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Current monitoring and innovative predictive modeling to improve care in the pediatric cardiac intensive care unit

Mary K. Olive, Gabe E. Owens
2018 Translational Pediatrics  
Footnote Conflicts of Interest: The authors have no conflicts of interest to declare.  ...  Decision tree induction can be used to integrate multiple different physiologic signals to distinguish true values from artifacts in monitored data (43) .  ...  Introduction A unique challenge exists in the visualization and interpretation of the enormous quantities of patient specific data in the extensively monitored environment of a pediatric cardiac intensive  ... 
doi:10.21037/tp.2018.04.03 pmid:29770293 pmcid:PMC5938248 fatcat:zaqicha6cjfvtearmfrsyo76sm

A Novel Electrocardiogram Algorithm Utilizing ST-Segment Instability for Detection of Cardiopulmonary Arrest in Single Ventricle Physiology

Eric L. Vu, Craig G. Rusin, Dan J. Penny, Kathy K. Kibler, Ronald Blaine Easley, Brendan Smith, Dean Andropoulos, Ken Brady
2017 Pediatric Critical Care Medicine  
Utilizing signal processing, there was an increase in ST vector magnitude (p = 0.02) and instability (p = 0.008) in the arrest group.  ...  Magnitude and instability of this continuous vector were compared between groups. There was no significant difference in mean unprocessed ST segment values in the arrest and control groups.  ...  Acknowledgments Sources of Funding: Funding for this investigation was provided by departmental funds and an NIH Pediatric Heart Network Mentored Research Award #U09-HL068270 (Craig Rusin).  ... 
doi:10.1097/pcc.0000000000000980 pmid:27755397 pmcid:PMC5466171 fatcat:uwmigfv5grd2tiydlmteux63yi

Sharing and Learning through the Pediatric Cardiac Critical Care Consortium : Moving Towards Precision Care

Peter C. Laussen
2020 Journal of Thoracic and Cardiovascular Surgery  
The PC4 registry demonstrates we can share, learn, and improve outcomes in pediatric cardiac critical care. Individualized pediatric critical care is an aspiration and achievable.  ...  It is noteworthy that predictive data analytics are used in less than 20% of pediatric cardiac ICUs. 24 In this era of ubiquitous electronic healthcare records and emerging methods for capturing high-frequency  ...  Time-series continuous physiologic data generated from patients in the operating room, ICU, and ward settings must be captured and stored permanently; analysis will allow better understanding of physiologic  ... 
doi:10.1016/j.jtcvs.2020.05.092 pmid:32680641 pmcid:PMC7286268 fatcat:xtpy6eebonejzponqpxwngytq4

The Physiology and the Clinical Significance of Postoperative Hyperlactatemia After Pediatric Cardiac Surgery [chapter]

Vered Molina-Hazan, Gideon Paret
2012 Perioperative Considerations in Cardiac Surgery  
These adverse events included death, The Physiology and the Clinical Significance of Postoperative Hyperlactatemia After Pediatric Cardiac Surgery 317 cardiac arrest, emergency chest  ... The Physiology and the Clinical Significance of Postoperative Hyperlactatemia After Pediatric Cardiac Surgery 315 6.  ...  The Physiology and the Clinical Significance of Postoperative Hyperlactatemia After Pediatric Cardiac Surgery, Perioperative Considerations in Cardiac Surgery, Prof.  ... 
doi:10.5772/26638 fatcat:ocbg6bm7qbc7jdqxkz46twcu2q

Time series analysis as input for clinical predictive modeling: Modeling cardiac arrest in a pediatric ICU

Curtis E Kennedy, James P Turley
2011 Theoretical Biology and Medical Modelling  
We illustrate the method by applying it to the specific case of building a predictive model for cardiac arrest in a pediatric intensive care unit.  ...  There are no models to predict cardiac arrest in pediatric intensive care units though, where the risk of an arrest is 10 times higher than for standard hospital beds.  ...  We illustrated the process through an example of cardiac arrest prediction in a pediatric intensive care setting.  ... 
doi:10.1186/1742-4682-8-40 pmid:22023778 pmcid:PMC3213024 fatcat:7xoia6uccnh4fcmwchcjws7eku

Limitations of adaptive physiology: are normal values really normal in the critically ill child?

