Article
Biochemistry & Molecular Biology
Alexandra-Cristina Scutca, Delia-Maria Nicoara, Niculina Mang, Iulius Juganaru, Giorgiana-Flavia Brad, Otilia Marginean, Galina F. Sud'ina
Summary: This study investigated the relationship between neutrophil-to-lymphocyte ratio (NLR) levels and the presence of cerebral edema in children with severe diabetic ketoacidosis (DKA). The results showed that lower blood pH and elevated NLR and blood urea were associated with cerebral edema. After adjusting for confounding factors, NLR remained positively associated with cerebral edema. Therefore, NLR may be an additional tool to identify high-risk patients with severe cerebral edema.
Article
Pediatrics
Nicole S. Glaser, Michael J. Stoner, Aris Garro, Scott Baird, Sage R. Myers, Arleta Rewers, Kathleen M. Brown, Jennifer L. Trainor, Kimberly S. Quayle, Julie K. McManemy, Andrew D. DePiero, Lise E. Nigrovic, Leah Tzimenatos, Jeff E. Schunk, Cody S. Olsen, T. Charles Casper, Simona Ghetti, Nathan Kuppermann
Summary: Research findings suggest that changes in glucose-corrected sodium concentrations during diabetic ketoacidosis treatment are influenced by various factors, including sodium and chloride concentrations at presentation, pre-existing diabetes, and the sodium content of intravenous fluids. However, declines in glucose-corrected sodium concentrations are not associated with mental status changes during treatment.
Article
Endocrinology & Metabolism
Arleta Rewers, Nathan Kuppermann, Michael J. Stoner, Aris Garro, Jonathan E. Bennett, Kimberly S. Quayle, Jeffrey E. Schunk, Sage R. Myers, Julie K. McManemy, Lise E. Nigrovic, Jennifer L. Trainor, Leah Tzimenatos, Maria Y. Kwok, Kathleen M. Brown, Cody S. Olsen, T. Charles Casper, Simona Ghetti, Nicole S. Glaser
Summary: In children treated for DKA, faster fluid administration rates led to a more rapid normalization of anion gap and Pco(2) than slower fluid infusion rates but were associated with an increased frequency of hyperchloremic acidosis.
Article
Multidisciplinary Sciences
William H. Hoffman, Stephen A. Whelan, Norman Lee
Summary: Diabetic ketoacidosis (DKA) is a serious complication of Type 1 diabetes (T1D) caused by insulin deficiency and insulin resistance. The metabolic and immunologic dysregulation in DKA leads to oxidative stress, inflammation, and the development of brain edema (BE). Changes in the tryptophan (TRP)/kynurenine pathway (KP) metabolites may play a role in the pathogenesis of DKA/BE.
Article
Medicine, General & Internal
Kelly R. Bergmann, Amanda Nickel, Matt Hall, Gretchen Cutler, M. Jennifer Abuzzahab, Brianna Bretscher, Shea Lammers, Dave Watson, Gabrielle Z. Hester
Summary: The study aimed to explore the association between the Child Opportunity Index and health outcomes in children with type 1 diabetes of different races and ethnicities. The results suggest that there are disparities in health outcomes among Black children compared to other racial and ethnic groups. These findings highlight the importance of considering racial disparities and community factors in preventing readmissions for diabetic ketoacidosis.
Article
Endocrinology & Metabolism
Estelle M. Everett, Timothy P. Copeland, Tannaz Moin, Lauren E. Wisk
Summary: The rate of pediatric DKA admissions in the United States has increased by 40% between 2006 and 2016, with higher rates observed in 18- to 20-year-old females, Black youth, those without private insurance, with lower incomes, and from nonurban areas. There is a need for further studies to understand the challenges faced by these vulnerable groups in order to develop interventions to reduce their DKA risk and address the rising national DKA rates.
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
(2021)
Article
Critical Care Medicine
Benjamin E. E. Zusman, Yijen Wu, Patrick M. M. Kochanek, Vincent E. E. Vagni, Keri Janesko-Feldman, Volodymyr Gerzanich, J. Marc Simard, Katherine Karahalios, Sandra Mihaljevic, Sudhanshu Raikwar, Anupama Rani, Jarrod Rulney, Shashvat M. M. Desai, Joshua Catapano, Ruchira M. M. Jha
Summary: This study evaluated the differential effects of glibenclamide on dose, TBI type, and imaging endophenotype. High-dose glibenclamide showed benefits in reducing hematoma volume, vasogenic edema, cytotoxic edema, and maintaining blood-brain barrier integrity after isolated brain contusion. However, its anti-edema effects were not robust in the presence of concomitant hemorrhagic shock.
