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Acute Otitis Media English (8) French All (8)

Key study: Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Visit

Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, C...

Objective: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.

Key study: Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media

Visit

Brinker DL Jr, MacGeorge EL, Hackman N

Objective: To assess the implications and recommendations to improve antibiotic stewardship through watchful waiting as an alternative to immediate antibiotic treatment in children with AOM.

Key study: Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial

Visit

van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, D...

Objective: We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.

Key study: Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children

Visit

Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Mart...

Objective: Given methodologic limitations in available publications, we undertook the current trial involving children 6 to 23 months of age to determine whether limiting antimicrobial treatment to 5 days rather than using the standard 10-day regimen would afford equivalent outcomes and whether doing so also for subsequent episodes would lead to a reduction in the overall use of antimicrobial treatment, with a resulting reduction in the development of antimicrobial resistance.

Key study: Use of symptoms and risk factors to predict acute otitis media in infants

Visit

McCormick DP, Jennings K, Ede LC, Alvarez-Fernandez P, Patel J, Chonmaitree T

Objective: The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants.

Key study: Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development

Visit

Chonmaitree T, Alvarez-Fernandez P, Jennings K, Trujillo R, Marom T, Loeffelh...

Objective: This study determined the epidemiologic characteristics and etiology of asymptomatic upper respiratory tract infection in the first year of life and the association with acute otitis media complication.

Key study: Treatment of acute otitis media in children under 2 years of age

Visit

Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn ...

Objective: We undertook this clinical trial to determine the extent to which antimicrobial treatment affects the course of both symptoms and signs of acute otitis media, irrespective of the apparent severity of the disease, among children 6 to 23 months of age in whom the diagnosis of acute otitis media is quite certain.

Key study: A placebo-controlled trial of antimicrobial treatment for acute otitis media

Visit

Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A

Objective: We conducted a randomized, double-blind, placebo-controlled study of the efficacy of antimicrobial therapy in the age group with the highest incidence of acute otitis media. Our aim was to assess the efficacy of antimicrobial treatment for acute otitis media when strict diagnostic criteria are used and the antimicrobial coverage and dosage of the active treatment are adequate.

Key study: Acute otitis media in children presenting to the emergency department: Is it diagnosed and managed appropriately?

Visit

Niroshan Balasundaram, Dung Phan, Daniel Mazzoni, Elliot Duong, Amy Sweeny, C...

Objective: To describe the diagnostic and management practice in children with acute otitis media (AOM) presenting to the emergency department (ED) and compare diagnosis and management against existing guidelines.

Key study: Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media

Visit

Brinker DL Jr, MacGeorge EL, Hackman N

Objective: To assess the implications and recommendations to improve antibiotic stewardship through watchful waiting as an alternative to immediate antibiotic treatment in children with AOM.

Key study: Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial

Visit

van Uum RT, Venekamp RP, Sjoukes A, van de Pol AC, de Wit GA, Schilder AGM, D...

Objective: We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.

Key study: Shortened Antimicrobial Treatment for Acute Otitis Media in Young Children

Visit

Hoberman A, Paradise JL, Rockette HE, Kearney DH, Bhatnagar S, Shope TR, Mart...

Objective: Given methodologic limitations in available publications, we undertook the current trial involving children 6 to 23 months of age to determine whether limiting antimicrobial treatment to 5 days rather than using the standard 10-day regimen would afford equivalent outcomes and whether doing so also for subsequent episodes would lead to a reduction in the overall use of antimicrobial treatment, with a resulting reduction in the development of antimicrobial resistance.

Key study: Use of symptoms and risk factors to predict acute otitis media in infants

Visit

McCormick DP, Jennings K, Ede LC, Alvarez-Fernandez P, Patel J, Chonmaitree T

Objective: The purpose of this study was to evaluate the usefulness of symptoms and other risk factors in predicting the presence of AOM in infants.

Key study: Symptomatic and asymptomatic respiratory viral infections in the first year of life: association with acute otitis media development

Visit

Chonmaitree T, Alvarez-Fernandez P, Jennings K, Trujillo R, Marom T, Loeffelh...

Objective: This study determined the epidemiologic characteristics and etiology of asymptomatic upper respiratory tract infection in the first year of life and the association with acute otitis media complication.

Key study: Treatment of acute otitis media in children under 2 years of age

Visit

Hoberman A, Paradise JL, Rockette HE, Shaikh N, Wald ER, Kearney DH, Colborn ...

Objective: We undertook this clinical trial to determine the extent to which antimicrobial treatment affects the course of both symptoms and signs of acute otitis media, irrespective of the apparent severity of the disease, among children 6 to 23 months of age in whom the diagnosis of acute otitis media is quite certain.

Key study: A placebo-controlled trial of antimicrobial treatment for acute otitis media

Visit

Thtinen PA, Laine MK, Huovinen P, Jalava J, Ruuskanen O, Ruohola A

Objective: We conducted a randomized, double-blind, placebo-controlled study of the efficacy of antimicrobial therapy in the age group with the highest incidence of acute otitis media. Our aim was to assess the efficacy of antimicrobial treatment for acute otitis media when strict diagnostic criteria are used and the antimicrobial coverage and dosage of the active treatment are adequate.

Anaphylaxis English (8) French All (8)

Key Study: Epinephrine Use for Anaphylaxis - A Multi-Incident Analysis

Visit

Institute for Safe Medication Practices Canada

This multi-incident analysis was conducted to identify factors contributing to errors when epinephrine was used for the treatment of anaphylaxis and to suggest strategies to prevent or minimize potential harm when epinephrine is used for this indication.

Key Study: The Risk of Recurrent Anaphylaxis

Visit

O'Keefe A, Clarke A, St Pierre Y, Mill J, Asai Y, Eisman H, La Vieille S, Ali...

factors contributing to errors when epinephrine was

Key Study: Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children

Visit

Brown JC, Tuuri RE, Akhter S, Guerra LD, Goodman IS, Myers SR, Nozicka C, Man...

used for the treatment of anaphylaxis and to suggest

Key Study: Embedded Needles Caused by Epinephrine Autoinjector Use in Children

Visit

Dreborg S, Wen X, Kim L, Tsai G, Nevis I, Potts R, Chiu J, Dominic A, Kim H

strategies to prevent or minimize potential harm

Key Study: Increasing visits for anaphylaxis and the benefits of early epinephrine administration: A 4-year study at a pediatric emergency department in Montreal, Canada

Visit

Hochstadter E, Clarke A, De Schryver S, LaVieille S, Alizadehfar R, Joseph L,...

when epinephrine is used for this indication.

