Abstract:
Objective:To evaluate the relative incidence of cardiogenic and septic shock in term neonates and identify findings that help differentiate the two entities. Study Design:We conducted a retrospective chart review of term neonates presenting to British Columbia Children's Hospital (BCCH) with decompensated shock of an undiagnosed etiology between January 1, 2008 and January 1, 2013. Charts were reviewed to determine the underlying diagnoses of all neonates meeting our inclusion criteria. Patients were categorized as having septic, cardiogenic, or other etiologies of shock. We then evaluated potential demographic, clinical, and biochemical parameters that could help differentiate between septic and cardiogenic shock. Results:Cardiogenic shock was more common than septic shock (relative risk=1.53). A history of cyanosis was suggestive of cardiogenic shock (positive likelihood ratio, LR+=3.2 and negative likelihood ratio, LR-=0.4). Presence of a murmur or gallop (LR+=5.4, LR-=0.3), or decreased femoral pulses (LR+=5.1, LR-=0.5) on physical exam were also suggestive of cardiogenic shock as was cardiomegaly on chest x-ray (LR+=4.9, LR-=0.5). Notably, temperature instability (LR+=0.7, LR-=1.8) and white blood cell count elevation or depression (LR+=0.8, LR-=1.1) were all poor predictors of septic shock. Conclusion:Cardiogenic shock is a more common cause of decompensated shock than septic shock. A history of cyanosis, murmur or gallop, or decreased femoral pulses on exam and cardiomegaly on chest x-ray are useful indicators of cardiogenic shock. In evaluating the neonate with decompensated shock, early consideration for Cardiology consultation and interventions to treat the underlying condition is warranted.
journal_name
Paediatr Child Healthjournal_title
Paediatrics & child healthauthors
Chan KH,Sanatani S,Potts JE,Harris KCdoi
10.1093/pch/pxz078subject
Has Abstractpub_date
2019-06-24 00:00:00pages
372-377issue
6eissn
1205-7088issn
1918-1485pii
pxz078journal_volume
25pub_type
杂志文章abstract:BACKGROUND:Many intervention studies typically require data from several centres to ensure adequate power. The usual intention is to pool data after testing for heterogeneity. Sites that differ in sample characteristics may, on the one hand, complicate the assessment of the intervention, but on the other hand, they may...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/8.7.433
更新日期:2003-09-01 00:00:00
abstract::The ability to communicate effectively with patients and families is paramount for good patient care. This practice point reviews the importance of communicating effectively in cross-cultural encounters. The concept of cultural competence is introduced, along with the LEARN (Listen, Explain, Acknowledge, Recommend, Ne...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx126
更新日期:2018-02-01 00:00:00
abstract::Canada lags behind other countries when it comes to investing in families with children. Canada, therefore, fails to promote health by not optimizing early development. The authors diagnose the Canadian failure. The problem is not research or fiscal capacity, but rather a sickness in Canadian culture. Four ailments ar...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/14.10.685
更新日期:2009-12-01 00:00:00
abstract::Respiratory syncytial virus (RSV) is recognized as an important cause of childhood morbidity and mortality. Vaccine development has been challenging in young infants and has required the advent of molecular technologies to optimize the safety profile, while maintaining immunogenicity of live-attenuated vaccines. Prote...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/8.10.605
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:The optimal timing for changing intravenous (IV) administration sets that contain total parenteral nutrition (TPN), with and without lipids, in neonates remains unknown. OBJECTIVE:To determine whether decreasing the frequency of changing IV administration sets (>24 h versus every 24 h) in neonates increases...
