Simulation Use in Outreach Setting: A Novel Approach to Building Sustainability.

Simulation is a well-studied teaching tool for multidisciplinary teamwork, crisis resource management, and communication skills. These attributes are essential for successful international medical missions, which include healthcare providers with different familiarities with the outreach environment and each team member's role. However, immersive simulation remains underused in similar settings.

Outcomes of Children With Critical Bronchiolitis Meeting at Risk for Pediatric Acute Respiratory Distress Syndrome Criteria.

Objectives: New definitions of pediatric acute respiratory distress syndrome include criteria to identify a subset of children "at risk for pediatric acute respiratory distress syndrome." We hypothesized that, among PICU patients with bronchiolitis not immediately requiring invasive mechanical ventilation, those meeting at risk for pediatric acute respiratory distress syndrome criteria would have worse clinical outcomes, including higher rates of pediatric acute respiratory distress syndrome development.

Design: Single-center, retrospective chart review.

Nutrition and High-Flow Nasal Cannula Respiratory Support in Children With Bronchiolitis.

Objectives: No guidelines are available regarding initiation of enteral nutrition in children with bronchiolitis on high-flow nasal cannula (HFNC) support. We hypothesized that the incidence of feeding-related adverse events (AEs) would not be associated with HFNC support.

Methods: This retrospective study included children ≤24 months old with bronchiolitis receiving HFNC in a PICU from September 2013 through April 2014.

Hyponatremia and Hypotonic Intravenous Fluids Are Associated With Unfavorable Outcomes of Bronchiolitis Admissions.

Objectives: Hyponatremia has been associated with unfavorable outcomes when present at admission in children with bronchiolitis. Delayed hyponatremia may be a modifiable risk factor for severe disease that is influenced by intravenous fluid (IVF) tonicity. We hypothesized that both hyponatremia and prescription of severely hypotonic IVF are associated with unfavorable outcomes, and that prescription of severely hypotonic IVF is associated with subsequent hyponatremia.

Poor Oral Health Linked with Increased Risk of Infectious Complications in Adults with Leukemia.

Objective: The objective of this study is to examine the impact of the presence of gingivitis/periodontitis on the occurrence of infectious complications (including septicemia, bacterial infections, and mycoses) in hospitalized leukemic adults in the United States.

Methods: A retrospective analysis of the Nationwide Inpatient Sample (NIS) for the years 2004-2010 was performed. All hospitalized leukemic patients aged 18 to 65 years were selected.

Predictors of Complications of Tonsillectomy With or Without Adenoidectomy in Hospitalized Children and Adolescents in the United States, 2001-2010: A Population-Based Study.

Outcomes of tonsillectomy (with or without adenoidectomy [w/woA]) in hospitalized children are unclear. We sought, to describe the characteristics of hospitalized children who underwent tonsillectomy (w/woA), to estimate the prevalence of complications and to evaluate the relative impact of different comorbid conditions (CMC) on the risk of occurrence of common complications following these procedures. All patients aged ≤21years who underwent a tonsillectomy (w/woA) were selected from the Nationwide Inpatient Sample (NIS 2001-2010).

Immediate Effects of Use of Recombinant Bone Morphogenetic Protein in Children Having Spinal Fusion and Refusion Procedures in United States.

Study Design: Retrospective study of Nationwide Inpatient Sample (NIS).

Objective: The objective of this study is to estimate the prevalence of complications in children who had insertion of recombinant human bone morphogenetic protein (rhBMP) at the time of spinal fusion procedures (SFP) and to examine if the use of rhBMP is associated with an increased risk of complications.

Summary Of Background Data: Use of rhBMP for SFP has been associated with conflicting safety profile reports in adults.

Prevalence and Predictors of Gastrostomy Tube and Tracheostomy Placement in Anoxic/Hypoxic Ischemic Encephalopathic Survivors of In-Hospital Cardiopulmonary Resuscitation in the United States.

Introduction: Current prevalence estimates of gastrostomy tube (GT)/tracheostomy placement in hospitalized patients with anoxic/hypoxic ischemic encephalopathic injury (AHIE) post cardiopulmonary resuscitation (CPR) are unknown. We sought, to estimate the prevalence of AHIE in hospitalized patients who had CPR and to identify patient/hospital level factors that predict the performance of GT/tracheostomy in those with AHIE.

Methods: We performed a retrospective analysis of the Nationwide Inpatient Sample (years 2004-2010).