Key Study: Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

Visit

Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G

The objective of this study was to investigate the incidence and clinical predictors of biphasic reactions in children presenting to the emergency department (ED) with anaphylaxis.

Key Study: Early treatment of food-induced anaphylaxis with epinephrine is associated with a lower risk of hospitalization

Visit

Fleming JT, Clark S, Camargo CA Jr, Rudders SA

The objective of this study was to identify factors associated with early epinephrine treatment for FIA and to specifically examine the association between early epinephrine treatment and hospitalization.

Key Study: Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

Visit

Umasunthar T, Procktor A, Hodes M, Smith JG, Gore C, Cox HE, Marrs T, Hanna H...

Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices.

Key Study: Epinephrine Use for Anaphylaxis - A Multi-Incident Analysis

Visit

Institute for Safe Medication Practices Canada

This multi-incident analysis was conducted to identify factors contributing to errors when epinephrine was used for the treatment of anaphylaxis and to suggest strategies to prevent or minimize potential harm when epinephrine is used for this indication.

Key Study: The Risk of Recurrent Anaphylaxis

Visit

O'Keefe A, Clarke A, St Pierre Y, Mill J, Asai Y, Eisman H, La Vieille S, Ali...

factors contributing to errors when epinephrine was

Key Study: Lacerations and Embedded Needles Caused by Epinephrine Autoinjector Use in Children

Visit

Brown JC, Tuuri RE, Akhter S, Guerra LD, Goodman IS, Myers SR, Nozicka C, Man...

used for the treatment of anaphylaxis and to suggest

Key Study: Embedded Needles Caused by Epinephrine Autoinjector Use in Children

Visit

Dreborg S, Wen X, Kim L, Tsai G, Nevis I, Potts R, Chiu J, Dominic A, Kim H

strategies to prevent or minimize potential harm

Key Study: Increasing visits for anaphylaxis and the benefits of early epinephrine administration: A 4-year study at a pediatric emergency department in Montreal, Canada

Visit

Hochstadter E, Clarke A, De Schryver S, LaVieille S, Alizadehfar R, Joseph L,...

when epinephrine is used for this indication.

Key Study: Epidemiology and clinical predictors of biphasic reactions in children with anaphylaxis

Visit

Alqurashi W, Stiell I, Chan K, Neto G, Alsadoon A, Wells G

The objective of this study was to investigate the incidence and clinical predictors of biphasic reactions in children presenting to the emergency department (ED) with anaphylaxis.

Key Study: Early treatment of food-induced anaphylaxis with epinephrine is associated with a lower risk of hospitalization

Visit

Fleming JT, Clark S, Camargo CA Jr, Rudders SA

The objective of this study was to identify factors associated with early epinephrine treatment for FIA and to specifically examine the association between early epinephrine treatment and hospitalization.

Key Study: Patients' ability to treat anaphylaxis using adrenaline autoinjectors: a randomized controlled trial

Visit

Umasunthar T, Procktor A, Hodes M, Smith JG, Gore C, Cox HE, Marrs T, Hanna H...

Previous work has shown patients commonly misuse adrenaline autoinjectors (AAI). It is unclear whether this is due to inadequate training, or poor device design. We undertook a prospective randomized controlled trial to evaluate ability to administer adrenaline using different AAI devices.

Asthma English (2) French All (2)

Key Study: The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers (2008)

Visit

Ducharme, FM, Chalut, D, Plotnick, L, Savdie, C, Kudirka, D, Zhang, X, Meng, ...

To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma.

Key Study: The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity (2000)

Visit

Chalut DS, Ducharme FM, Davis GM

To elaborate and validate a Preschool Respiratory Assessment Measure (PRAM) that would accurately reflect the severity of airway obstruction and the response to treatment in young patients with asthma.

Key Study: The Pediatric Respiratory Assessment Measure: a valid clinical score for assessing acute asthma severity from toddlers to teenagers (2008)

Visit

Ducharme, FM, Chalut, D, Plotnick, L, Savdie, C, Kudirka, D, Zhang, X, Meng, ...

To determine the performance characteristics of the Preschool Respiratory Assessment Measure (PRAM) in preschool and school-aged children with acute asthma.

Key Study: The Preschool Respiratory Assessment Measure (PRAM): a responsive index of acute asthma severity (2000)

Visit

Chalut DS, Ducharme FM, Davis GM

To elaborate and validate a Preschool Respiratory Assessment Measure (PRAM) that would accurately reflect the severity of airway obstruction and the response to treatment in young patients with asthma.

Bacterial Meningitis English (11) French All (11)

Key study: Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study

Visit

Costerus JM, Brouwer MC, Sprengers MES, Roosendaal SD, van der Ende A, van de...

Objective: In 2006, we started a prospective cohort study to identify and characterize host genetic traits and bacterial genetic factors controlling occurrence and outcome of bacterial meningitis (MeninGene). Here, we report data from this study, focusing on complications of LP in adults with community-acquired bacterial meningitis and the role of cranial CT prior to LP.

Key study: Lumbar Puncture Performed Promptly or After Neuroimaging in Acute Bacterial Meningitis in Adults: A Prospective National Cohort Study Evaluating Different Guidelines

Visit

Glimker M, Sjlin J, kesson S, Naucler P

Objective: The aim was to evaluate the effect on outcome of adherence to European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), and Swedish guidelines regarding neuroimaging before LP.

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines

Visit

Salazar L, Hasbun R

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Key study: Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture

Visit

Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J

Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.

Key study: Prevalence and predictors of bacterial meningitis in young infants with Fever without a source

Visit

Martinez E, Mintegi S, Vilar B, Martinez MJ, Lopez A, Catediano E, Gomez B

Objective: Our objectives were to analyze the prevalence and microbiology of bacterial meningitis in this group and its prevalence in relation to clinical and laboratory risk factors.

Key study: Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study

Visit

Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, Betti...

Objective: The objectives of this study were to describe the outcomes following invasive meningococcal disease (IMD) in a prospective cohort of children and adults, and to identify specific risk factors for death and development of neurological and nonneurological complications.

Key study: Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules

Visit

Dubos F, Korczowski B, Aygun DA, Martinot A, Prat C, Galetto-Lacour A, Casado...

Objective: To compare the performance of two of these CDRs for children: the Bacterial Meningitis Score (BMS) and the Meningitest.