journal_title:Paediatrics & child health
pub_type: 杂志文章,评审
doi:
更新日期:2012-11-01 00:00:00
abstract::Cutaneous malignant melanoma has increased more than three-fold in the past 35 years. Because damage is cumulative, exposure to ultraviolet radiation early in life elevates a risk that is increased further as individuals use artificial sources of ultraviolet radiation. The full impact and scope of damage caused by yea...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/17.2.89
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:To identify a target group of children with acute immune thrombocytopenic purpura (ITP) that may not require hospitalization for management. METHODS:A retrospective chart review was conducted of all children admitted over a two-year period to a tertiary care paediatric hospital with the diagnosis of acute IT...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/7.6.386
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:To explore how and when chiropractors are involved in the care of patients younger than 18 years of age, and to examine chiropractors' beliefs about treating paediatric patients. DESIGN:A cross-sectional survey of a random sample of 140 chiropractors practising in Alberta. Data were collected by means of a ...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/6.7.433
更新日期:2001-09-01 00:00:00
abstract::Mitigating the harmful effects of adverse social conditions is critical to promoting optimal health and development throughout the life course. Many Canadians worry over food access or struggle with household food insecurity. Public policy positions breastfeeding as a step toward eradicating poverty. Breastfeeding ful...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx067
更新日期:2017-07-01 00:00:00
abstract::Although multiple critical steps are taken to minimize the risk of infection from transfusion of blood or blood products in developed countries, this risk can never be entirely eliminated. In Canada, the risks of noninfectious transfusion reactions, such as transfusion-related acute lung injury and major allergic or a...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/17.10.e102
更新日期:2012-12-01 00:00:00
abstract::Concerns about vaccine safety make some parents hesitant about immunization. Health care providers are pivotal in helping parents understand that Canada is a leader in vaccine safety. The present practice point provides an update on the eight components of Canada's vaccine safety system: (1) an evidence-based pre-lice...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx102
更新日期:2017-07-01 00:00:00
abstract::In the past three decades, rapidly changing demographic characteristics have been witnessed in western society. Concurrently, numerous culture-related studies have attested to the disparity in health services among different ethnic groups. Reports have shown contributing factors that can render main stream services in...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/9.9.627
更新日期:2004-11-01 00:00:00
abstract:Background:Constipation is a common condition in children. Little is known about the acute health care utilization of constipated children, including how many present to the paediatric emergency department (ED), the spectrum of presenting complaints, investigations and treatments used. Methods:We conducted a cross-sec...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx041
更新日期:2017-06-01 00:00:00
abstract::Cranial asymmetry occurring as a result of forces that deform skull shape in the supine position is known as deformational plagiocephaly. The risk of plagiocephaly may be modified by positioning the baby on alternate days with the head to the right or the left side, and by increasing time spent in the prone position d...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/16.8.493
更新日期:2011-10-01 00:00:00
abstract::Child sexual abuse is an important and not uncommon problem. Children who have been sexually abused may present to a physician's office, urgent care centre, or emergency department for medical evaluation. A medical evaluation can provide reassurance to both child and caregiver, identify care needs, and offer an accura...
