525 results match your criteria: "Advocate Children's Hospital[Affiliation]"

Background And Objectives: Cold-stored whole blood (CS-WB) in paediatric cardiac surgery is making a resurgence, given its identified benefits compared to conventional blood component therapy (CT).

Study Design And Methods: A single-centre retrospective study was conducted from January 2018 to October 2018 by including children <18 years of age undergoing cardiac surgery requiring cardiopulmonary bypass. ABO-compatible CS-WB from non-directed random donors was leukoreduced with platelet-sparing filters and compared with CT.

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Article Synopsis
  • 1. The article discusses the use of acute mechanical circulatory support (MCS) systems, which help patients with severe heart problems by improving blood flow during critical situations.
  • 2. It highlights how a cardiovascular simulator can provide valuable insights and data on the effectiveness and functioning of these MCS systems in real-time scenarios.
  • 3. The findings aim to improve clinical decision-making and optimize treatment strategies for patients needing immediate heart support, potentially leading to better health outcomes.
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Article Synopsis
  • Congenital heart disease (CHD) significantly increases the risk of thromboembolism (TE) in children, with a study finding that 33% of affected patients experienced recurrent TE within a year.
  • Among the risk factors identified, immobility and the presence of central venous catheters (CVC) were strongly associated with a higher likelihood of recurrence, demonstrating the need for careful monitoring and management in this population.
  • The study calls for larger multicenter research to further validate these findings and improve understanding of TE recurrence in pediatric patients with CHD.
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Background: Professional standards and the Codes of Ethics from the International Council of Nurses and American Nurses Association are frameworks driving professional practice and are linked to positive patient and nursing outcomes.

Objective: To describe qualitative themes extracted from narrative responses on how nurses' personal values influence nursing care and converge with quantitative results assessing personal values, professional values, and the practice environment, a key component of nurse satisfaction and subsequent care quality.

Methods: A convenience sample of nurses across 19 sites within a large nonprofit healthcare system was surveyed.

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Introduction: Pediatric patients often receive vasoactive agents following cardiothoracic surgery or when in shock. The use of vasoactive agents varies between different settings and has largely changed because of anecdotal observations or small observational studies. Although vasoactive agents are frequently used, there are limited studies in pediatric populations comparing them to one another.

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Objective: Monochorionic twin gestations affected by Type-II selective fetal growth restriction (sFGR) are at increased risk of intrauterine fetal demise, extreme preterm birth, severe neurodevelopmental impairment (NDI) and neonatal death of one or both twins. In the absence of a consensus on the optimal management strategy, we chose to evaluate which strategy was cost-effective in the setting of Type-II sFGR.

Methods: A decision-analytic model was used to compare expectant management (EM), bipolar cord occlusion (BCO), radiofrequency ablation (RFA) and fetoscopic laser photocoagulation (FLP) for a hypothetical cohort of 10 000 people with a monochorionic diamniotic twin pregnancy affected by Type-II sFGR.

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Article Synopsis
  • Fluid overload in pediatric cardiac surgery can lead to serious health issues, and managing it is challenging, with traditional methods potentially harming kidney function.
  • This study evaluated aminophylline's effect on fluid balance, urine output, and kidney function in pediatric patients after cardiac surgery, analyzing data from 72 patients who received the drug between September 2022 and December 2023.
  • Results showed that aminophylline significantly reduced fluid balance by 115% and doubled urine output in the 24 hours following administration without negatively impacting kidney function markers, indicating it is a safe option for these patients.
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Applications, Limitations, and Considerations of Clinical Trials in a Dish.

Bioengineering (Basel)

October 2024

Section of Cardiac Surgery, Department of Surgery, University of Chicago, 5841 S. Maryland Ave., Chicago, IL 60637, USA.

Recent advancements in biotechnology forged the path for clinical trials in dish (CTiDs) to advance as a popular method of experimentation in biomedicine. CTiDs play a fundamental role in translational research through technologies such as induced pluripotent stem cells, whole genome sequencing, and organs-on-a-chip. In this review, we explore advancements that enable these CTiD biotechnologies and their applications in animal testing, disease modeling, and space radiation technologies.

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Interventionist training and on-going guidance by the research team are essential in psychosocial interventional research to ensure fidelity. Consistency in delivering an intervention requires recruiting interventionists with well-aligned clinical experience, developing a replicable training process, and reassessing ongoing intervention fidelity using an assessment tool of observable behaviors that are essential to the intervention. This paper describes one research team's experience of hiring and training nurse interventionists to deliver a theory-based, telehealth psychosocial intervention for a single-arm pilot study.

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Background: An inspiration-synchronized vibrating mesh nebulizer (VMN) has been reported to improve aerosol delivery during adult mechanical ventilation. A prototype VMN generating smaller particles was developed. We aimed to compare the aerosol delivery efficiency of small-particle and conventional VMNs in inspiration-synchronized and continuous modes during neonatal and pediatric mechanical ventilation.

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Essentials of genomics in nursing undergraduate education: A discussion paper.

Nurse Educ Pract

November 2024

Creighton University, College of Nursing, 2500 California Plaza, Omaha, NE 68178, USA. Electronic address:

Aim: To map the 2021 American Association of Colleges of Nursing Essentials to the American Nurses Association Essentials of Genomic Nursing for all nurses and provide resources for nursing faculty to support the seamless integration of genomics into existing undergraduate curricula.

Background: Since the completion of the Human Genome Project in 2003, rapid advancements in genomic science leading to practical applications of genomics have revolutionized all areas of healthcare. Nursing is built on foundational life sciences, including genomics.

