Abstract:
OBJECTIVE:To estimate the incidence of clinical deterioration leading to intensive care unit transfer in previously healthy infants with respiratory syncytial virus (RSV) infection hospitalized on a general pediatric unit and, to assess the hypothesis that history, physical examination, oximetry, and chest radiographic findings at time of presentation can accurately identify these infants. STUDY DESIGN:A virology database was used to identify and determine the disposition of all children =1 year of age admitted to the Children's Hospital at Strong (CHaS) with RSV infection during the 1985 to 1994 respiratory seasons. Index patients were all previously healthy, full-term infants admitted initially to the general inpatient services at CHaS or Rochester General Hospital, a second University of Rochester teaching hospital, whose clinical deterioration led to transfer to the pediatric intensive care unit (PICU). These infants were matched retrospectively (for year and date of infection, sex, chronologic age, and race) with two hospitalized controls who did not require PICU transfer. Chest radiographic findings, respiratory rate (RR), O(2) saturation, and presence of wheezing at time of presentation to the emergency department (ED) were compared. RESULTS:During the study years, 542 previously healthy, full-term infants were admitted to the general pediatric unit at CHaS with proven RSV infection. Ten (1.8%; 95% confidence interval, 0.9%, 3.4%) were transferred subsequently to the PICU, primarily for close monitoring of progressive respiratory distress. Data for these patients and 7 patients transferred from Rochester General Hospital to the PICU at the CHaS were compared with those for control patients. The mean RR in the ED (63 vs 50), and O(2) saturation in the ED (88% vs 93%) were modestly abnormal in cases compared with controls. Wheezing on examination at time of presentation and chest radiographic findings did not differ between the two groups. A RR >80 and an O(2) saturation <85% at time of presentation each had a specificity >97% for predicting subsequent deterioration. Each parameter, however, had a sensitivity =30%. CONCLUSION:Clinical deterioration requiring PICU admission is an uncommon occurrence in previously healthy infants admitted to a general pediatric inpatient unit with RSV infection. Extreme tachypnea and hypoxemia were both associated with subsequent deterioration; however, only a small proportion of patients who clinically deteriorated presented in this way. The clinical usefulness of these parameters, therefore, is limited. respiratory syncytial virus, deterioration, healthy infants, prediction.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Brooks AM,McBride JT,McConnochie KM,Aviram M,Long C,Hall CBdoi
10.1542/peds.104.3.463subject
Has Abstractpub_date
1999-09-01 00:00:00pages
463-7issue
3 Pt 1eissn
0031-4005issn
1098-4275journal_volume
104pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract:OBJECTIVE:To assess the effects of electronic health record-based clinical decision support (CDS) and physician performance feedback on adherence to guidelines for acute otitis media (AOM) and otitis media with effusion (OME). METHODS:We conducted a factorial-design cluster randomized trial with primary care practices...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2012-1988
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Although suicide is a known leading cause of death among street youth, few prospective studies have explored childhood experiences as risk factors for future suicide attempt in this population. We examined the risk of attempted suicide in relation to childhood maltreatment among street youth. METHODS:From S...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-1108
更新日期:2015-09-01 00:00:00
abstract::The findings reported in this article are based on a nationwide survey of the attitudes and practices of pediatric surgeons and pediatricians with respect to some of the difficult ethical choices confronting them in medical practice. Four hundred fifty-seven physicians completed a questionnaire in the spring of 1975 i...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-10-01 00:00:00
abstract:OBJECTIVES:This is an investigation into the longitudinal patterns of bed sharing, the characteristics associated with those patterns, and the relationship with breastfeeding. METHODS:The study used prospective, population-based data from the United Kingdom to investigate nocturnal bed sharing at 5 time points from bi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2010-1277
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the role of primary vesicoureteral reflux (VUR) in increasing the frequency and severity of urinary tract infections (UTIs) and renal parenchymal damage among patients with acute pyelonephritis and to determine whether urinary antibiotic prophylaxis reduces the frequency and/or severity of UTIs a...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1542/peds.2005-1362
更新日期:2006-03-01 00:00:00