Key study: Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis

Visit

Nigrovic LE, Kuppermann N, Macias CG, Cannavino CR, Moro-Sutherland DM, Schem...

Objective: To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.

Key study: Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment

Visit

Kanegaye JT, Soliemanzadeh P, Bradley JS

Objective: We conducted a retrospective review of children with bacterial meningitis to describe the rate at which parenteral antibiotic pretreatment sterilizes CSF cultures.

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis

Visit

Negrini B, Kelleher KJ, Wald ER

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.

Key study: A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children

Visit

Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Berna...

Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).

Key study: Cranial CT, Lumbar Puncture, and Clinical Deterioration in Bacterial Meningitis: A Nationwide Cohort Study

Visit

Costerus JM, Brouwer MC, Sprengers MES, Roosendaal SD, van der Ende A, van de...

Objective: In 2006, we started a prospective cohort study to identify and characterize host genetic traits and bacterial genetic factors controlling occurrence and outcome of bacterial meningitis (MeninGene). Here, we report data from this study, focusing on complications of LP in adults with community-acquired bacterial meningitis and the role of cranial CT prior to LP.

Key study: Lumbar Puncture Performed Promptly or After Neuroimaging in Acute Bacterial Meningitis in Adults: A Prospective National Cohort Study Evaluating Different Guidelines

Visit

Glimker M, Sjlin J, kesson S, Naucler P

Objective: The aim was to evaluate the effect on outcome of adherence to European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), and Swedish guidelines regarding neuroimaging before LP.

Key study: Cranial Imaging Before Lumbar Puncture in Adults With Community-Acquired Meningitis: Clinical Utility and Adherence to the Infectious Diseases Society of America Guidelines

Visit

Salazar L, Hasbun R

Objective: The main objectives of this study were to identify the adherence of clinicians to IDSA guidelines regarding cranial imaging in patients with CAM, to evaluate the clinical and prognostic differences between those patients with and without an indication for cranial imaging, and to assess the clinical impact in management in those with abnormal intracranial findings with or without altered mental status as their sole indication for imaging.

Key study: Adult bacterial meningitis: earlier treatment and improved outcome following guideline revision promoting prompt lumbar puncture

Visit

Glimker M, Johansson B, Grindborg , Bottai M, Lindquist L, Sjlin J

Objective: Despite guideline emphasis on early treatment, performing CT prior to LP implies a risk of delayed treatment and unfavorable outcome. Therefore, Swedish guidelines were revised in 2009, deleting impaired mental status as a contraindication for LP without prior CT scan. The aim of the present study was to evaluate the guideline revision.

Key study: Prevalence and predictors of bacterial meningitis in young infants with Fever without a source

Visit

Martinez E, Mintegi S, Vilar B, Martinez MJ, Lopez A, Catediano E, Gomez B

Objective: Our objectives were to analyze the prevalence and microbiology of bacterial meningitis in this group and its prevalence in relation to clinical and laboratory risk factors.

Key study: Outcomes of invasive meningococcal disease in adults and children in Canada between 2002 and 2011: a prospective cohort study

Visit

Sadarangani M, Scheifele DW, Halperin SA, Vaudry W, Le Saux N, Tsang R, Betti...

Objective: The objectives of this study were to describe the outcomes following invasive meningococcal disease (IMD) in a prospective cohort of children and adults, and to identify specific risk factors for death and development of neurological and nonneurological complications.

Key study: Distinguishing between bacterial and aseptic meningitis in children: European comparison of two clinical decision rules

Visit

Dubos F, Korczowski B, Aygun DA, Martinot A, Prat C, Galetto-Lacour A, Casado...

Objective: To compare the performance of two of these CDRs for children: the Bacterial Meningitis Score (BMS) and the Meningitest.

Key study: Clinical prediction rule for identifying children with cerebrospinal fluid pleocytosis at very low risk of bacterial meningitis

Visit

Nigrovic LE, Kuppermann N, Macias CG, Cannavino CR, Moro-Sutherland DM, Schem...

Objective: To validate the Bacterial Meningitis Score in the era of widespread pneumococcal conjugate vaccination.

Key study: Lumbar puncture in pediatric bacterial meningitis: defining the time interval for recovery of cerebrospinal fluid pathogens after parenteral antibiotic pretreatment

Visit

Kanegaye JT, Soliemanzadeh P, Bradley JS

Objective: We conducted a retrospective review of children with bacterial meningitis to describe the rate at which parenteral antibiotic pretreatment sterilizes CSF cultures.

Key study: Cerebrospinal fluid findings in aseptic versus bacterial meningitis

Visit

Negrini B, Kelleher KJ, Wald ER

Objective: To assess 1) the characteristics of the CSF differential in aseptic versus bacterial meningitis, 2) the influence of duration of illness on the CSF differential, and 3) the role of the CSF differential in discriminating between aseptic versus bacterial meningitis.

Key study: A comparison of ceftriaxone and cefuroxime for the treatment of bacterial meningitis in children

Visit

Schaad UB, Suter S, Gianella-Borradori A, Pfenninger J, Auckenthaler R, Berna...

Objective: To compare ceftriaxone with cefuroxime for the treatment of meningitis, we conducted a study in which 106 children with acute bacterial meningitis were randomly assigned to receive either ceftriaxone (100 mg per kilogram of body weight per day, administered intravenously once daily; n = 53) or cefuroxime (240 mg per kilogram per day, administered intravenously in four equal doses; n = 53).

Bronchiolitis English (4) French All (4)

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial

Visit

Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddar...

Objectives: Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has not been rigorously studied in randomised trials. This study aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

Visit

Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S...

This randomized, double-blind, placebo-controlled, clinical trial with a factorial design at multiple sites was undertaken to determine whether treatment with nebulized epinephrine, a short course of oral dexamethasone, or both resulted in a clinically important decrease in hospital admissions among infants with bronchiolitis who were seen in the emergency department.

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis

Visit

Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Mal...

The goal of this study was to determine the effectiveness of a single dose of oral dexamethasone in infants with moderate-to-severe bronchiolitis.

Key Study: Evaluation of the utility of radiography in acute bronchiolitis

Visit

Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokansk...

Objectives: to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given antibiotics after radiography.

Key Study: High-flow warm humidified oxygen versus standard low-flow nasal cannula oxygen for moderate bronchiolitis (HFWHO RCT): An open, phase 4, randomised controlled trial

Visit

Kepreotes E, Whitehead B, Attia J, Oldmeadow C, Collison A, Searles A, Goddar...