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Article Synopsis
  • Diastolic heart failure in pediatric patients is rare, representing only 0.5% of critically ill children, with a 5% mortality rate found in a study of 2,273 admissions from 2016 to 2021.
  • The research analyzed various factors, including age, comorbidities, and medications, finding that milrinone and ACE inhibitors may lower mortality rates, while older age and diuretics correlate with shorter hospital stays for survivors.
  • The study emphasizes the need for more targeted data on pediatric diastolic heart failure, given the limited existing research primarily focused on adult cases.
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Introduction: Cardiac intensive care providers require a comprehensive understanding of cardiac output and oxygen delivery. The estimation of cardiac output in clinical practice often relies on thermodilution and the Fick principle. Central venous saturation and lactate levels are commonly used indicators for cardiac output assessment.

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Aortic atresia is a rare finding and has not been previously described with superior-inferior ventricles. Presented here is a case of a heart with these concomitant findings and review of reported cases of aortic atresia in the absence of hypoplastic left heart syndrome. The aim of this report is to help highlight associated findings and the clinical approach taken.

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The diagnosis of coarctation of the aorta (CoA) prior to birth can be challenging due to the physiologic changes during postnatal transition. Prenatal risk stratification can standardize postnatal management and improve outcome. CT Children's Fetal Cardiology created the Antenatal Risk of CoA in Hartford (ARCH) clinical pathway defining four distinct postnatal order sets based on degree of suspicion for ductal dependency on fetal evaluation: low, low-moderate, moderate-high, and high risk.

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Changes in adequacy of splanchnic oxygen delivery and splanchnic artery Doppler after bolus feedings in infants: A systematic review and meta-analysis.

Pediatr Neonatol

September 2024

Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, TX, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.

Article Synopsis
  • A systematic review was conducted to analyze the effects of feeding on splanchnic regional oxygen saturation and Doppler patterns in infants under 1 year of age, utilizing objective measures.
  • The study included 8 studies with 240 patients, revealing no significant change in oxygen saturation after feeding, but a notable increase in splanchnic artery systolic velocity following feeds.
  • It was found that infants born under 28 weeks of gestation experienced a significant decrease in oxygen saturation after feeding, highlighting the need for careful monitoring in this vulnerable group.
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Importance: In 2022, the US House of Representatives passed a bipartisan resolution (House of Representatives Resolution 1118 at the 117th Congress [2021-2022]) calling for meaningful nutrition education for medical trainees. This was prompted by increasing health care spending attributed to the growing prevalence of nutrition-related diseases and the substantial federal funding via Medicare that supports graduate medical education. In March 2023, medical education professional organizations agreed to identify nutrition competencies for medical education.

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Twin girls born at 30 weeks' gestation with spinal muscular atrophy (SMA) received onsasemnogene-abeparvovec (OA) at 3.5 weeks of life. They had no treatment-related adverse events, normal acquisition of motor milestones, and normal neurological examination at 19 months.

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Purpose: Defects in the gene encoding selenocysteine insertion sequence binding protein 2, SECISBP2, result in global impaired selenoprotein synthesis manifesting a complex syndrome with characteristic serum thyroid function tests due to impaired thyroid hormone metabolism. Knowledge about this multisystemic defect remains limited.

Methods: Genetic and laboratory investigations were performed in affected members from 6 families presenting with short stature and failure to thrive.

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Article Synopsis
  • Vasoactive and inotropic medications are commonly used in pediatric heart failure cases, but their effects are difficult to predict due to their complex interactions, with limited supporting evidence.
  • This study aimed to assess the impact of these medications on cardiovascular parameters in children with low heart function using a computer simulator to model responses to various drug combinations.
  • Results showed that dobutamine and milrinone consistently improved cardiac output, while epinephrine and norepinephrine had negative effects, indicating that milrinone and dobutamine are effective in enhancing systemic oxygen delivery, especially when used together.
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Background: Patients living with chronic pain may feel frustrated with and neglected by clinicians who care for them, leading to negative health care experiences. Clinicians may struggle to find new ways to engage and connect with patients experiencing chronic pain. Both patients and clinicians may benefit from expressive writing by potentially improving communication and creating a deeper sense of connection within medical visits.

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Exploring Determinants of Nurse Retention: The Influence of Personal and Professional Values, and Work Environment in Predicting Intent to Leave.

Nurs Adm Q

August 2024

Author Affiliations: Magnet and Nursing Excellence, Advocate Condell Medical Center, Libertyville, Illinois (Ms Rothbart); Nursing Education and Professional Development, Advocate Good Samaritan Hospital, Downers Grove, Illinois (Ms Leddy); Pediatric Cardiac Intensive Care Unit, Advocate Children's Hospital, Oak Lawn, Illinois (Ms Brady); Nursing Administration, Advocate Sherman Hospital, Elgin, Illinois (Ms Kruse); and Institute for Nursing Excellence, Advocate Health, Milwaukee, Wisconsin (Dr Lancaster).

Nurse retention remains a pivotal issue, necessitating urgent strategies aimed at the recruitment and retention of highly qualified nurses. However, there is limited knowledge regarding the influence of nurses' personal and professional values, along with work environment, on predicting intent to leave an organization. Utilizing a secondary analysis approach, this study employed logistic regression to predict intent to leave among registered nurses (n = 671) using results from the Short Schwartz's Value Survey, the Nurses Professional Values Scale-3, and the Practice Environment Scale of the Nursing Work Index.

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Bittersweet Prognostication.

JAMA

September 2024

Division of Pediatric Critical Care and Division of Pediatric Palliative Care, Advocate Children's Hospital, Park Ridge, Illinois.

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The leading cause of death in children in the United States is injury caused by firearm violence. States that enact stricter laws related to firearm injury prevention have lower rates of mortality in children. In Illinois, we formed a coalition with medical professionals, medical organizations, community partners, and legislators to craft legislation to reduce the burden of firearm violence on children.

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