abstract::Central nervous system manifestations in association with adenovirus infections have rarely been documented. In this report, four children, ages 4, 5, 6, and 10 years, with adenoviral meningoencephalitis are described. Adenoviruses were recovered from CSF specimens in all four patients. ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Observation status, in contrast to inpatient status, is a billing designation for hospital payment. Observation-status stays are presumed to be shorter and less resource-intensive, but utilization for pediatric observation-status stays has not been studied. The goal of this study was to describ...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2012-2494
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:This study evaluates the impact that a Medicaid managed care program had on avoidable hospitalization, a form of health care misuse that we hypothesize can be reduced by improved access to and quality of primary care in the context of a managed care program. Ambulatory care sensitive (ACS) hospitalizations, a...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.101.3.e1
更新日期:1998-03-01 00:00:00
abstract::Thirty-six preterm, sick, low-birth-weight neonates were given either total or partial parenteral nutrition. The patients were divided into three groups according to their birth weights: group A -less than 1,000 gm, 12 patients: group B--between 1,000 and 1,500 gm, 15 patients: group C--more than 1,500 gm, 9 patients....
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1977-05-01 00:00:00
abstract:CONTEXT:The optimal oxygen saturation target for extremely preterm infants remains unclear. OBJECTIVE:To systematically review evidence evaluating the effect of lower (85%-89%) versus higher (91%-95%) pulse oxygen saturation (Spo2) target on mortality and neurodevelopmental impairment (NDI) at 18 to 24 months. DATA S...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2016-1609
更新日期:2017-01-01 00:00:00
abstract:OBJECTIVE:To identify correlates of objectively measured moderate and vigorous physical activity (MVPA) in children during preschool attendance. METHODS:This cross-sectional study included data from 426 apparently healthy Danish children (49.5% boys), 5 to 6 years of age enrolled in 42 randomly selected preschools. Th...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2012-3961
更新日期:2013-11-01 00:00:00
abstract::This article provides background information on acoustic impedance testing and illustrates utilization of test results in pediatric clinical practice. Acoustic impedance measurement devices are presently being used successfully by hearing screening programs and by otorhinolaryngologists in clinical and hospital setti...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1975-05-01 00:00:00
abstract:OBJECTIVE:The goal of this study was to evaluate the impact of the Active Teen Leaders Avoiding Screen-time (ATLAS) intervention for adolescent boys, an obesity prevention intervention using smartphone technology. METHODS:ATLAS was a cluster randomized controlled trial conducted in 14 secondary schools in low-income c...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2014-1012
更新日期:2014-09-01 00:00:00
abstract::Children with autism spectrum disorder (ASD) are at risk for self-injurious behaviors that can be difficult to treat in the context of co-occurring low IQ and adaptive skills. Increased prevalence and decriminalization of cannabis in some states have led to more frequent questions for pediatricians about the use of ca...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-0558
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:To identify vaccination policies and beliefs associated with practice immunization rates (PIR) among office-based pediatricians. METHODS:Primary care pediatricians recruited from the Pediatric Research in Office Settings (PROS) network of the American Academy of Pediatrics or the Pediatric Section of the Nat...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.109.2.294
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:Frequent violent behavior among adolescents has been found to be associated with previous exposure to violence, personal victimization, depression, hopelessness, and older age. Although young adolescents engage in less severe violent behavior than older adolescents, their perceived normative expectations to u...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Trisomy 21 is known to decrease the risk of several (nonocular) angiogenic-mediated diseases. The objective of this study was to determine whether trisomy 21 can also be shown to be significantly protective against ocular angiogenic-mediated disorders such as retinopathy of prematurity (ROP). ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-0623
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Children with special health care needs (CSHCN) face unique challenges in accessing affordable health care. Massachusetts implemented major health reform in 2006; little is known about the impact of this state's health reform on uninsurance, access to care, and financial protection for private...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-3884
