Review of Noninvasive Neuromonitoring Modalities in Children II: EEG, qEEG – Neurocritical Care (if the link is paywalled, try this one)
SR | Systemic corticosteroid regimens for prevention of bronchopulmonary dysplasia in preterm infants21 Mar, 2023 | 13:14h | UTC
Point-of-care ultrasound (POCUS) protocol for systematic assessment of the crashing neonate—expert consensus statement of the international crashing neonate working group – European Journal of Pediatrics
This updated systematic review analyzed nine randomized controlled trials comparing ultrasound guidance to traditional methods of locating arteries for cannulation, such as palpation and Doppler auditory assistance.
The review found that ultrasound guidance probably improves first-attempt success rates, reduces the risk of complications such as hematoma formation, improves success rates within two attempts and the overall rate of successful cannulation, and reduces the number of attempts and duration of the cannulation procedure.
However, the review also notes that the evidence is only of moderate certainty due to the inability to mask the doctors performing the cannulation and the limited number of children studied. More research is needed to confirm the benefits of ultrasound guidance for arterial cannulation in different age groups of children.
BTS Clinical Guidance | Prevention and management of community-acquired pneumonia in people with learning disability6 Mar, 2023 | 14:34h | UTC
RCT | 2-y outcomes confirm the harms caused by high prophylactic platelet transfusion thresholds in preterm infants28 Feb, 2023 | 13:53h | UTC
Summary: The study investigated the long-term outcomes of preterm infants who participated in a randomized trial of platelet transfusions at different threshold levels. Infants with platelet counts below 50×109/L were enrolled and randomized to either a higher threshold of 50×109/L or a lower threshold of 25×109/L. The study found that infants randomized to the higher threshold had a higher rate of death or significant neurodevelopmental impairment at a corrected age of 2 years compared to the lower threshold group. The study further supports evidence of harm caused by high prophylactic platelet transfusion thresholds in preterm infants. The mechanisms by which platelet transfusions could mediate harmful effects remain unknown, but the study identified increased rates of intraventricular hemorrhage and bronchopulmonary dysplasia in the higher threshold group, which may contribute to the adverse outcomes observed.
Original Study: Randomized Trial: Platelet-Transfusion Thresholds in Neonates
Commentary from the author on Twitter (thread – click for more)
We already knew from the @PlaNeT2_trial that a higher prophylactic platelet transfusion threshold (<50) in preterm babies is associated with significantly increased mortality or major bleeding compared with a lower one (<25)… https://t.co/pJrE44BIIx
— Carmel Moore (@carmelmoore) February 22, 2023
AAP Policy Statement | Crowding in the emergency department: challenges and recommendations for the care of children28 Feb, 2023 | 13:50h | UTC
Summary: The article discusses a systematic review and meta-analysis of randomized controlled trials comparing low-dose insulin at 0.05 units/kg/hr to standard dose at 0.1 units/kg/hr for children with diabetic ketoacidosis (DKA). The study found that low-dose insulin infusion is probably as efficacious and safer than standard-dose insulin in treating DKA in children, as it has no effect on the time to resolution of hyperglycemia or acidosis and probably reduces the risk of developing hypokalemia and hypoglycemia. However, the results are limited by imprecision and generalizability to other settings since all studies were performed in a single country. Therefore, further studies are required to identify the optimal insulin dose for children with DKA in terms of safety and effectiveness.
Instant noodle burns common in pediatric scald injuries: Study highlights need for prevention efforts21 Feb, 2023 | 11:50h | UTC
Summary: The study examined pediatric scald burns at the University of Chicago Burn Center between 2010 and 2020 and found that 31% of burns were attributed to instant noodles. Children with instant noodle burns were typically older, more likely to be Black/African American, and from lower socio-economic backgrounds. They were also more likely to be unsupervised at the time of the injury. While instant noodle burns were smaller and required less operative intervention than other scald burns, some still required hospitalization and were associated with complications. The study highlights the need for targeted burn prevention efforts to reduce the incidence of these common but serious injuries.
Article: Pediatric instant noodle burns: A ten-year single center retrospective study – Burns (link to abstract – $ for full-text)
Other articles in the supplement:
What’s new in the management of neonatal early-onset sepsis? – ADC Fetal & Neonatal Edition (free for a limited period)
RCT | Methylprednisolone vs. immunoglobulins equally effective in PIMS temporally associated with SARS-CoV-28 Feb, 2023 | 12:42h | UTC
Methylprednisolone versus intravenous immunoglobulins in children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS): an open-label, multicentre, randomised trial – The Lancet Child & Adolescent Health
RCT | Efficacy of a loading dose of IV salbutamol in children with severe acute asthma admitted to a PICU8 Feb, 2023 | 12:10h | UTC
Cohort Study | Perinatal predictors of clinical instability at birth in late-preterm and term infants8 Feb, 2023 | 12:09h | UTC
RCT | Assessment of infant position and timing of stylet removal to improve lumbar puncture success in neonates31 Jan, 2023 | 14:07h | UTC
Assessment of infant position and timing of stylet removal to improve lumbar puncture success in neonates (NeoCLEAR): an open-label, 2 × 2 factorial, randomised, controlled trial – The Lancet Child & Adolescent Health
Commentary on Twitter
Sitting lumbar puncture is safe, cost neutral, and well tolerated.
— The Lancet Child & Adolescent Health (@LancetChildAdol) November 30, 2022
Case Series | Higher Troponin was associated with persistent cardiac MRI lesions in children with myocarditis after mRNA-based COVID-19 vaccination30 Jan, 2023 | 01:01h | UTC
Higher Troponin Levels on Admission are associated With Persistent Cardiac Magnetic Resonance Lesions in Children Developing Myocarditis After mRNA-Based COVID-19 Vaccination – The Pediatric Infectious Disease Journal