CRITICAL CARE MEDICINE
(2023)
Article
Biochemistry & Molecular Biology
Onofrio Valente, Raffaella Messina, Giuseppe Ingravallo, Emilio Bellitti, Domenico Sergio Zimatore, Luigi de Gennaro, Pasqua Abbrescia, Roberta Pati, Claudia Palazzo, Grazia Paola Nicchia, Maria Trojano, Francesco Signorelli, Antonio Frigeri
Summary: This study evaluates the expression and distribution of AQP4 and AQP4ex in tissue samples from GBM patients and finds that the downregulation of AQP4ex is correlated with the severity of edema and BBB alteration. This suggests that AQP4ex may serve as a potential early biomarker of GBM progression.
CELLULAR AND MOLECULAR LIFE SCIENCES
(2022)
Article
Pediatrics
Nicole S. Glaser, Kimberly S. Quayle, Julie K. McManemy, Lise E. Nigrovic, Leah Tzimenatos, Michael J. Stoner, Jonathan E. Bennett, Jennifer L. Trainor, Arleta Rewers, Jeff E. Schunk, Sage R. Myers, Maria Y. Kwok, Kathleen M. Brown, Simona Ghetti, T. Charles Casper, Cody S. Olsen, Nathan Kuppermann
Summary: This study found that lower pH and higher BUN levels at presentation are associated with cerebral injury.
JOURNAL OF PEDIATRICS
(2022)
Article
Pediatrics
Michelle M. Perez, Shivanand Medar, Leanne Quigley, Bradley C. Clark
Summary: The study investigated the association between diabetic ketoacidosis (DKA) and prolonged QTc interval in pediatric patients, finding that 31% of patients with DKA demonstrated QTc prolongation on ECG. Severity of DKA and worsening acidosis were associated with increased prolongation of the QTc. Further research is needed to evaluate the clinical impact of these findings.
JOURNAL OF PEDIATRICS
(2021)
Article
Spectroscopy
Di Wu, Yi-Wen Luo, Ji Zhang, Bin Luo, Kai Zhang, Kai Yu, Rui-Na Liu, Han-Cheng Lin, Xin Wei, Zhen-Yuan Wang, Ping Huang
Summary: This study utilized FTIR microspectroscopy coupled with chemometrics to characterize pulmonary edema fluid from different causes of death and established models for diagnosing diabetic ketoacidosis. The results showed that variations in proteins can effectively differentiate deaths caused by DKA.
SPECTROCHIMICA ACTA PART A-MOLECULAR AND BIOMOLECULAR SPECTROSCOPY
(2021)
Article
Clinical Neurology
Hanwool Jeon, Moinay Kim, Wonhyoung Park, Joon Seo Lim, Eunyeup Lee, Hyeuk Cha, Jae Sung Ahn, Jeong Hoon Kim, Seok Ho Hong, Ji Eun Park, Eun-Jae Lee, Chul-Woong Woo, Seungjoo Lee
Summary: Intracerebral hemorrhage (ICH) can lead to delayed cerebral edema due to disruption of the blood-brain barrier (BBB), with perihematomal edema (PHE) considered a major factor in morbidity and mortality. The water channel AQP4 on astrocytes plays a crucial role in PHE formation, influenced by reactive oxygen species (ROS) from the hemorrhage. Modulating AQP4 may present a potential therapeutic target for alleviating delayed cerebral edema in ICH.
Article
Medicine, General & Internal
Hugo Segerer, Michael Wurm, Julia M. Grimsmann, Beate Karges, Andreas Neu, Marina Sindichakis, Katharina Warncke, Axel Dost, Reinhard W. Holl
Summary: The study found that the incidence of DKA at the time of T1D diagnosis in children and adolescents did not decrease between 2000 and 2019. Patients with MiH, children under 6, and girls were at a higher risk of DKA.
DEUTSCHES ARZTEBLATT INTERNATIONAL
(2021)
Article
Cell Biology
Lina Bergman, Roxanne Hastie, Henrik Zetterberg, Kaj Blennow, Sonja Schell, Eduard Langenegger, Ashley Moodley, Susan Walker, Stephen Tong, Catherine Cluver
Summary: The study found evidence of neuroinflammation and an injured blood-brain barrier in women with preeclampsia and eclampsia, especially in those with eclampsia.
Article
Pediatrics
Stefano Passanisi, Giuseppina Salzano, Pietro Basile, Bruno Bombaci, Flavia Caime, Immacolata Rulli, Mariella Valenzise, Eloisa Gitto, Fortunato Lombardo
Summary: DKA is a major concern in the management of type 1 diabetes in children. This study assessed the prevalence of severe DKA treated in PICU in a 5-year experience, and found that about 10% of individuals with T1D required admission to PICU. Public awareness campaigns are needed to recognize early symptoms and reduce morbidity and mortality related to DKA.
