Response-based therapy for ruptured appendicitis reduces resource utilization.

Abstract:

PURPOSE:We examined the effectiveness of a postoperative ruptured appendicitis protocol that eliminated Pseudomonas coverage and based the duration of IV antibiotic treatment and length of hospital stay on the patient's clinical response. METHODS:In our new protocol, IV antibiotics were administered until the patient met discharge criteria: adequate oral intake, pain control with oral medications, and afebrile for 24h. We collected data on all patients with ruptured appendicitis at our institution following protocol implementation (May 1, 2012, to April 30, 2013) and compared them to a control group. RESULTS:306 patients were treated (154 prior protocol, 152 new protocol). The new clinical response-based protocol led to a decrease in hospital stay from 134h (SD 66.1) to 94.5h (SD 61.7) (p<0.001) and total cost of care per patient also decreased from $13,610 (SD $6859) to $9870 (SD $5670) (p<0.001). CONCLUSION:Our clinical response-based protocol for pediatric patients with ruptured appendicitis decreased LOS, cost, and IV antibiotics use without significant changes in adverse events.

journal_name

J Pediatr Surg

authors

Skarda DE,Schall K,Rollins M,Andrews S,Olson J,Greene T,McFadden M,Thorell EA,Barnhart D,Meyers R,Scaife E

doi

10.1016/j.jpedsurg.2014.09.012

subject

Has Abstract

pub_date

2014-12-01 00:00:00

pages

1726-9

issue

12

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(14)00545-4

journal_volume

49

pub_type

杂志文章
  • Guidelines for synoptic reporting of surgery and pathology in Hirschsprung disease.

    abstract:BACKGROUND/PURPOSE:Synoptic, or standardized, reporting of surgery and pathology reports has been widely adopted in surgical oncology. Patients with Hirschsprung disease may experience morbidity related to surgical factors or underlying pathology and often undergo multiple operations. Our aim is to improve the postoper...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.jpedsurg.2019.03.010

    authors: Veras LV,Arnold M,Avansino JR,Bove K,Cowles RA,Durham MM,Goldstein AM,Krishnan C,Langer JC,Levitt M,Monforte-Munoz H,Rabah R,Reyes-Mugica M,Rollins MD 2nd,Kapur RP,Gosain A,American Pediatric Surgical Association Hirschsp

    更新日期:2019-10-01 00:00:00

  • Anterior urethral valves: a rare cause of infravesical obstruction in children.

    abstract:PURPOSE:The aim of this study was to report the clinical presentation, mode of diagnosis, and treatment of patients with anterior urethral valves (AUV), a rare congenital anomaly causing infravesical obstruction in children. METHODS:Three patients with anterior urethral valves were admitted in the Pediatric Urology Un...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1053/jpsu.2000.0350556

    authors: Zia-ul-Miraj M

    更新日期:2000-04-01 00:00:00

  • Transanal rectal mucosectomy and partial internal anal sphincterectomy for Hirschsprung's disease.

    abstract:PURPOSE:Hirschsprung-associated enterocolitis (HAEC) is a serious complication of Hirschsprung's disease (HD), with generalized sepsis and high mortality rate. Although the surgical correction of HD is mostly successful, challenges remain in the management of children with repeated episodes of enterocolitis. The author...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2014.02.042

    authors: Zhang JS,Li L,Hou WY,Liu SL,Diao M,Zhang J,Ming AX,Cheng W

    更新日期:2014-05-01 00:00:00

  • Pumpless arteriovenous extracorporeal membrane oxygenation: A novel mode of respiratory support in a lamb model of congenital diaphragmatic hernia.

    abstract:BACKGROUND:Extracorporeal membrane oxygenation (ECMO) is commonly required in neonates with congenital diaphragmatic hernia (CDH) complicated by pulmonary hypertension (PH). ECMO carries significant risk, and is contraindicated in the setting of extreme prematurity or intracranial hemorrhage. Pumpless arteriovenous ECM...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2018.02.061

    authors: Partridge EA,Davey MG,Hornick M,Dysart KC,Olive A,Caskey R,Connelly JT,Hedrick HL,Peranteau WH,Flake AW

    更新日期:2018-08-01 00:00:00

  • Indomethacin-associated bowel perforations: a study of possible risk factors.

    abstract:BACKGROUND:The association between indomethacin administration and bowel perforation in premature infants is well known. The goal of this study was to examine possible risk factors for this complication. METHODS:Fifteen cases of indomethacin-associated bowel perforation occurred from 1993 to 1996. All had a birth weig...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(99)90495-5

    authors: Shorter NA,Liu JY,Mooney DP,Harmon BJ

    更新日期:1999-03-01 00:00:00

  • Review of bedside surgeon-performed ultrasound in pediatric patients.

