Publications by authors named "Baleine J"
Introduction: High-flow nasal cannula (HFNC) is commonly used as first step respiratory support in infants with moderate-to-severe acute viral bronchiolitis (AVB). This device, however, fails to effectively manage respiratory distress in about a third of patients, and data are limited on determinants of patient response. The respiratory rate-oxygenation (ROX) index is a relevant tool to predict the risk for HFNC failure in adult patients with lower respiratory tract infections.
View Article and Find Full Text PDFObjective: To assess whether music therapy (MT) is effective to reduce pain during daily personal hygiene care (DPHC), a procedure performed in all patients in a pediatric intensive care unit.
Methods: Fifty critically ill children were enrolled in a crossover controlled clinical trial with random ordering of the intervention, that is, passive MT, and standard conditions, and blind assessment of pain on film recordings. The primary outcome was variation of the Face Legs Activity Cry Consolability (FLACC) score (range, 0-10) comparing before and during DPHC.
Background: Aromatic l-amino acid decarboxylase deficiency (AADCD) is a rare, early-onset, dyskinetic encephalopathy mostly reflecting a defective synthesis of brain dopamine and serotonin. Intracerebral gene delivery (GD) provided a significant improvement among AADCD patients (mean age, ≤6 years).
Objective: We describe the clinical, biological, and imaging evolution of two AADCD patients ages >10 years after GD.
Purpose: We present guidelines for the management of infants under 12 months of age with severe bronchiolitis with the aim of creating a series of pragmatic recommendations for a patient subgroup that is poorly individualized in national and international guidelines.
Methods: Twenty-five French-speaking experts, all members of the Groupe Francophone de Réanimation et Urgence Pédiatriques (French-speaking group of paediatric intensive and emergency care; GFRUP) (Algeria, Belgium, Canada, France, Switzerland), collaborated from 2021 to 2022 through teleconferences and face-to-face meetings. The guidelines cover five areas: (1) criteria for admission to a pediatric critical care unit, (2) environment and monitoring, (3) feeding and hydration, (4) ventilatory support and (5) adjuvant therapies.
Article Synopsis
- - This study focused on 15 infants under a year old in intensive care who were suspected to have genetic conditions and underwent rapid trio exome sequencing (rES) from April 2019 to April 2021.
- - The key finding was that results from rES were available to parents within 16 days for 86% of the participants, and 40% received a confirmed diagnosis.
- - The study highlights the potential of rES to enhance medical care for critically ill infants, despite some patients not receiving a diagnosis and a few passing away before results were available.
Objectives: To review use of semiautomated regional citrate anticoagulation (saRCA) for continuous kidney replacement therapy (CKRT) in young children.
Design: Retrospective cohort study.
Setting: Three independent PICUs.
Article Synopsis
- Idiopathic purpura fulminans (IPF) is a rare and serious blood clotting disorder linked to infections like chickenpox and HHV-6, resulting in a drop in protein S levels due to autoantibodies.* -
- In a study from 13 French pediatric centers, 18 patients were directly observed, with an additional 34 cases reviewed from literature, showing a median age of 4.9 years and a 7-day delay in diagnosis after initial viral symptoms.* -
- The majority of patients (94%) had lesions on their lower limbs, with 78% having recent chickenpox infections; treatments primarily included heparin and plasma transfusions, and a call for a global
Article Synopsis
- This case study discusses a rare instance of cardiac and neurological complications in a 27-month-old girl diagnosed with hemolytic uremic syndrome caused by Shiga-like toxin-producing Escherichia coli, presenting symptoms like diarrhea and seizures.
- The girl experienced severe neurological impairment and developed pericardial effusion, which is a rare complication in this syndrome.
- An analysis of the effusion revealed the presence of human herpesvirus-6B, indicating a primary infection that complicated her condition, highlighting the need for further investigation in similar cases.
Background: Malignant pertussis (MP) affects young infants and is characterized by respiratory distress, perpetual tachycardia and hyperleukocytosis up to 50 G/l, leading to multiple organ failure and death in 75% of cases. Leukodepletion may improve prognosis. A therapeutic strategy based on leukodepletion and extracorporeal life support (ECLS) according to different thresholds of leucocytes has been proposed by Rowlands and colleagues.
View Article and Find Full Text PDFObjective: To assess the inspiratory demand in young infants with acute viral bronchiolitis to provide a physiological basis for initial flow setting for patients supported with high flow nasal cannula.
Study Design: Prospective study in 44 infants up to 6 months old with acute viral bronchiolitis, admitted to a pediatric intensive care unit from November 2017 to March 2019. Airflow measurements were performed using spirometry.
Article Synopsis
- Heterozygous mutations in the KMT2B gene are linked to early-onset dystonia (DYT28), featuring motor problems that start locally and can spread throughout the body, particularly affecting the face and neck.
