Association Between Time to Appropriate Antimicrobial Treatment and 30-day Mortality in Patients With Bloodstream Infections: A Retrospective Cohort Study.

Background: Effective antimicrobial treatment is key for survival in bloodstream infection (BSI), but the impact of timing of treatment remains unclear. Our aim was to assess the association between time to appropriate antimicrobial treatment and 30-day mortality in BSI patients.

Methods: This was a retrospective cohort study using electronic health record data from a large academic center in Sweden.

Effect of general anesthesia on neonatal aEEG-A cohort study of patients with non-cardiac congenital anomalies.

Introduction: The aim of the current study was to determine the effect of general anesthesia on neonatal brain activity using amplitude-integrated EEG (aEEG).

Methods: A prospective cohort study of neonates (January 2013-December 2015), who underwent major neonatal surgery for non-cardiac congenital anomalies. Anesthesia was administered at the discretion of the anesthetist.

Brain Oxygenation During Thoracoscopic Repair of Long Gap Esophageal Atresia.

Background: Elongation and repair of long gap esophageal atresia (LGEA) can be performed thoracoscopically, even directly after birth. The effect of thoracoscopic CO-insufflation on cerebral oxygenation (rScO) during the consecutive thoracoscopic procedures in repair of LGEA was evaluated.

Methods: Prospective case series of five infants, with in total 16 repetitive thoracoscopic procedures.

Anesthesia-related critical incidents in the perioperative period in children; a proposal for an anesthesia-related reporting system for critical incidents in children.

Background: The incidence, type and severity of anesthesia-related critical incidents during the perioperative phase has been investigated less in children than in adults.

Aim: The aim of the study was to identify and analyze anesthesia-related critical incidents in children to identify areas to improve current clinical practice, and to propose a specialized anesthesia-related critical incidence registration for children.

Method: All reported pediatric anesthesia-related critical incidents reported on a voluntary reporting based on a 20-item complication list of the Dutch Society of Anesthesiology between January 2007 and August 2013 were analyzed.

Evaluating NIR vascular imaging to support intravenous cannulation in awake children difficult to cannulate; a randomized clinical trial.

Background: Recently, various near-infrared vascular imaging devices aimed at facilitating peripheral intravenous cannulation (PIC) were introduced, all claiming to increase success rate of PIC. We evaluated the clinical utility of a near-infrared vascular imaging device (VascuLuminator(®)) in pediatric patients who were referred to the anesthesiologist because of difficult cannulation.

Methods: There were 226 consecutive children referred to pediatric anesthesiologists by the treating pediatrician of the in- and outpatient clinic, because of difficulties with intravenous cannulation, were included in this cluster randomized clinical trial.

Perioperative complications in patients diagnosed with mucopolysaccharidosis and the impact of enzyme replacement therapy followed by hematopoietic stem cell transplantation at early age.

Background: Mucopolysaccharidoses (MPS) are hereditary storage diseases; airway management typically worsens in these patients with the progression of the disease.

Objective(s): To assess the incidence of perioperative complications in children with MPS and the impact of enzyme replacement therapy (ERT) followed by hematopoietic stem cell transplantation (HSCT).

Methods: The records of patients with MPS treated with ERT followed by HSCT, who received anesthesia at the Wilhelmina Children's Hospital between 2003 and 2012, were reviewed.

[Is anaesthesia detrimental to brain development?].

Many experimental studies in mammals, and increasingly also in primates, have shown that almost all anaesthetic agents when administered during a young animal's brain-development phase cause increased neuroapoptosis and changes in dendritic morphology at short term, and later, learning disorders. These findings are being confirmed in increasing numbers of retrospective cohort studies in humans. However, these retrospective cohort studies are considerably influenced by confounding.

Predictive factors for difficult intravenous cannulation in pediatric patients at a tertiary pediatric hospital.

Background: It is generally believed that certain patient characteristics (e.g., Body Mass Index and age) predict difficulty of intravenous cannulation in children, but there is not much literature evaluating these risk factors.

Towards evidence-based pharmacotherapy in children.

In daily practice, it is difficult to find a registered drug for children, because about 70% of the drugs prescribed in children are not studied, off-label or unlicensed in this age group. Clinical trials have usually been performed in adults, and then in daily practice dosages are adjusted for children without proper studies in that age group. In some countries, national formularies are being established to overcome the existing variance in prescribing between physicians.

Quality improvement: implementation of a pain management policy in a university pediatric hospital.

Background: Until recently, individual doctors and nurses in our pediatric hospital made decisions about the application of pain relief in patients, resulting in a wide variety of practice. The main task of our pain group was to develop hospital-wide practice standards for acute pain management to improve care. One of the key points of the pain policy was the introduction of pain assessment tools (COMFORT and Visual Analogue Scale).

CD8+ T cell responses in bronchoalveolar lavage fluid and peripheral blood mononuclear cells of infants with severe primary respiratory syncytial virus infections.

A protective role for CD8+ T cells during viral infections is generally accepted, but little is known about how CD8+ T cell responses develop during primary infections in infants, their efficacy, and how memory is established after viral clearance. We studied CD8+ T cell responses in bronchoalveolar lavage (BAL) samples and blood of infants with a severe primary respiratory syncytial virus (RSV) infection. RSV-specific CD8+ T cells with an activated effector cell phenotype: CD27+CD28+CD45RO+CCR7-CD38+HLA-DR+Granzyme B+CD127- could be identified in BAL and blood.