Cardiac output monitoring in children: a review
Cardiac output monitoring enables physiology-directed management of critically ill children and aids in the early detection of clinical deterioration. Multiple invasive techniques have been developed and have demonstrated ability to improve clinical outcomes. However, all require invasive arterial or venous catheters, with associated risks of infection, thrombosis and vascular injury. Non-invasive monitoring of cardiac output and fluid responsiveness in infants and children is an active area of interest and several proven techniques are available. Novel non-invasive cardiac output monitors offer a promising alternative to ...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Cave, D. G., Bautista, M. J., Mustafa, K., Bentham, J. R. Tags: Review Source Type: research
Message to the new prime minister (whoever this might be)
The country is in serious difficulties. Here I suggest a course of action alternative to that pursued by recent administrations, one that recognises the value of healthy children to the economy. The UK is experiencing a revolving-door set of prime ministers in this 12th year of Conservative rule. New cabinet ministers are no doubt eager to make their mark, aware that the country is in very grave economic difficulty. However, the turbulence in fiscal policy is clear evidence of disagreement in the approach to pursue. Therefore, it seems an appropriate moment to draw their attention to the value of children to the nation&rsq...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Modi, N. Tags: Viewpoint Source Type: research
Atoms
The new turquoise A good case could be made for awarding the dynamics of etymology the (centuries overdue) ‘official’ eighth wonder of the world award. I concede this is a more nebulous entity than the already recognised (edificial) jaw-droppers making up the standard listings, but, if artistic value, imagination, development, communication are the pre-requisites, why look further? Expanding the argument, which other ‘ology’ is a more sensitive final common pathway for the amalgam that is history, global migratory patterns, geology, archaeology and genetics. Most of us are off the pulse in terms of ...
Source: Archives of Disease in Childhood - November 17, 2023 Category: Pediatrics Authors: Brown, N. Tags: Highlights from this issue Source Type: research
Highlights from the literature
Gun crime Gun Crime is a major concern in USA; the annual death rate from gun violence is 3.6 per 100 000 population. The annual rate of gun murder per 100 000 of the population is currently 0.03 in UK. The total firearms death rate is 51 times higher in the US than in the UK the USA. Gun violence remains the number one cause of death for children ages 1–19 at a rate of almost 5 in every 100 000 in the USA. It is a political hot topic. What can be done? How can it be prevented other than the obvious banning of firearms? Kjærvik SL et al [JAMA Pediatr. 2023;177(9):903–910. doi:10.1001/jamapediatrics.2023.2...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Paediatric hospital antimicrobial guidelines: a national UK review
Paediatric inpatient antimicrobial prescribing is frequently inappropriate and varies markedly and unnecessarily across the UK between tertiary centres, district general hospitals and even between clinicians in individual hospitals.1 Antimicrobial guidelines have been frequently mentioned by clinicians in the UK as informing paediatric antibiotic prescribing practice.2 Guidelines are more likely to be used by clinicians if they are evidence based, rigorously produced and shown to improve outcomes.3 The UK Paediatric Antimicrobial Stewardship (UK-PAS) network therefore aims to reach national consensus by publishing an antim...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Shears, A., Hoskyns, L., Flinders, P., Conry, R., McMaster, P., UK-PAS Committee, Channon-Wells, Demirjian, Doerholt, Drysdale, Hatcher, Hindocha, Emonts, Patel, Rafferty, Ferras-Antolin, Trivedi, Vergano, Verma Tags: PostScript Source Type: research
Incidence and aetiology of Danish children with community-acquired pneumonia treated with chest tube drainage in 2022-2023 versus the previous three decades
An emergence of complicated pneumonia due to invasive group A Streptococcus (GAS) was reported in 2022–2023.1 We aimed to explore the incidence and cause of complicated community-acquired pneumonia treated with chest tube drainage (CTD) in 2022–2023, compared with the preceding three decades. We retrospectively enrolled all patients aged 0–17 years treated with CTD due to community-acquired pneumonia from 1993–1994 to 2022–2023 at Copenhagen University Hospital, Rigshospitalet, a tertiary referral centre for CTD in Eastern Denmark, the Faroe Islands and Greenland (2.6 million inhabitants). Dat...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Nygaard, U., Bloch, J., Dungu, K. H. S., Vollmond, C., Buchvald, F. F., Nielsen, K. G., Kristensen, K., Poulsen, A., Vissing, N. H. Tags: Open access PostScript Source Type: research
Mobile apps and childrens privacy: a traffic analysis of data sharing practices among childrens mobile iOS apps
Despite policy recognition of children’s vulnerability online, children’s apps (or parental apps involving children’s data) may share user data with third parties, which may be used to create detailed, long-term profiles of children, generating privacy risks.1 2 These risks have attracted policy attention from the Federal Trade Commission; Apple Inc. subsequently stipulated that apps developed for children may not send personally identifiable or device information to third parties and should not include third-party trackers or advertising. We conducted a cross-sectional study of top user-rated mobile apps...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Pimienta, J., Brandt, J., Bethe, T., Holz, R., Continella, A., Jibb, L., Grundy, Q. Tags: Open access PostScript Source Type: research
Towards evidence-based medicine for paediatricians
Different devices Occasionally in paediatrics you will be thinking about using a ‘medical device’. (Though you probably did not realise it, you are likely to have had a Class Im medical device to auscultate a chest in the last month or so, if you have worked in a clinical environment. Or used one to check a blood pressure.) We are making clinical decisions with some of them and about the use of them in other cases. How can we evaluate them? It turns out, like most things we prescribe, most of the hard work has been done for us. Devices are classified from low risk (class I, eg, stethoscope) to high risk (class ...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Phillips, B. Tags: ADC Archimedes Source Type: research
Is chest drain insertion and fibrinolysis therapy equivalent to video-assisted thoracoscopic surgery to treat children with parapneumonic effusions?