Objectives: Bronchiolitis is the most common lung infection in infants and treatment focuses on management of respiratory distress and hypoxia. High-flow warm humidified oxygen (HFWHO) is increasingly used, but has not been rigorously studied in randomised trials. This study aimed to examine whether HFWHO provided enhanced respiratory support, thereby shortening time to weaning off oxygen

Key Study: Epinephrine and dexamethasone in children with bronchiolitis

Visit

Plint AC, Johnson DW, Patel H, Wiebe N, Correll R, Brant R, Mitton C, Gouin S...

This randomized, double-blind, placebo-controlled, clinical trial with a factorial design at multiple sites was undertaken to determine whether treatment with nebulized epinephrine, a short course of oral dexamethasone, or both resulted in a clinically important decrease in hospital admissions among infants with bronchiolitis who were seen in the emergency department.

Key Study: A multicenter, randomized, controlled trial of dexamethasone for bronchiolitis

Visit

Corneli HM, Zorc JJ, Mahajan P, Shaw KN, Holubkov R, Reeves SD, Ruddy RM, Mal...

The goal of this study was to determine the effectiveness of a single dose of oral dexamethasone in infants with moderate-to-severe bronchiolitis.

Key Study: Evaluation of the utility of radiography in acute bronchiolitis

Visit

Schuh S, Lalani A, Allen U, Manson D, Babyn P, Stephens D, MacPhee S, Mokansk...

Objectives: to determine the proportion of radiographs inconsistent with bronchiolitis in children with typical presentation of bronchiolitis and to compare rates of intended antibiotic therapy before radiography versus those given antibiotics after radiography.

Burns English (5) French All (5)

Key study: Delayed Healing Associated with Silver Sulfadiazine Use for Partial Thickness Scald Burns in Children

Visit

Raymond SL, Zecevic A, Larson SD, Ruzic A, Islam S

Objective: The purpose of this study was to compare outcomes of three different dressings for pediatric partial-thickness scald burns.

Key study: Effectiveness of aspiration or deroofing for blister management in patients with burns: A prospective randomized controlled trial

Visit

Ro HS, Shin JY, Sabbagh MD, Roh SG, Chang SC, Lee NH

Objective: To determine which treatment is the best option when encountering blisters while treating burn patients.

Key study: A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department

Visit

Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M

Objective: This study sought to determine whether silver sodium carboxymethyl cellulose dressing is a superior treatment to nanocrystalline silver-coated polyethylene dressing in pediatric patients with partial thickness burns.

Key study: Randomized controlled trial of three burns dressings for partial thickness burns in children

Visit

Gee Kee EL, Kimble RM, Cuttle L, Khan A, Stockton KA

Objective: This study compared the effects of three silver dressing combinations on small to medium size acute partial thickness burns in children, focusing on re-epithelialization time, pain and distress during dressing changes.

Key study: Discrepancy in Initial Pediatric Burn Estimates and Its Impact on Fluid Resuscitation

Visit

Goverman J, Bittner EA, Friedstat JS, Moore M, Nozari A, Ibrahim AE, Sarhane ...

Objective: To evaluate the differences between initial TBSA estimates and its impact on fluid resuscitation at an American Burn Associationverified pediatric burn center.

Key study: Delayed Healing Associated with Silver Sulfadiazine Use for Partial Thickness Scald Burns in Children

Visit

Raymond SL, Zecevic A, Larson SD, Ruzic A, Islam S

Objective: The purpose of this study was to compare outcomes of three different dressings for pediatric partial-thickness scald burns.

Key study: Effectiveness of aspiration or deroofing for blister management in patients with burns: A prospective randomized controlled trial

Visit

Ro HS, Shin JY, Sabbagh MD, Roh SG, Chang SC, Lee NH

Objective: To determine which treatment is the best option when encountering blisters while treating burn patients.

Key study: A Randomized Controlled Study of Silver-Based Burns Dressing in a Pediatric Emergency Department

Visit

Brown M, Dalziel SR, Herd E, Johnson K, Wong She R, Shepherd M

Objective: This study sought to determine whether silver sodium carboxymethyl cellulose dressing is a superior treatment to nanocrystalline silver-coated polyethylene dressing in pediatric patients with partial thickness burns.

Key study: Randomized controlled trial of three burns dressings for partial thickness burns in children

Visit

Gee Kee EL, Kimble RM, Cuttle L, Khan A, Stockton KA

Objective: This study compared the effects of three silver dressing combinations on small to medium size acute partial thickness burns in children, focusing on re-epithelialization time, pain and distress during dressing changes.

Key study: Discrepancy in Initial Pediatric Burn Estimates and Its Impact on Fluid Resuscitation

Visit

Goverman J, Bittner EA, Friedstat JS, Moore M, Nozari A, Ibrahim AE, Sarhane ...

Objective: To evaluate the differences between initial TBSA estimates and its impact on fluid resuscitation at an American Burn Associationverified pediatric burn center.

Concussion English (10) French All (10)

Key Study: Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department

Visit

Osmond MH, Klassen TP, Wells GA, Davidson J, Correll R, Boutis K, Joubert G, ...

Methods: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability. Physicians completed standardized assessment forms before CT, including clinical predictors of the rule. The primary outcome was neurosurgical intervention and the secondary outcome was brain injury on CT. We calculated test characteristics of the rule and used recursive partitioning to further refine the rule.

Key Study: Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED

Visit

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M,...

Objective: To derive and validate a clinical risk score for persistent postconcussion symptoms among children presenting to the emergency department.

Key Study: Effect of cognitive activity level on duration of post-concussion symptoms

Visit

Brown NJ, Mannix RC, O'Brien MJ, Gostine D, Collins MW, Meehan WP III

Objective: To determine the effect of cognitive activity level on duration of post-concussion symptoms.

Key Study: Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study

Visit

Easter JS, Bakes K, Dhaliwal J, Miller M, Caruso E, Haukoos JS

Objective: To evaluate the diagnostic accuracy of clinical decision rules and physician judgment for identifying clinically important traumatic brain injuries in children with minor head injuries presenting to the emergency department.

Key Study: Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department

Visit

Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ

Objective: To determine the acute predictors associated with the development of postconcussion syndrome (PCS) in children and adolescents after mild traumatic brain injury.

