, and heart rate are associated with changes in the modified COMFORT sedation score during suction from the trachea. Nociceptive stimulation induces an outgoing sympathetic nervous burst to the skin and the palmar and plantar sweat glands are filled, which creates a skin conductance fluctuation. ⋯ The number of skin conductance fluctuations during endotracheal suctioning showed better correlation with the increase in the modified COMFORT sedation score than heart rate and arterial blood pressure. Thus, the number of skin conductance fluctuations seems to be an objective supplement to the modified COMFORT sedation score for monitoring increased stress in artificially ventilated and circulatory stable children.
-
Multicenter Study Comparative Study
Influenza-associated pediatric mortality in the United States: increase of Staphylococcus aureus coinfection.
Pediatric influenza-associated death became a nationally notifiable condition in the United States during 2004. We describe influenza-associated pediatric mortality from 2004 to 2007, including an increase of Staphylococcus aureus coinfections. ⋯ Influenza-associated pediatric mortality is rare, but the proportion of S aureus coinfection identified increased fivefold over the past 3 seasons. Research is needed to identify risk factors for influenza coinfection with invasive bacteria and to determine the impact of influenza vaccination and antiviral agents in preventing pediatric mortality.
-
Comparative Study
Procalcitonin in young febrile infants for the detection of serious bacterial infections.
The objectives of the study were (1) to study the test performance of procalcitonin for identifying serious bacterial infections in febrile infants
-
Comparative Study
Pulse oximetry screening at 4 hours of age to detect critical congenital heart defects.
The purpose of this prospective study was to assess the feasibility and reliability of pulse oximetry screening to detect critical congenital heart defects in a newborn nursery. ⋯ All neonates with a critical congenital heart defect were detected clinically, and no cases of critical congenital heart defect were detected by pulse oximetry screening. These results indicate that pulse oximetry screening does not improve detection of critical congenital heart defects above and beyond clinical observation and assessment. Our findings do not support a recommendation for routine pulse oximetry screening in seemingly healthy neonates.
-
Comparative Study
Preventing unintentional scald burns: moving beyond tap water.
The goal was to examine in detail the mechanisms of significant scald burns among children <5 years of age, to discover insights into prevention. ⋯ Current prevention strategies and messages do not adequately address the most common mechanisms of scald injury requiring hospitalization. Easy access to a microwave oven poses a significant scald risk to children as young as 18 months of age, who can open the door and remove the hot contents. An engineering fix for microwave ovens could help protect young children from this mechanism of scalding. Involvement of older children in a subset of scald injuries is a new finding that may have prevention implications.