Scenario A 12-year-old boy, previously fit and well, presents to his local paediatric emergency department after 5 days of fever and a cough, and 2 days of increasing difficulty breathing. His oxygen saturation is 90% in air, and he requires 2 L of oxygen via nasal cannula. He is started on broad-spectrum antibiotics and further investigations are arranged. A chest X-ray is performed and shows a large left-sided pleural effusion. An ultrasound demonstrates the effusion is complex and loculated, with underlying lung consolidation, in keeping with a stage II parapneumonic effusion. The medical team wonders whether insertion ...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Bell, A. C. J., Baker, C., Duret, A. Tags: ADC Archimedes Source Type: research
Resilience in children with congenital heart disease: a comparative study with health counterparts
Conclusions
Resilience was reduced in children and adolescents with CHD compared with healthy peers during the COVID-19 pandemic. Children with complex severity appeared to be particularly affected. These findings emphasise continued efforts to provide a holistic and multidisciplinary approach in medical aftercare of these patients and their families. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Köble, K., Willinger, L., Brudy, L., Oberhoffer-Fritz, R., Ewert, P., Müller, J. Tags: COVID-19 Original research Source Type: research
Understanding caregiver experiences with disease-modifying therapies for spinal muscular atrophy: a qualitative study
Conclusion
The caregiver experience with SMA has been transformed by the advent of disease-modifying therapies. Consistent and predictable access to disease-modifying therapies is a major concern for caregivers of children with SMA but is influenced by regulatory approvals, funding and eligibility criteria that are heterogenous across jurisdictions. Many caregivers described going to great lengths to access therapies, highlighting issues related to justice, such as equity and access. This diverse population reflects contemporary patients and families with SMA; their broad experiences may inform the healthcare delivery of o...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Xiao, L., Kang, S., Djordjevic, D., Gonorazky, H., Chiang, J., Ambreen, M., Nigro, E., Law, E., Weinstock, L., McCradden, M., Amin, R. Tags: Editor's choice Original research Source Type: research
Severe encephalitis: aetiology, management and outcomes over 10 years in a paediatric intensive care unit
Conclusions
Encephalitis has a varied aetiology and causes death or severe disability in 1 in every 10 children requiring intensive care. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Palmas, G., Duke, T. Tags: Original research Source Type: research
Rising Kawasaki disease incidence in New Zealand: analysis of national population incidence and outcomes 2000-2017
Conclusions
There is evidence of increasing KD hospitalisation in NZ, similar to recent studies from Northeast Asia and Australia. KD incidence data were available for retrospective review from a national database, but data on complications and outcomes were incomplete. Notification for KD and an active national surveillance system are recommended to improve care. Future work should focus on factors contributing to poorer outcomes in Māori. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Gee, P., Burgner, D., Gee, W., Forbes, A., Frampton, C. M. A., McCombie, A. Tags: Original research Source Type: research
More on Kawasaki disease
Coronary artery aneurysms (CAA) are the major sequelae following a diagnosis of Kawasaki disease (KD). We know that the younger infant is more at risk of this complication and early commencement of IV Immunoglobulin (IVIG) is the key to prevention. There is, of course a genetic and environmental influence on response and outcome. Can we identify those infants or children at risk early on in their illness? Several prediction tools are available for identification of those at risk of CAA and the initial ones were based on Japanese populations. It may be necessary to have those prediction tools derived from different populati...
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Tags: Miscellanea Source Type: research
Intrahepatic portosystemic shunts, from prenatal diagnosis to postnatal outcome: a retrospective study
Conclusions
IHPSS usually close spontaneously by 2 years of age. Children with prenatally detected IHPSS may develop FTT and mild developmental delay. Close surveillance at a paediatric gastroenterology unit may be beneficial. (Source: Archives of Disease in Childhood)
Source: Archives of Disease in Childhood - October 30, 2023 Category: Pediatrics Authors: Steg Saban, O., Weissbach, T., Achiron, R., Pekar Zlotin, M., Haberman, Y., Anis Heusler, A., Kassif, E., Weiss, B. Tags: Original research Source Type: research