    abstract:PURPOSE:Pediatric surgeon performed bedside ultrasound (PSPBUS) is a targeted examination that is diagnostic or therapeutic. The aim of this paper is to review literature involving PSPBUS. METHODS:PSPBUS practices reviewed in this paper include central venous catheter placement, physiologic assessment (volume status a...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审

    doi:10.1016/j.jpedsurg.2018.04.040

    authors: Bonasso PC,Dassinger MS,Wyrick DL,Gurien LA,Burford JM,Smith SD

    更新日期:2018-11-01 00:00:00

  • The value of circular myotomy for esophageal atresia.

    abstract::The joining of widely separated proximal and distal esophageal segments in esophageal atresia remains a challenging problem. Livaditis introduced the operation of circular myotomy as an effective means of bridging such a wide gap. Three babies with esophageal atresia were successfully treated in this manner at the Hos...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(78)80453-9

    authors: Vizas D,Ein SH,Simpson JS

    更新日期:1978-08-01 00:00:00

  • Pretreatment with edaravone reduces lung mitochondrial damage in an infant rabbit ischemia-reperfusion model.

    abstract:PURPOSE:Free radical scavenger edaravone has been approved as a new drug for treatment of stroke patients. The purpose of this study was to examine whether pretreatment with edaravone could attenuate ischemia-reperfusion (IR)-induced lung damage in infant rabbits. METHODS:New Zealand White rabbits (Experimental Animal...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2008.05.019

    authors: Qiu W,Gu H,Zheng L,Zhou J,Chen D,Chen Y

    更新日期:2008-11-01 00:00:00

  • Blocking of endogenous nitric oxide increases white blood cell accumulation in rat lung.

    abstract:BACKGROUND/PURPOSE:Nitric oxide (NO) is a known selective dilator of the pulmonary vascular tree. There also is evidence that it plays a role in diminishing neutrophil adherence to vascular endothelial cells. An understanding of these effects of NO on the pulmonary microcirculation is essential to our understanding of ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2003.09.003

    authors: Roman A,Legallo R,McGahren ED

    更新日期:2004-01-01 00:00:00

  • Intracranial pressure monitoring in the management of the pediatric trauma patient.

    abstract::Intracranial pressure (ICP) monitoring is an important adjunct in the management of the severely injured child with major head trauma. From a series of 18 patients with multiple trauma, smoke inhalation, and near-drowning, we report an illustrative case of head injury and pulmonary aspiration in which ICP monitoring w...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(80)80769-x

    authors: Caniano DA,Nugent SK,Rogers MC,Haller JA

    更新日期:1980-08-01 00:00:00

  • Improved quality of life by combined transplantation in Hirschsprung's disease with a very long aganglionic segment.

    abstract:BACKGROUND/PURPOSE:The treatment of children with Hirschsprung's disease beginning in the proximal jejunum remains a challenge for the pediatric surgeon. These patients need a definitive parenteral nutrition, which could lead to a liver impairment. The goal of this work is to assess the quality of life after combined l...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1053/jpsu.2003.50072

    authors: Yann R,Yves A,Dominique J,Thierry Y,Olivier G,Florence L

    更新日期:2003-03-01 00:00:00

  • Exosomal miR-34s panel as potential novel diagnostic and prognostic biomarker in patients with hepatoblastoma.

    abstract:PURPOSE:The aim of this study is to identify the diagnostic values of serum exosomal miRNA-34s of patients with HB in a large Asian group and explore the prognostic value of the exosomal miRNA-34s panel compared with other risk factors. METHODS:We retrospectively reviewed 89 children with HB. Among these patients, 63 ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2016.09.070

    authors: Jiao C,Jiao X,Zhu A,Ge J,Xu X

    更新日期:2017-04-01 00:00:00

  • Effect of antenatal tetrandrine administration on endothelin-1 and epidermal growth factor levels in the lungs of rats with experimental diaphragmatic hernia.

    abstract:PURPOSE:The aim of this study was to evaluate the effect of the traditional Chinese medicine tetrandrine (Tet) and to determine its possible mechanism on expression of endothelin-1 (ET-1) and epidermal growth factor (EGF) in the lung of a rat model of nitrofen-induced congenital diaphragmatic hernia (CDH). METHODS:A s...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2007.05.017

    authors: Lin H,Wang Y,Xiong Z,Tang Y,Liu W

    更新日期:2007-10-01 00:00:00

  • The therapy of biliary atresia combining the Kasai portoenterostomy with liver transplantation: a single center experience.