Key Study: Time interval between concussions and symptom duration

Visit

Eisenberg MA, Andrea J, Meehan W, Mannix R

Objective: To test the hypothesis that children with a previous history of concussion have a longer duration of symptoms after a repeat concussion than those without such a history.

Key Study: Mild traumatic brain injury: a description of how children and youths between 16 and 18 years of age perform leisure activities after 1 year

Visit

Jonsson C, Andersson EE

Objective: To describe how children and youths perform leisure activities, 1 year after a mild traumatic brain injury (MTBI).

Key Study: Identifying neurocognitive deficits in adolescents following concussion

Visit

Thomas DG, Collins MW, Saladino RA, Frank V, Raab J, Zuckerbraun NS

This study of concussed adolescents sought to determine if a computer-based neurocognitive assessment (Immediate Postconcussion Assessment and Cognitive Test [ImPACT]) performed on patients who present to the emergency department (ED) immediately following head injury would correlate with assessments performed 3 to 10 days postinjury and if ED neurocognitive testing would detect differences in concussion severity that clinical grading scales could not.

Key Study: Identifying the specific needs of adolescents after a mild traumatic brain injury: a service provider perspective

Visit

Swaine BR, Gagnon I, Champagne F, Lefebvre H, Friedman D, Atkinson J, Feldman D

Objectives: To identify the specific service needs of adolescents with mild traumatic brain injury (MTBI) and those of their parents through the perspective of expert service providers as well as to compare it to the perspective of adolescents and their parents obtained in a prior study.

Key Study: Visuomotor response time in children with a mild traumatic brain injury

Visit

Gagnon I, Swaine B, Friedman D, Forget R

Objective: To compare the visuomotor response times of children after a mild traumatic brain injury (mTBI) with those of noninjured children matched for age, sex, and premorbid level of physical activity.

Key Study: Validation and refinement of a clinical decision rule for the use of computed tomography in children with minor head injury in the emergency department

Visit

Osmond MH, Klassen TP, Wells GA, Davidson J, Correll R, Boutis K, Joubert G, ...

Methods: This multicentre cohort study in 9 Canadian pediatric emergency departments prospectively enrolled children with blunt head trauma presenting with a Glasgow Coma Scale score of 13-15 and loss of consciousness, amnesia, disorientation, persistent vomiting or irritability. Physicians completed standardized assessment forms before CT, including clinical predictors of the rule. The primary outcome was neurosurgical intervention and the secondary outcome was brain injury on CT. We calculated test characteristics of the rule and used recursive partitioning to further refine the rule.

Key Study: Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED

Visit

Zemek R, Barrowman N, Freedman SB, Gravel J, Gagnon I, McGahern C, Aglipay M,...

Objective: To derive and validate a clinical risk score for persistent postconcussion symptoms among children presenting to the emergency department.

Key Study: Effect of cognitive activity level on duration of post-concussion symptoms

Visit

Brown NJ, Mannix RC, O'Brien MJ, Gostine D, Collins MW, Meehan WP III

Objective: To determine the effect of cognitive activity level on duration of post-concussion symptoms.

Key Study: Comparison of PECARN, CATCH, and CHALICE rules for children with minor head injury: a prospective cohort study

Visit

Easter JS, Bakes K, Dhaliwal J, Miller M, Caruso E, Haukoos JS

Objective: To evaluate the diagnostic accuracy of clinical decision rules and physician judgment for identifying clinically important traumatic brain injuries in children with minor head injuries presenting to the emergency department.

Key Study: Predicting postconcussion syndrome after mild traumatic brain injury in children and adolescents who present to the emergency department

Visit

Babcock L, Byczkowski T, Wade SL, Ho M, Mookerjee S, Bazarian JJ

Objective: To determine the acute predictors associated with the development of postconcussion syndrome (PCS) in children and adolescents after mild traumatic brain injury.

Key Study: Time interval between concussions and symptom duration

Visit

Eisenberg MA, Andrea J, Meehan W, Mannix R

Objective: To test the hypothesis that children with a previous history of concussion have a longer duration of symptoms after a repeat concussion than those without such a history.

Key Study: Mild traumatic brain injury: a description of how children and youths between 16 and 18 years of age perform leisure activities after 1 year

Visit

Jonsson C, Andersson EE

Objective: To describe how children and youths perform leisure activities, 1 year after a mild traumatic brain injury (MTBI).

Key Study: Identifying neurocognitive deficits in adolescents following concussion

Visit

Thomas DG, Collins MW, Saladino RA, Frank V, Raab J, Zuckerbraun NS

This study of concussed adolescents sought to determine if a computer-based neurocognitive assessment (Immediate Postconcussion Assessment and Cognitive Test [ImPACT]) performed on patients who present to the emergency department (ED) immediately following head injury would correlate with assessments performed 3 to 10 days postinjury and if ED neurocognitive testing would detect differences in concussion severity that clinical grading scales could not.

Key Study: Identifying the specific needs of adolescents after a mild traumatic brain injury: a service provider perspective

Visit

Swaine BR, Gagnon I, Champagne F, Lefebvre H, Friedman D, Atkinson J, Feldman D

Objectives: To identify the specific service needs of adolescents with mild traumatic brain injury (MTBI) and those of their parents through the perspective of expert service providers as well as to compare it to the perspective of adolescents and their parents obtained in a prior study.

Key Study: Visuomotor response time in children with a mild traumatic brain injury

Visit

Gagnon I, Swaine B, Friedman D, Forget R

Objective: To compare the visuomotor response times of children after a mild traumatic brain injury (mTBI) with those of noninjured children matched for age, sex, and premorbid level of physical activity.

Congenital Heart Defect English (17) French All (17)

Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department

Visit

Judge P, Meckler G

Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.

Key Study: The Critically Ill Infant with Congenital Heart Disease

Visit

Strobel, AM & Lu, N.

Objective: This article presents an approach for identification of infants with congenital heart disorders.

Key Study: Reappraisal of the prostaglandin E1 dose for early newborns with patent ductus arteriosus-dependent pulmonary circulation

Visit

Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS

Objective: To review our experience of a low initial dose of PGE1 treatment in early newborns with congenital heart disease and patent ductus arteriosus (PDA)-dependent pulmonary flow.

Key Study: Congenital heart disease

Visit

Dolbec K, Mick NW

This publication provides an overview of the presentations of congenital heart defects, and makes diagnosis and management recommendations for emergency physicians.