journal_title:Paediatrics & child health
pub_type: 杂志文章,评审
doi:10.1093/pch/pxaa019
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:To determine whether an association exists between the publication of journal articles before and during paediatrics residency. METHODS:A retrospective search of PubMed was conducted for publications by all 567 Canadian paediatricians certified between 2009 and 2012, inclusive. Paediatricians were separated ...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/21.4.187
更新日期:2016-05-01 00:00:00
abstract::Parents of children with type 1 diabetes commonly worry about the ability of school personnel to respond to their child's diabetes needs, and may feel anxious about the health, safety and inclusion of their child in school. Physicians may be confronted by parents' fears, anxieties and apprehension, and need to know ho...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/10.1.25
更新日期:2005-01-01 00:00:00
abstract:Objective:To determine if treatment failure varies based on ROME III classification and adherence to guideline congruent therapy among children diagnosed in an emergency department with functional constipation. Methods:Children aged 1 month to 18 years who were diagnosed with constipation in a paediatric emergency dep...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxy121
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:In 2001, a chart review of children referred to the authors' endocrine clinic because of short stature revealed that many were referred with insufficient baseline data, had normal height velocity and were within genetic target height. Therefore, a two-way fax communication system was implemented b...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/18.10.533
更新日期:2013-12-01 00:00:00
abstract::The present paper describes research on the skills and processes associated with word and text reading acquisition in preschool children and during the first years of school. The aim is to provide an overview that gives a sense of the important milestones in language and literacy acquisition. A comparison of children'...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/11.9.589
更新日期:2006-11-01 00:00:00
abstract::Acute otitis media (AOM) continues to be a common infection in young children. Milder disease, usually due to viruses or less virulent bacteria, resolves equally quickly with or without antibiotics. A bulging tympanic membrane, especially if yellow or hemorrhagic, has a high sensitivity for AOM that is likely to be ba...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/21.1.39
更新日期:2016-01-01 00:00:00
abstract::There have been publically expressed concerns about the costs and allocation of neonatal and perinatal health care resources in Canada and elsewhere for the past 15 years. This paper reports information from a symposium held during the 1996 Canadian Paediatric Society (CPS) annual meeting sponsored by the CPS Section ...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/4.1.51
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:The treatment of celiac disease is a strict, life-long gluten-free (GF) diet. This diet is complex and can be challenging. Factors affecting adherence to the GF diet are important to identify for improving adherence. OBJECTIVE:To identify factors that inhibit or improve adherence to a GF diet in children wi...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/19.6.305
更新日期:2014-06-01 00:00:00
abstract:Background:Hyperbilirubinemia is a common neonatal condition requiring timely management to prevent acute bilirubin encephalopathy. Management protocols allow nonphysicians to initiate designated actions prior to physician assessment. Objective:To assess the effectiveness of a nurse-initiated neonatal jaundice managem...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxx056
更新日期:2017-08-01 00:00:00
abstract::In Canada, cerebral palsy (CP) is the most common physical disability, affecting approximately 2 to 3 per 1,000 individuals. Paediatricians are sure to encounter and care for children with CP and their families. The role of the general paediatrician in caring for a child with CP is crucial, from diagnosis to providing...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/pxaa100
更新日期:2020-09-16 00:00:00
abstract:BACKGROUND:Paediatrician human resource planning in Canada is currently a major concern. The optimal mix of physicians by type of practice and geographical distribution also remains controversial for many groups of physicians. OBJECTIVE:To compare 10-year trends (1987 to 1997) in paediatric practice with respect to ag...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/10.10.595
更新日期:2005-12-01 00:00:00
abstract::The present statement reviews the evidence for universal newborn hearing screening (UNHS). A systematic review of the literature was conducted using Medline and using search dates from 1996 to the third week of August 2009. The following search terms were used: neonatal screening AND hearing loss AND hearing disorders...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/16.5.301
更新日期:2011-05-01 00:00:00
abstract::Helicobacter pylori infection is acquired in childhood and plays a causative role in chronic gastritis, peptic ulcer disease and the development of gastric cancer. The present review focuses on recent advances in the management of H pylori infection in children and provides an update of current Canadian guidelines reg...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/9.10.709
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To assist in the diagnosis of retinopathy of prematurity (ROP) to facilitate treatment in a timely manner to help prevent blindness. DATA SOURCES:Systematic review using MEDLINE including the following key words, "retinopathy of prematurity", "retrolental fibroplasia", "blind", "blindness", "vision screening...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:
更新日期:1998-05-01 00:00:00
abstract:INTRODUCTION:In September 2005, the Alberta government introduced the daily physical activity (DPA) initiative, which requires that students from grades 1 to 9 be physically active in school for a minimum of 30 min per day. OBJECTIVE:To obtain information on whether and how the DPA initiative has been implemented in C...
journal_title:Paediatrics & child health
pub_type: 杂志文章
doi:10.1093/pch/15.7.e19
更新日期:2010-09-01 00:00:00