    abstract::Survival has improved dramatically for children with extrahepatic biliary atresia (EHBA), but optimal surgical management remains controversial. We have studied 28 infants born between June 1981, and April 1988, who underwent Kasai's portoenterostomy as primary surgical treatment. Those with evidence of subsequent hep...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(05)80182-4

    authors: Vacanti JP,Shamberger RC,Eraklis A,Lillehei CW

    更新日期:1990-01-01 00:00:00

  • Familial intussusception.

    abstract:PURPOSE:Intussusception is one of the common causes of intestinal obstruction in early childhood. Although a genetic predisposition has been suggested in some cases, its etiology is considered to be incidental, and it has not been traditionally regarded as having any genetic basis. Authors report on cases of so-called ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2007.04.012

    authors: Oshio T,Ogata H,Takano S,Ishibashi H

    更新日期:2007-09-01 00:00:00

  • Pediatric and adult renal transplants: a comparative study.

    abstract::In order to compare the results of renal transplantation in pediatric and adult recipients, a retrospective analysis of first transplants done at a single institution over a 6-yr period was carried out. The study included 21 pediatric and 196 adult recipients of cadaveric grafts, and 18 pediatric and 156 adult recipie...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(80)80140-0

    authors: Glass NR,Butt KM,Moel D,Kountz SL

    更新日期:1980-06-01 00:00:00

  • Surgical treatment of children with hyperparathyroidism: single centre experience.

    abstract:BACKGROUND:Hyperparathyroidism (HPT) in children is rare and surgical management is supported only by limited evidence. METHODS:Retrospective case series of all children under the age of 16 years who underwent parathyroidectomy (PTx) between 1978 and 2012. RESULTS:We identified 29 children who had surgery for HPT. Si...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2014.05.032

    authors: Alagaratnam S,Brain C,Spoudeas H,Dattani MT,Hindmarsh P,Allgrove J,Van't Hoff W,Kurzawinski TR

    更新日期:2014-11-01 00:00:00

  • Cyclooxygenase 2 mediates the antiangiogenic effect of rapamycin in Ewing sarcoma.

    abstract:BACKGROUND:Rapamycin can inhibit tumor growth and angiogenesis in various human cancers. Cyclooxygenase 2 (COX-2) is involved in the angiogenic process. We hypothesized that the antiangiogenic effect of rapamycin may be mediated by suppression of COX-2. METHODS:Ewing sarcoma (ES) cells were implanted in athymic mice. ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2009.02.037

    authors: Lipskar AM,Glick RD,Huang J,Fisher JC,DeVoti J,Pica R,Edelman M,Steinberg BM,Soffer SZ

    更新日期:2009-06-01 00:00:00

  • A combined tubularized/onlay graft technique for total correction of severe hypospadias.

    abstract:BACKGROUND/PURPOSE:A combined tubularized/onlay graft technique is described for the complete correction of chordee with urethroplasty in a single stage in cases of severe hypospadias. METHODS:Twenty-two patients with severe hypospadias ranging in age from 9 months to 11 years underwent single-stage correction using a...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(99)90775-3

    authors: Joseph VT

    更新日期:1999-06-01 00:00:00

  • The epidemiology of infant injuries and alarming health disparities.

    abstract:PURPOSE:Injury epidemiology is the underappreciated foundation of injury prevention and control strategies. Given the substantial disparity of infant injury-related mortality between African Americans (AA) and whites in our region, we sought to better understand the epidemiology of infant injury-related mortality rates...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2006.09.015

    authors: Falcone RA Jr,Brown RL,Garcia VF

    更新日期:2007-01-01 00:00:00

  • Pseudorheumatoid nodule in the liver of an adolescent male.

    abstract::Focal hepatic lesions in the pediatric population are rare and are usually found on incidental imaging of the abdomen. The most common lesions are focal nodular hyperplasia and hemangioma, but the differential diagnosis is quite broad. We present a case of an adolescent male who was found to have a large pseudorheumat...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2006.04.036

    authors: Saeed SA,Kelly DR,Hardin WD Jr

    更新日期:2006-08-01 00:00:00

  • Commentary regarding a baseline assessment of enhanced recovery protocol implementation at pediatric surgery practices performing inflammatory bowel disease surgeries.

    abstract::This is a commentary on the manuscript by Vacek J, Davis T, and Many B, et al., titled "A Baseline Assessment of Enhanced Recovery Protocol Implementation at Pediatric Surgery Practices Performing Inflammatory Bowel Disease Surgeries". ...

