October 2009

AARC Congress Coming Up Soon; Program Online Now
The AARC will be heading to San Antonio this Dec. 5–8, and if the Advance Program is any indication, it should be a great meeting for neonatal-pediatric RTs. With talks on everything from the latest in neonatal ventilation to current controversies in pediatric care, we’ll all go home with the cutting edge information we need to ensure the best possible care for our patients in 2010. So check out the program, and then register by Oct. 31 for earlybird savings. 

H1N1 in Children: Early Findings on Deaths Associated with the Virus
According to researchers publishing in the Sept. 4 edition of the Morbidity and Mortality Weekly Report, the Centers for Disease Control and Prevention received reports of 36 H1N1-related deaths among children under age 18 between April and early August. Data on these children show:

• Of 36 children who died, seven (19%) were under age five, and 24 (67%) had one or more of the high-risk medical conditions.
• Twenty-two (92%) of the 24 children with high-risk medical conditions had neurodevelopmental conditions.
• Among 23 children with culture or pathology results reported, laboratory-confirmed bacterial coinfections were identified in 10 (43%), including all six children who 1) were age five or older, 2) had no recognized high-risk condition, and 3) had culture or pathology results reported.

READ ABSTRACT

NPPV Keeps Trachs Away
A new study out of France finds noninvasive positive pressure ventilation (NPPV) can be helpful in the treatment of children with recurring obstructive symptoms following decannulation. It can also facilitate early weaning from tracheotomy in children who repeatedly fail decannulation trials. The researchers arrived at these conclusions after looking at outcomes among 13 children ages 2–12 who had a tracheotomy for upper airway obstruction, along with one who needed a trach for congenital diaphragmatic hypoplasia and one who needed a trach due to lung disease. Decannulation was successfully performed in all the children after acclimatization to NPPV, and none has required recannulation. In six of the children, NPPV was eventually withdrawn. The remaining nine children continue to receive NPPV. The study appeared in the Sept. 15 Epub edition of Pediatric Critical Care Medicine. READ ABSTRACT

Little Progress Seen in Survival of Smallest Babies
Researchers from Johns Hopkins paint a discouraging picture for infants born between 22 and 24 weeks gestation. According to their review of 160 women who gave birth to these infants either between 1993–1995 or 2001–2003, little progress has been made in survival to hospital discharge. While infants born during the second period did live longer—seven days versus two days—the mortality rate for 24 week infants was 46% during both time periods; the mortality rate for 22 week infants was 100%. Women who gave birth to these infants during the second period, however, did receive significantly more higher-level care, such as sonograms and antibiotics and steroids to facilitate fetal lung development. Their infants were more likely to be placed on ventilators, receive chest tubes, and be given drugs to boost heart and blood pressure rates as well. The report was published in a recent issue of the Archives of Pediatrics & Adolescent Medicine. READ NEWS ARTICLE

ED Intervention Falls Short
Improving asthma management for children who are seen in the emergency department for an acute exacerbation is a challenge. Researchers from the Children’s Hospital of Philadelphia attempted to increase compliance with follow up visits to a primary care physician (PCP) by initiating an intervention consisting of instructions to follow up with a PCP within 3–5 days, a letter to take to the PCP if the child screened positive for persistent asthma symptoms, a video viewed during the ED visit that discussed the importance of asthma control, and a mailed reminder to follow up with the PCP. Validated surveys were used to assess outcomes among 433 patients and caregivers randomized to either the intervention or a control group. While those in the intervention group were more likely to acknowledge the benefit of follow up care, they were no more likely to actually follow up with their PCP than those in the control group (about 44% for both), and the children also had similar quality of life scores, medication use, and ED visits in the month following the initial ED visit. The study appears in this month’s Pediatrics. READ ABSTRACT