Key Study: Impact of oxygen saturation targets and oxygen therapy during the transport of neonates with clinically suspected congenital heart disease

Visit

Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ

Objective: To determine the effect of average SpO(2) range and oxygen administration during neonatal transport on clinical markers of cardiovascular instability.

Key Study: Approach to diagnosing congenital cardiac disorders

Visit

Hartas GA, Tsounias E, Gupta-Malhotra M

Objective: To give a general picture of the diagnostic approach to a multitude of heart defects.

Key Study: To intubate or not to intubate? Transporting infants on prostaglandin E1

Visit

Meckler GD, Lowe C

This document describes the pretransport and transport management of infants receiving prostaglandin E(1) infusion for congenital heart disease and compares transport complications among unintubated and electively intubated infants.

Overview of studies: Emergency presentation of congenital heart disease in children

Visit

EB Medicine

Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.

Key Study: Lessons from transporting newborn infants with known or suspected congenital heart disease

Visit

Bouchut JC, Teyssedre S

This study presents the results of an evaluation of transporting, by a nonspecialized emergency medical service, neonates with known or suspected cardiac abnormalities.

Key Study: Evaluation and management of the cyanotic neonate

Visit

Steinhorn RH

This document discusses the potential challenges in recognizing cyanosis, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics.

Key Study: Transporting newborn infants with suspected duct dependent congenital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation

Visit

Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N

Objective: To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation.

Key Study: Cardiac emergencies in the first year of life

Visit

Yee L

This document discusses the most common causes of cyanotic and acyanotic heart disease in infants.

Key Study: ABC of clinical electrocardiography: Paediatric electrocardiography

Visit

Goodacre S, McLeod K

General clinicians and junior paediatricians may have little experience of interpreting paediatric electrocardiograms. Although the basic principles of cardiac conduction and depolarisation are the same as for adults, age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiographic features that differ from adults and vary with age. Awareness of these differences is the key to correct interpretation of paediatric electrocardiograms.

Key Study: Management of the neonate with symptomatic congenital heart disease

Visit

Penny DJ, Shekerdemian LS

This document addresses some of the principles on which resuscitation and stabilisation of the symptomatic neonate with congenital heart disease may be based.

Key Study: Prevalence and clinical significance of cardiac murmurs in neonates

Visit

Ainsworth S, Wyllie JP, Wren C

Objective: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.

Key Study: Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant

Visit

Pickert CB, Moss MM, Fiser DH

This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.

Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease

Visit

Kramer HH, Sommer M, Rammos S, Krogmann O

This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).

Overview of studies: Congenital Heart Disease In Pediatric Patients: Recognizing The Undiagnosed And Managing Complications In The Emergency Department

Visit

Judge P, Meckler G

Objective: This review focuses on the recognition and initial management of patients with undiagnosed congenital heart disease presenting to the ED and touches on considerations for postoperative infants and children with complex congenital heart disease.

Key Study: The Critically Ill Infant with Congenital Heart Disease

Visit

Strobel, AM & Lu, N.

Objective: This article presents an approach for identification of infants with congenital heart disorders.

Key Study: Reappraisal of the prostaglandin E1 dose for early newborns with patent ductus arteriosus-dependent pulmonary circulation

Visit

Huang FK, Lin CC, Huang TC, Weng KP, Liu PY, Chen YY, Wang HP, Ger LP, Hsieh KS

Objective: To review our experience of a low initial dose of PGE1 treatment in early newborns with congenital heart disease and patent ductus arteriosus (PDA)-dependent pulmonary flow.

Key Study: Congenital heart disease

Visit

Dolbec K, Mick NW

This publication provides an overview of the presentations of congenital heart defects, and makes diagnosis and management recommendations for emergency physicians.

Key Study: Impact of oxygen saturation targets and oxygen therapy during the transport of neonates with clinically suspected congenital heart disease

Visit

Shivananda S, Kirsh J, Whyte HE, Muthalally K, McNamara PJ

Objective: To determine the effect of average SpO(2) range and oxygen administration during neonatal transport on clinical markers of cardiovascular instability.

Key Study: Approach to diagnosing congenital cardiac disorders

Visit

Hartas GA, Tsounias E, Gupta-Malhotra M

Objective: To give a general picture of the diagnostic approach to a multitude of heart defects.

Key Study: To intubate or not to intubate? Transporting infants on prostaglandin E1

Visit

Meckler GD, Lowe C

This document describes the pretransport and transport management of infants receiving prostaglandin E(1) infusion for congenital heart disease and compares transport complications among unintubated and electively intubated infants.

Overview of studies: Emergency presentation of congenital heart disease in children

Visit

EB Medicine

Objective: To address the evaluation and management of pediatric patients with congenital heart defects in the context of the evidence available from the medical literature.

Key Study: Lessons from transporting newborn infants with known or suspected congenital heart disease

Visit

Bouchut JC, Teyssedre S

This study presents the results of an evaluation of transporting, by a nonspecialized emergency medical service, neonates with known or suspected cardiac abnormalities.

Key Study: Evaluation and management of the cyanotic neonate

Visit

Steinhorn RH

This document discusses the potential challenges in recognizing cyanosis, including the presence of higher concentrations of fetal hemoglobin, and its oxygen binding characteristics.

Key Study: Transporting newborn infants with suspected duct dependent congenital heart disease on low-dose prostaglandin E1 without routine mechanical ventilation

Visit

Browning Carmo KA, Barr P, West M, Hopper NW, White JP, Badawi N

Objective: To evaluate the safety of transporting newborn infants with suspected duct dependent congenital heart disease (CHD) treated with prostaglandin E1 (PGE1) without routine mechanical ventilation.

Key Study: Cardiac emergencies in the first year of life

Visit

Yee L

This document discusses the most common causes of cyanotic and acyanotic heart disease in infants.

Key Study: ABC of clinical electrocardiography: Paediatric electrocardiography

Visit

Goodacre S, McLeod K

General clinicians and junior paediatricians may have little experience of interpreting paediatric electrocardiograms. Although the basic principles of cardiac conduction and depolarisation are the same as for adults, age related changes in the anatomy and physiology of infants and children produce normal ranges for electrocardiographic features that differ from adults and vary with age. Awareness of these differences is the key to correct interpretation of paediatric electrocardiograms.

Key Study: Management of the neonate with symptomatic congenital heart disease

Visit

Penny DJ, Shekerdemian LS

This document addresses some of the principles on which resuscitation and stabilisation of the symptomatic neonate with congenital heart disease may be based.