    journal_title:Journal of pediatric surgery

    pub_type: 评论,杂志文章

    doi:10.1016/j.jpedsurg.2020.06.020

    authors: Heiss K

    更新日期:2020-10-01 00:00:00

  • The initial experience of antithrombin III in the management of neonates with necrotizing enterocolitis.

    abstract:BACKGROUND:Necrotizing enterocolitis (NEC), the devastating enteric process of premature neonates, is marked by severe intravascular abnormalities and disseminated intravascular coagulation. Treatment to date remains historical and continues to be merely supportive without attempts to ameliorate progress within the inf...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2006.12.018

    authors: St Peter SD,Little DC,Calkins CM,Holcomb GW 3rd,Snyder CL,Ostlie DJ

    更新日期:2007-04-01 00:00:00

  • Giant prostatic utricle associated with proximal hypospadias: repair by mucosa divesting and muscular tunnel obliteration.

    abstract:PURPOSE:The purpose of this study was to evaluate the effectiveness of a new approach to repair the giant prostatic utricle (pseudovagina) associated with proximal hypospadias. METHODS:Three patients with giant prostatic utricle associated with proximal hypospadias sought medical advice in our department from 1998 to ...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2007.07.015

    authors: Zhou L,Hwang AH,Xie HW,Deng CH,Li XH,Hardy BE

    更新日期:2007-11-01 00:00:00

  • Mesenteric leiomyosarcoma in a 13-year-old boy.

    abstract::Mesenteric leiomyosarcoma occurs most commonly in middle-aged individuals. Primary tumors of the mesentery are uncommon in pediatric and adolescent patients, and primary mesenteric leiomyosarcoma is particularly rare. Accurate preoperative diagnosis of mesenteric soft tumor is generally difficult. We describe a case o...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2010.05.015

    authors: Iwasaki M,Kitaguchi K,Kobayashi H

    更新日期:2010-09-01 00:00:00

  • Endoscopic esophageal substitution for pure esophageal atresia and wide gap esophageal atresia: A report of five cases with minimum follow-up of twelve months.

    abstract:AIM:The aim of the study is to report feasibility and safety of endoscopic esophageal substitution in infants with pure esophageal atresia and wide gap tracheoesophageal fistula with a minimum one year follow-up. MATERIALS AND METHODS:This prospective study was conducted from January 2012 for twenty four consecutive m...

    journal_title:Journal of pediatric surgery

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.jpedsurg.2015.08.004

    authors: Chowdhary SK,Kandpal DK,Agarwal D,Balan S,Jerath N,Sibal A,Broor SL

    更新日期:2016-03-01 00:00:00

  • Cesarean section does not improve outcome in gastroschisis.

    abstract::Elective cesarean section (CS) following prenatal diagnosis of gastroschisis has been advocated to decrease morbidity and mortality. To examine this hypothesis, we reviewed the records of 28 consecutive patients with gastroschisis treated between 1975 and 1987. Fourteen infants were delivered vaginally (V) and fourtee...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/s0022-3468(89)80289-1

    authors: Bethel CA,Seashore JH,Touloukian RJ

    更新日期:1989-01-01 00:00:00

  • A case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma.

    abstract::The authors report a case of neonatal neuroblastoma mimicking Altman type III sacrococcygeal teratoma. A newborn male infant delivered after a normal pregnancy was found to have an extremely large sacrococcygeal mass. Imaging studies strongly suggested Altman type III sacrococcygeal teratoma. On the 10th day after the...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2004.11.016

    authors: Tanaka K,Kanai M,Yosizawa J,Yamazaki Y

    更新日期:2005-03-01 00:00:00

  • A new approach to the surgical correction of buried penis.

    abstract::Buried penis has been variously attributed to obesity with excessive suprapubic fat, severe phimosis with trapping of the penis within the prepubic tissues, and inadequate fixation of the penile shaft skin at the base resulting in tenting. Previous attempts at surgical correction, by excising suprapubic fat, fixing pe...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/0022-3468(95)90702-5

    authors: Joseph VT

    更新日期:1995-05-01 00:00:00

  • Primary gastric tumors of infancy and childhood: 54-year experience at a single institution.

    abstract:BACKGROUND/PURPOSE:Primary gastric tumors are rare in infancy and childhood. Because of the infrequent occurrence of these tumors, the clinician may be unfamiliar with optimal management strategies. We review our experience over the past 54 years and the current literature. METHODS:During the period extending from 195...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章

    doi:10.1016/j.jpedsurg.2007.11.016

    authors: Curtis JL,Burns RC,Wang L,Mahour GH,Ford HR

    更新日期:2008-08-01 00:00:00