Yael Feinstein, Adela Matettore, Samiran Ray, Katherine Brown, Padmanabhan Ramnarayan, Mark Peters
2019 Pediatric Medicine  
In this review we evaluate and summarize the available evidence used to guide the management of critically ill children in the general pediatric intensive care setting.  ...  The concept of stress-related decompensation is deeply rooted in medicine and the notion of physiologic homeostasis has evolved over centuries.  ...  In the most severe states of disordered homeostasis, there may be a complete loss of control that no physiologic response can fully contain, such as in cardiac or respiratory arrest.  ... 
doi:10.21037/pm.2018.12.03 fatcat:bcy2ptw5wfbg3pdfsg6f6vizia


Julia A. Heneghan, Murray M. Pollack
2017 The Pediatric clinics of North America  
The focus of critical care has evolved from saving lives to preservation of function. Morbidity rates in pediatric critical care are about double mortality rates.  ...  In pediatric critical care, functional status morbidity is an intermediate outcome in the progression towards death, and is the result of the same factors associated with mortality including physiological  ...  For example, the Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) trial investigated whether the intervention of targeted temperature management to hypothermia following cardiac arrest would  ... 
doi:10.1016/j.pcl.2017.06.011 pmid:28941541 pmcid:PMC5654565 fatcat:geycahgdx5ezvi7ixi6oa2747u

Evaluation of Electronic Medical Record Vital Sign Data Versus a Commercially Available Acuity Score in Predicting Need for Critical Intervention at a Tertiary Children's Hospital

Yong Sing da Silva, Melinda Fiedor Hamilton, Christopher Horvat, Ericka L. Fink, Fereshteh Palmer, Andrew J. Nowalk, Daniel G. Winger, Robert S. B. Clark
2015 Pediatric Critical Care Medicine  
Measurements and Main Results: Physiologic data 24 hours preceding the event were extracted from the electronic medical record.  ...  The pediatric Rothman Index (added to the electronic medical record in April 2009) was evaluated in a subset of these patients (n = 131) and 16,138 hospitalized unmatched non-ICU control patients for the  ...  PeraHealth has a contractual arrangement with Children's Hospital of Pittsburgh of UPMC for the pediatric Rothman Index.  ... 
doi:10.1097/pcc.0000000000000444 pmid:25901545 fatcat:rmg2rufmefewxfr5kcvz2g7nx4

Rapid response systems

Patrick G. Lyons, Dana P. Edelson, Matthew M. Churpek
2018 Resuscitation  
Controversy exists about the benefits of rapid response systems.  ...  Data sources-Articles written in English and published in PubMed.  ...  Cardiac Arrest Most evaluations of RRS outcomes have shown that RRS activations are associated with fewer cardiac arrests on the wards or fewer overall in-hospital cardiac arrests. 13, 44, 47, 58, 63  ... 
doi:10.1016/j.resuscitation.2018.05.013 pmid:29777740 pmcid:PMC6147149 fatcat:j4utg76x5fa47a47xxzbr6yfbu

Prognostic value of baseline carotid blood flow in critically ill children with septic shock

Fatma Mamdouh, Hafez Bazaraa, Ahmed Baz, HebatAllah Fadel Algebaly, Vincenzo Lionetti
2021 PLoS ONE  
The present study aimed to test the value of carotid artery ultrasound analysis in prediction of mortality in pediatric patients with septic shock.  ...  and aim Hemodynamic monitoring and cardiac output (CO) assessment in the ICU have been trending toward less invasive methods. Carotid blood flow (CBF) was suggested as a candidate for CO assessment.  ...  Acknowledgments We would like to thank the PICU team without their sincere work we would not accomplish this work. Author Contributions Conceptualization: HebatAllah Fadel Algebaly.  ... 
doi:10.1371/journal.pone.0251154 pmid:34298550 pmcid:PMC8302249 fatcat:bkhd6mzefzcexbhxmnybvo73ju

Biomarkers of acute kidney injury: the pathway from discovery to clinical adoption