更新日期:2014-08-01 00:00:00
abstract::Bone health is a critical concern in managing preterm infants. Key nutrients of importance are calcium, vitamin D, and phosphorus. Although human milk is critical for the health of preterm infants, it is low in these nutrients relative to the needs of the infants during growth. Strategies should be in place to fortify...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:10.1542/peds.2013-0420
更新日期:2013-05-01 00:00:00
abstract::: media-1vid110.1542/5804909532001PEDS-VA_2018-1051Video Abstract OBJECTIVES: In 2015, California passed Senate Bill 227 (SB277), eliminating nonmedical vaccine exemptions for school entry. Our objective for this study was to describe the experiences of health officers and immunization staff addressing medical exempti...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-1051
更新日期:2018-11-01 00:00:00
abstract::This report describes an adolescent boy who has Tourette's syndrome and developed a subtle but significant increase in vocal tics after an 8-month respite. The increase in vocal tics was associated with an acute increase in psychological stressors and resulted in recurrent air swallowing, which, in turn, caused abdomi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2005-2914
更新日期:2006-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Diagnostic imaging is often used in the evaluation of children with possible appendicitis. The utility of imaging may vary according to a patient's age and gender. The objectives of this study were (1) to examine the use of computed tomography (CT) and ultrasound for age and gender subgroups o...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-3375
更新日期:2012-05-01 00:00:00
abstract::After postoperative deaths in children who were prescribed codeine, several pediatric hospitals have removed it from their formularies. These deaths were attributed to atypical cytochrome P450 2D6 (CYP2D6) pharmacogenetics, which is also implicated in poor analgesic response. Because codeine is often prescribed to pat...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-3479
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVE:Most clinical descriptions of invasive staphylococcal disease (ISD) in neonates date from before the mid-1980s, when neonatal viability and intensive care differed substantially from current standards. We aimed to describe the contemporary incidence, clinical features, and outcome of infants with ISD in a neo...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-0043
更新日期:2004-10-01 00:00:00
abstract:OBJECTIVE:Currently, the methods for assessing milk ejection in women include serial sampling of plasma oxytocin and measurement of intraductal pressure, both of which are invasive and may induce stress. We hypothesized that milk ejection would cause an increase in milk-duct diameter that could be observed noninvasivel...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.113.2.361
更新日期:2004-02-01 00:00:00
abstract::This article is a review of the effects that ingested dietary fiber has on gastrointestinal transit time. The various phases of gastrointestinal motility are considered, and the effect of fiber on these various components is explored. Fiber affects each phase of gastrointestinal motility differently; however, the most...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To characterize the clinical features of hepatitis C virus (HCV) infection associated with the administration of intravenous immunoglobulin (IVIG) in patients with varied immunodeficiencies. DESIGN:Prospective collection of clinical and virologic data in patients determined to have HCV exposure associated wi...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1996-08-01 00:00:00
abstract::The effects of beclomethasone, dipropionate aerosol (DBA) (400 microgram/day) on clinical course, pulmonary function, and pituitary-adrenal function was studied in 34 steroid-dependent asthmatic children. Asthma severity was assessed by daily symptom and medication scores, peak flow measured three times a day, and wee...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章
doi:
更新日期:1978-08-01 00:00:00
abstract::Children and youth with complex medical issues, especially those with technology dependencies, experience frequent and often lengthy hospitalizations. Hospital discharges for these children can be a complicated process that requires a deliberate, multistep approach. In addition to successful discharges to home, it is ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2012-0606
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Varicella vaccine was licensed in the United States in 1995 for individuals ≥12 months of age. A second dose was recommended in the United States in June 2006. Varicella incidence and vaccine effectiveness were assessed in a 14-year prospective study conducted at Kaiser Permanente Northern California. METHO...
journal_title:Pediatrics
pub_type: 杂志文章,多中心研究
doi:10.1542/peds.2012-3303
更新日期:2013-05-01 00:00:00