ITALIAN JOURNAL OF PEDIATRICS
(2023)
Article
Critical Care Medicine
Erwin Ista, Juliana Redivo, Paurav Kananur, Karen Choong, Jose Colleti, Dale M. Needham, Ronke Awojoodu, Sapna R. Kudchadkar
Summary: The study evaluated current international practices in PICUs regarding the components of the ABCDEF bundle, finding significant variability in adoption across regions. While standardized pain assessment (A), family engagement (F), and sedation assessment (C) were common, practices for delirium monitoring (D) and early exercise/mobility (E) were less prevalent. Further research is needed to evaluate the efficacy of specific elements and to address barriers to implementation and sustainability, particularly considering cultural and regional differences.
CRITICAL CARE MEDICINE
(2022)
Article
Pediatrics
E. Vincent S. Faustino, Oliver Karam, Robert Parker, Sheila J. Hanson, Leonardo R. Brandao, Paul Monagle
Summary: This study reviewed current evidence and proposed criteria for diagnosing coagulation dysfunction in critically ill children. The study identified several potential indicators of coagulation dysfunction and emphasized the need for future validation.
Article
Pediatrics
Katri Typpo, Sharon Y. Irving, Jose M. Prince, Nazima Pathan, Ann-Marie Brown
Summary: This article aims to establish consensus criteria for gastrointestinal dysfunction in critically ill children. The systematic review provides criteria for severe gastrointestinal dysfunction.
Article
Pediatrics
L. Nelson Sanchez-Pinto, Melania M. Bembea, Reid Wd Farris, Mary E. Hartman, Folafoluwa O. Odetola, Michael C. Spaeder, R. Scott Watson, Jerry J. Zimmerman, Tellen D. Bennett
Summary: This study evaluates the application of the PODIUM organ dysfunction criteria in two EHR databases. The results show that the PODIUM criteria perform well in discriminating in-hospital mortality and can be used for epidemiologic and clinical research. However, more studies are needed to evaluate the PODIUM criteria that are not routinely collected in EHR databases.
Article
Pediatrics
Nadir Yehya, Robinder G. Khemani, Simon Erickson, Lincoln S. Smith, Courtney M. Rowan, Philippe Jouvet, Doug F. Willson, Ira M. Cheifetz, Shan Ward, Neal J. Thomas
Summary: This study aimed to develop an operational and evidence-based definition of respiratory dysfunction for critically ill children through a comprehensive literature review.
Article
Medicine, General & Internal
Michael J. Bell, Bedda L. Rosario, Patrick M. Kochanek, P. David Adelson, Kevin P. Morris, Alicia K. Au, Michelle Schober, Warwick Butt, Richard J. Edwards, Jerry Zimmerman, Jose Pineda, Truc M. Le, Nathan Dean, Michael J. Whalen, Anthony Figaji, James Luther, Sue R. Beers, Deepak K. Gupta, Jessica Carpenter, Sandra Buttram, Stephen R. Wisniewski
Summary: This study aimed to investigate the treatment effect of cerebrospinal fluid (CSF) diversion on children with severe traumatic brain injury (TBI). The results showed that CSF diversion was not associated with improved Glasgow Outcome Score-Extended for Pediatrics (GOS-EP) at 6 months after TBI, but it was associated with a decrease in intracranial pressure (ICP).
Article
Critical Care Medicine
Alicia M. Alcamo, Gregory J. Barren, Andrew E. Becker, Katie Hayes, Julie C. Fitzgerald, Fran Balamuth, Jeffrey W. Pennington, Martha A. Q. Curley, Robert C. Tasker, Alexis A. Topjian, Scott L. Weiss
Summary: This study aimed to validate a computational phenotype that identifies acute brain dysfunction based on clinician concern for neurologic or behavioral changes in pediatric sepsis. The results showed that the computational phenotype had high sensitivity and specificity, and was able to identify sepsis episodes involving acute brain dysfunction.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Robert C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Editorial Material
Critical Care Medicine
Robert C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Matthew Luchette, Kerri LaRovere, Cheuk C. Au, Robert C. Tasker, Alireza Akhondi-Asl
Summary: In silico pharmacokinetic modeling of midazolam and pentobarbital suggests that standard treatment protocols for refractory status epilepticus result in higher steady-state serum concentrations. Not including bolus doses delays the achievement of steady-state concentration, while abrupt discontinuation reduces medication exposure. These models provide potential variables to optimize in future clinical studies.
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Robert C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Robert C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Robert C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Robert C. C. Tasker
PEDIATRIC CRITICAL CARE MEDICINE
(2023)
Article
Clinical Neurology
Arnold J. J. Sansevere, Melissa L. L. DiBacco, Bo Zhang, Alireza Akhondi-Asl, Mark H. H. Libenson, Robert C. C. Tasker, Phillip L. L. Pearl
Summary: The study evaluated interictal discharges (IEDs) as a biomarker for the time to development of electrographic seizures (ES). Through continuous electroencephalography (cEEG) monitoring of 254 critically ill children, it was found that high-frequency interictal discharges and periodic patterns are associated with ES.
JOURNAL OF CLINICAL NEUROPHYSIOLOGY
(2023)