Kianoush Kashani, Wisit Cheungpasitporn, Claudio Ronco
2017 Clinical Chemistry and Laboratory Medicine  
Finally, we review the current and future states of implementation of biomarkers in the clinical practice.  ...  In this article, we review the available literature on characteristics of promising AKI biomarkers that are currently the focus of preclinical and clinical investigations.  ...  [20] No certain prediction of AKI in adults [10] 0.82 Pediatric cardiac surgery [31] 0.59 ICU [32] [TIMP-2] × [IGFBP7] TIMP-2: a 21-kDa protein, endogenous inhibitor of metalloproteinase activities  ... 
doi:10.1515/cclm-2016-0973 pmid:28076311 fatcat:7tffcjoobng7boruxb2uzxehj4

EEG monitoring during therapeutic hypothermia in neonates, children, and adults

Nicholas S Abend, Ram Mani, Tammy N Tschuda, Tae Chang, Alexis A Topjian, Maureen Donnelly, Denise LaFalce, Margaret C Krauss, Sarah E Schmitt, Joshua M Levine
2011 American Journal of Electroneurodiagnostic Technology  
The most common indications are hypoxic ischemic encephalopathy in neonates and post cardiac arrest in adults.  ...  Electroencephalographic monitoring use is increasing in critical care units, and is sometimes a component of therapeutic hypothermia clinical pathways.  ...  PEDIATRIC Indications and Implementation of Therapeutic Hypothermia Cardiac Arrest-Pediatric cardiac arrest occurs in more than 8,000 children per year in the United States.  ... 
pmid:21988034 pmcid:PMC3422126 fatcat:7dhog2bu6ndwzf43fv3erdjotu

Brain Resuscitation in the Drowning Victim

Alexis A. Topjian, Robert A. Berg, Joost J. L. M. Bierens, Christine M. Branche, Robert S. Clark, Hans Friberg, Cornelia W. E. Hoedemaekers, Michael Holzer, Laurence M. Katz, Johannes T. A. Knape, Patrick M. Kochanek, Vinay Nadkarni (+2 others)
2012 Neurocritical Care  
Preclinical research should focus on models of asphyxial cardiac arrest.  ...  When cardiac arrest is present, chest compressions with rescue breathing are recommended due to the asphyxial insult.  ...  Acknowledgments The authors are grateful to the Maatschappij tot Redding van Drenkelingen (Society to Rescue People from Drowning), Amsterdam, the Netherlands, which supported costs and organization of  ... 
doi:10.1007/s12028-012-9747-4 pmid:22956050 pmcid:PMC3677166 fatcat:6bzdrzq43zbclo5dauajzcglpi

Clinical review: New technologies -- venturing out of the intensive care unit

Ronny Otero, A Joseph Garcia
2004 Critical Care  
The delivery of critical care is no longer limited to the intensive care unit. The information gained by utilization of new technologies has proven beneficial in some populations.  ...  Research into earlier and more widespread use of these modalities may prove to be of even greater benefit to critically ill patients.  ...  post-cardiac arrest (Table 1) .  ... 
doi:10.1186/cc2982 pmid:15987384 pmcid:PMC1175863 fatcat:eu55rtevufa3takir3rnjnsmq4

Evaluating the Pediatric Early Warning Score ( PEWS ) System for Admitted Patients in the Pediatric Emergency Department

Delia L. Gold, Leslie K. Mihalov, Daniel M. Cohen, Jennifer Walthall
2014 Academic Emergency Medicine  
Most studies investigating the PEWS evaluate its usefulness in the inpatient setting. Limited studies evaluate the effectiveness and integration of PEWS in the pediatric emergency department (ED).  ...  To predict the need for ICU admission, the optimal cutoff points on the ROC are P 0 = 1 and P 1 = 2, with areas under the ROC curve (AUCs) of 0.79 and 0.86, respectively.  ...  Acknowledgments This project was supported by Award Number Grant UL1TR001070 from the National Center for Advancing Translational Sciences. The authors thank Wei Wang MS, MAS, and Igor Dvorchik, PhD.  ... 
doi:10.1111/acem.12514 pmid:25377402 pmcid:PMC4300231 fatcat:jn7xj6h2uzelna2xxtomak3bsq
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