Key Study: Prevalence and clinical significance of cardiac murmurs in neonates

Visit

Ainsworth S, Wyllie JP, Wren C

Objective: To determine the prevalence and clinical significance of murmurs detected during routine neonatal examination.

Key Study: Differentiation of systemic infection and congenital obstructive left heart disease in the very young infant

Visit

Pickert CB, Moss MM, Fiser DH

This retrospective review of critically ill infants 0 to 28 days of age presenting with either bacterial sepsis or meningitis or a congenital obstructive left heart syndrome (COLHS), identifies historical, physical, or laboratory findings which might differentiate the two groups at presentation.

Key Study: Evaluation of low dose prostaglandin E1 treatment for ductus dependent congenital heart disease

Visit

Kramer HH, Sommer M, Rammos S, Krogmann O

This study reports experience with low-dose prostaglandin E1 (PGE1) treatment of 91 newborns with ductus dependent congenital heart disease (CHD).

Constipation English (25) French All (25)

Key Study: Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study

Visit

Freedman SB, Rodean J, Hall M, Alpern ER, Aronson PL, Simon HK, Shah SS, Mari...

The objective of this study was to evaluate the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation.

Key Study: Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care

Visit

van Engelenburg-van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, de Bie RA

This study aimed to compare the effectiveness of pelvic physiotherapy (PPT) vs standard medical care (SMC) in children with functional constipation.

Key Study: Using the Bristol Stool Scale and Parental Report of Stool Consistency as Part of the Rome III Criteria for Functional Constipation in Infants and Toddlers

Visit

Koppen IJ, Velasco-Benitez CA, Benninga MA, Di Lorenzo C, Saps M

The objectives of this study were to evaluate among parents of infants and toddlers the agreement between parental report and the Bristol Stool Scale (BSS) in assessing stool consistency and the effect of both methods on determining the prevalence of functional constipation (FC) according to the Rome III criteria.

Key Study: Follow-up in Childhood Functional Constipation: A Randomized, Controlled Clinical Trial

Visit

Modin L, Walsted AM, Rittig CS, Hansen AV, Jakobsen MS

The objective of this study was to evaluate whether follow-up by phone or self-management through Web-based information improved treatment outcomes for childhood functional constipation.

Key Study: Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children

Visit

Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Lund SH, Bjornsson ES

This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas for treating constipation in children.

Key Study: Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction

Visit

Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, Bhatnagar S, I...

The objectives of this longitudinal study were to describe the clinical characteristics of children with bowel dysfunction and to examine the effects of bowel dysfunction on patient outcomes in children with and without vesicoureteral reflux.

Key Study: Comparison of Polyethylene Glycol-Electrolyte Solution vs Polyethylene Glycol-3350 for the Treatment of Fecal Impaction in Pediatric Patients

Visit

Boles EE, Gaines CL, Tillman EM

The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.

Key Study: Polyethylene glycol 4000 for treatment of functional constipation in children

Visit

Dziechciarz P, Horvath A, Szajewska H

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.

Key Study: Disimpaction of children with severe constipation in 3-4 days in a suburban clinic using polyethylene glycol with electrolytes and sodium picosulphate

Visit

Jordan-Ely J, Hutson JM, Southwell BR

The aim of this study was to assess the effectiveness of a high-dose oral protocol using polyethylene glycol with electrolytes (PEG + E) (Movicol Rx) combined with sodium picosulphate (SP) (Dulcolax SP Rx) in faecal impaction in children presenting to a suburban clinic.

Key Study: PedsQL Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in pediatric patients with functional and organic gastrointestinal diseases in comparison to healthy controls

Visit

Varni JW, Bendo CB, Denham J, Shulman RJ, Self MM, Neigut DA, Nurko S, Patel ...

The primary objective of this study was to compare the gastrointestinal (GI) symptoms and worry of pediatric patients with functional GI disorders (FGIDs) and organic GI diseases to healthy controls utilizing the Pediatric Quality of Life Inventor (PedsQL) Gastrointestinal Symptoms and Worry Scales for patient self-reports ages 5-18 years and parent proxy-reports for ages 2-18 years. The secondary objective was to compare FGIDs and organic GI diseases to each other.

Key Study: Safety and efficacy of milk and molasses enemas in the emergency department

Visit

Vilke GM, DeMers G, Patel N, Castillo EM

The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.

Key Study: Pediatric abdominal radiograph use, constipation, and significant misdiagnoses

Visit

Freedman SB, Thull-Freedman J, Manson D, Rowe MF, Rumantir M, Eltorki M, Schuh S

The objectives of this study were to determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there was an association between abdominal radiograph (AXR) performance and misdiagnosis, and if there were features that might identify children with misdiagnoses.

Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes

Visit

Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S

The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.

Key Study: Prucalopride is no more effective than placebo for children with functional constipation

Visit

Mugie SM, Korczowski B, Bodi P, Green A, Kerstens R, Ausma J, Ruth M, Levine ...

This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial aimed to evaluate the efficacy and safety of prucalopride in children (6 months to 18 years old) with functional constipation.

Key Study: A randomized trial of enemaversus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department

Visit

Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.

Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department

Visit

Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J

The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.

Key Study: Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG

Visit

Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, B...

This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.

Key Study: A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation

Visit

Bongers ME, van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA

This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children.

Key Study: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial

Visit

Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C

This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.

Key Study: Behavioral therapy for childhood constipation: a randomized, controlled trial

Visit

van Dijk M, Bongers ME, de Vries GJ, Grootenhuis MA, Last BF, Benninga MA

The aim of this study was to evaluate the clinical effectiveness of behavioral therapy with laxatives compared with conventional treatment in treating functional constipation in childhood.

Key Study: Functional defecation disorders in children: PACCT criteria versus Rome II criteria

Visit

Boccia G, Manguso F, Coccorullo P, Masi P, Pensabene L, Staiano A

The aim of this study was to evaluate the clinical validity and applicability of the Paris Consensus on Childhood Constipation Terminology (PACCT) versus the Rome II criteria for pediatric functional defecation disorders (FDDs).

Key Study: Emergency department management and short-term outcome of children with constipation

Visit

Miller MK, Dowd MD, Fraker M

The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.

Key Study: Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study

Visit

Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC...

The objective of this study were to assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children.

Key Study: A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence

Visit

Loening-Baucke V, Pashankar DS

The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 3350 without electrolytes and milk of magnesia, evaluating the efficacy, safety, acceptance, and 1-year outcomes.

