Off-Hours Admissions and Mortality in PICU Without 24-Hour Onsite Intensivist Coverage.

Objective: To evaluate whether the off-hours admission has any effect on risk-adjusted mortality and length of stay for nonelective patients admitted to a pediatric intensive care unit (PICU) without 24-hour in-house intensivist coverage.

Design: Prospective cohort study.

Setting: A 34-bed tertiary PICU.

Adherence to surviving sepsis guidelines among pediatric intensivists. A national survey.

To assess the compliance with the 2006 American College of Critical Care-Pediatric Advanced Life Support (ACCM-PALS) guidelines for sepsis management, and the 2012 surviving sepsis campaign (SSC), for the management of pediatric patients with sepsis and to identify the main barriers to adherence to these guidelines. Methods: In November 2015, a prospective cohort study in which a web based electronic survey using a case scenario to explore the usual management of a child with severe sepsis was designed and sent to all consultant pediatric intensivists practicing in Kingdom of Saudi Arabia (KSA). Adherences to 2012 SSC guidelines and to 4 algorithmic time-specific goals outlined in the ACCM-PALS guidelines were measured.

Incidence, Risk Factors, and Prognosis of Intra-Abdominal Hypertension in Critically Ill Children: A Prospective Epidemiological Study.

Purpose: To assess the incidence, risk factors, and outcomes of intra-abdominal hypertension (IAH) in a pediatric intensive care unit (PICU).

Methods: Prospective cohort study from January 2011 to January 2013. All children consecutively admitted to the PICU, staying more than 24 hours and requiring bladder catheterization, were included in the study.

Septic pulmonary embolism secondary to Staphylococcus aureus septic thrombophlebitis in a pediatric patient.

We present the clinical course of an 11-year-old child with septic pulmonary embolism secondary to community acquired methicillin-resistant Staphylococcus aureus (MRSA) septic deep venous thrombosis. The aim is to emphasize the non-specific symptoms of septic pulmonary embolism in pediatrics, the frequent association with septic deep venous thrombosis and osteomyelitis, and to highlight that MRSA is the most frequently isolated organism. Pediatricians should consider septic pulmonary embolism in cases of septic deep venous thrombosis even in the absence of respiratory symptoms.

Overview of bronchiolitis.

Respiratory syncytial virus RSV, a nonsegmented, single stranded ribonucleic acid virus, infects one-half of all infants within the first year of life. Respiratory syncytial virus possesses pathogenetic qualities that may be attributed to the interplay of viral and host-specific factors including virus strains of different virulence, size of the inoculum, family history of asthma or airway hyper-reactivity and immunologic anomalies of the host. Inflammatory cell recruitment and activation occur in response to RSV infection of epithelial cells.

Can we reduce mortality in sepsis?

Considerable progress has been made over the last 2 decades in diagnosing and treating sepsis. Although the mortality rate is beginning to decline with the development of new therapeutic interventions, it still remains unacceptably high. Five such interventions are discussed in this review article to provide guidance for intensivists on the integration and implementation of new interventions into the intensive care unit.

Pediatric living-related liver transplantation in Saudi Arabia.

Objective: The purpose of this paper is to report our experience of the first 29 consecutive living-related liver transplants in pediatric recipients and to demonstrate the feasibility of living-related liver transplantation in the Arab World. The first living-related liver transplantation in the Kingdom of Saudi Arabia was performed in November 1998 by Bassas et al following an appropriate period of multi-disciplinary preparation.

Methods: This study was carried out at the Armed Forces Hospital, Riyadh, Kingdom of Saudi Arabia, during the period November 1998 through to October 2001.

Living-related liver transplantation for Crigler-Najjar syndrome in Saudi Arabia.

Objective: To analyse the outcome of six children with Crigler-Najjar syndrome type I (CNS-I) and report the first three living-related liver transplants for this syndrome in Saudi Arabia and the Middle East.

Settings: To review the medical records of six children suffering from CNS-I, three of whom underwent living-related liver transplantation (LRLT) between 22 November 1998 and January 2001.

Main Results: Living-related liver transplantation was performed in three children with a pre-transplant unconjugated bilirubin level of 362, 381 and 502 micromol/L, respectively, despite daily phototherapy of >or= 12 h.