- A study of 53 patients with KMT2B mutations revealed new disease presentations and identified various health issues, such as growth retardation and endocrine disorders, as well as a higher impact on patients with more severe genetic variants.
- Patients who underwent deep brain stimulation for severe dystonia showed significant improvement in motor function and disability over time, with more than half experiencing over 30% improvement at the one-year mark.
The French Society of Intensive Care Medicine (SRLF), jointly with the French-Speaking Group of Paediatric Emergency Rooms and Intensive Care Units (GFRUP) and the French-Speaking Association of Paediatric Surgical Intensivists (ADARPEF), worked out guidelines for the management of central venous catheters (CVC), arterial catheters and dialysis catheters in intensive care unit. For adult patients: Using GRADE methodology, 36 recommendations for an improved catheter management were produced by the 22 experts. Recommendations regarding catheter-related infections' prevention included the preferential use of subclavian central vein (GRADE 1), a one-step skin disinfection(GRADE 1) using 2% chlorhexidine (CHG)-alcohol (GRADE 1), and the implementation of a quality of care improvement program.
View Article and Find Full Text PDFBackground: The incidence of meningitis caused by Klebsiella pneumoniae (Kp) and Klebsiella oxytoca (Ko) in high-income countries is unknown, and no series have been published to date.
Methods: We conducted a nationwide multicenter observational study in France between 2006 and 2016. All children from the French national registry for paediatric bacterial meningitis under the age of 1 year and hospitalized for Kp or Ko meningitis were included.
Article Synopsis
- The study aimed to compare the effectiveness of two different flow rates (2 L/kg/min and 3 L/kg/min) for high-flow nasal cannula therapy in infants with acute viral bronchiolitis.
- Results showed similar failure rates in both groups, with respiratory distress being the main reason for failure; however, discomfort and length of stay in the pediatric ICU were greater in the 3 L/kg/min group.
- The conclusion indicated that increasing the flow rate to 3 L/kg/min did not provide any additional benefits over 2 L/kg/min for managing respiratory support in these infants.
Article Synopsis
- * Researchers investigated six patients with these mutations, noting symptoms like global motor retardation and recurrent hyperkinetic episodes, with five undergoing deep brain stimulation (GPi-DBS) treatment.
- * Results showed GPi-DBS effectively halted severe hyperkinetic episodes in five patients, highlighting its potential as a life-saving treatment for those with GNAO1 mutations.
Introduction: The role of anemia is raised as a risk of low respiratory infection of the child, but there are no data on anemia as a severity factor in acute viral bronchiolitis (AVB) in infants.
Methods: All infants less than 16 weeks old admitted to Montpellier University Hospital from 2015/10/01 to 2016/04/01 for AVB were included in a retrospective observational study. The primary objective was to determine whether the hemoglobin (Hb) concentration on admission was an independent factor of clinical severity, judged by the modified Wood's clinical asthma score (m-WCAS).
Unlabelled: Placement of a central venous catheter (CVC) in the brachiocephalic vein (BCV) via the ultrasound (US)-guided supraclavicular approach was recently described in children. We aimed to determine the CVC maintenance-related complications at this site compared to the others (i.e.
View Article and Find Full Text PDFNasal midazolam vs ketamine for neonatal intubation in the delivery room: a randomised trial.
Arch Dis Child Fetal Neonatal Ed
May 2018
Objective: To compare the effectiveness of sedation by intranasal administration of midazolam (nMDZ) or ketamine (nKTM) for neonatal intubation.
Design: A multicentre, prospective, randomised, double-blind study.
Setting: Delivery rooms at four tertiary perinatal centres in France.
Article Synopsis
- Nasal continuous positive airway pressure (nCPAP) is the standard treatment for moderate to severe acute viral bronchiolitis in infants, while high flow nasal cannula (HFNC) is also being used but lacks strong evidence of safety and effectiveness.
- A randomized controlled trial compared nCPAP with HFNC for infants under 6 months with moderate to severe viral bronchiolitis, measuring the failure rate within 24 hours as the primary outcome.
- Results showed that HFNC did not meet the noninferiority criteria compared to nCPAP, indicating that nCPAP had a significantly higher success rate, although both treatments had comparable rates of other outcomes and no severe adverse events were reported.
Neonatal transport is necessary where a neonate is transferred between two care units. It provides all the skills of a dedicated team, representing a real mobile neonatal intensive care unit. Informing and involving the families is essential during this transport, which can be a source of stress for the child and its family.
View Article and Find Full Text PDFIsolated methylmalonic acidemia (AMR) is an inborn error of metabolism due to an enzymatic deficit in methylmalonyl-CoA mutase. AMR lead to increased methylmalonic acid in plasma and urine without hyperhomocysteinemia. The clinical signs are recurrent episodes of ketoacidosis and bouts of vomiting, dehydration and mental retardation.
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