Key Study: Predictive factors for short-term symptom persistence in children after emergency department evaluation for constipation

Visit

Patel H, Law A, Gouin S

The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.

Key Study: Delayed Diagnoses in Children with Constipation: Multicenter Retrospective Cohort Study

Visit

Freedman SB, Rodean J, Hall M, Alpern ER, Aronson PL, Simon HK, Shah SS, Mari...

The objective of this study was to evaluate the association between abdominal radiograph performance and emergency department (ED) revisits with important alternate diagnosis among children with constipation.

Key Study: Effectiveness of Pelvic Physiotherapy in Children With Functional Constipation Compared With Standard Medical Care

Visit

van Engelenburg-van Lonkhuyzen ML, Bols EM, Benninga MA, Verwijs WA, de Bie RA

This study aimed to compare the effectiveness of pelvic physiotherapy (PPT) vs standard medical care (SMC) in children with functional constipation.

Key Study: Using the Bristol Stool Scale and Parental Report of Stool Consistency as Part of the Rome III Criteria for Functional Constipation in Infants and Toddlers

Visit

Koppen IJ, Velasco-Benitez CA, Benninga MA, Di Lorenzo C, Saps M

The objectives of this study were to evaluate among parents of infants and toddlers the agreement between parental report and the Bristol Stool Scale (BSS) in assessing stool consistency and the effect of both methods on determining the prevalence of functional constipation (FC) according to the Rome III criteria.

Key Study: Follow-up in Childhood Functional Constipation: A Randomized, Controlled Clinical Trial

Visit

Modin L, Walsted AM, Rittig CS, Hansen AV, Jakobsen MS

The objective of this study was to evaluate whether follow-up by phone or self-management through Web-based information improved treatment outcomes for childhood functional constipation.

Key Study: Free fatty acid suppositories are as effective as docusate sodium and sorbitol enemas in treating constipation in children

Visit

Ormarsson OT, Asgrimsdottir GM, Loftsson T, Stefansson E, Lund SH, Bjornsson ES

This phase two clinical trial evaluated the efficacy of suppositories containing free fatty acids (FFA) compared with Klyx docusate sodium and sorbitol enemas for treating constipation in children.

Key Study: Recurrent Urinary Tract Infections in Children With Bladder and Bowel Dysfunction

Visit

Shaikh N, Hoberman A, Keren R, Gotman N, Docimo SG, Mathews R, Bhatnagar S, I...

The objectives of this longitudinal study were to describe the clinical characteristics of children with bowel dysfunction and to examine the effects of bowel dysfunction on patient outcomes in children with and without vesicoureteral reflux.

Key Study: Comparison of Polyethylene Glycol-Electrolyte Solution vs Polyethylene Glycol-3350 for the Treatment of Fecal Impaction in Pediatric Patients

Visit

Boles EE, Gaines CL, Tillman EM

The objective of this study was to evaluate the safety and efficacy of polyethylene glycol-electrolyte solution vs polyethylene glycol-3350 for the treatment of fecal impaction in pediatric patients.

Key Study: Polyethylene glycol 4000 for treatment of functional constipation in children

Visit

Dziechciarz P, Horvath A, Szajewska H

The aim of the study was to evaluate the effectiveness and safety of 2 different polyethylene glycol (PEG) doses for the maintenance treatment of functional constipation in children.

Key Study: Disimpaction of children with severe constipation in 3-4 days in a suburban clinic using polyethylene glycol with electrolytes and sodium picosulphate

Visit

Jordan-Ely J, Hutson JM, Southwell BR

The aim of this study was to assess the effectiveness of a high-dose oral protocol using polyethylene glycol with electrolytes (PEG + E) (Movicol Rx) combined with sodium picosulphate (SP) (Dulcolax SP Rx) in faecal impaction in children presenting to a suburban clinic.

Key Study: PedsQL Gastrointestinal Symptoms Scales and Gastrointestinal Worry Scales in pediatric patients with functional and organic gastrointestinal diseases in comparison to healthy controls

Visit

Varni JW, Bendo CB, Denham J, Shulman RJ, Self MM, Neigut DA, Nurko S, Patel ...

The primary objective of this study was to compare the gastrointestinal (GI) symptoms and worry of pediatric patients with functional GI disorders (FGIDs) and organic GI diseases to healthy controls utilizing the Pediatric Quality of Life Inventor (PedsQL) Gastrointestinal Symptoms and Worry Scales for patient self-reports ages 5-18 years and parent proxy-reports for ages 2-18 years. The secondary objective was to compare FGIDs and organic GI diseases to each other.

Key Study: Safety and efficacy of milk and molasses enemas in the emergency department

Visit

Vilke GM, DeMers G, Patel N, Castillo EM

The objective of this study was to evaluate the success and complication rates of administering milk and molasses enemas in the ED.

Key Study: Pediatric abdominal radiograph use, constipation, and significant misdiagnoses

Visit

Freedman SB, Thull-Freedman J, Manson D, Rowe MF, Rumantir M, Eltorki M, Schuh S

The objectives of this study were to determine the proportion of children diagnosed with constipation assigned a significant alternative diagnosis within 7 days (misdiagnosis), if there was an association between abdominal radiograph (AXR) performance and misdiagnosis, and if there were features that might identify children with misdiagnoses.

Key Study: Pediatric constipation in the emergency department: evaluation, treatment, and outcomes

Visit

Freedman SB, Thull-Freedman J, Rumantir M, Eltorki M, Schuh S

The primary objective of this study was to determine whether enema administration is associated with 7-day emergency department (ED) revisits for persistent symptoms of pediatric constipation. Secondary objectives focused on assessing other predictors of ED revisits.

Key Study: Prucalopride is no more effective than placebo for children with functional constipation

Visit

Mugie SM, Korczowski B, Bodi P, Green A, Kerstens R, Ausma J, Ruth M, Levine ...

This multicenter, randomized, placebo-controlled, double-blind, phase 3 trial aimed to evaluate the efficacy and safety of prucalopride in children (6 months to 18 years old) with functional constipation.

Key Study: A randomized trial of enemaversus polyethylene glycol 3350 for fecal disimpaction in children presenting to an emergency department

Visit

Miller MK, Dowd MD, Friesen CA, Walsh-Kelly CM

This study aimed to compare efficacy of enema versus polyethylene glycol (PEG) 3350 for pediatric fecal impaction treatment.

Key Study: Safety and efficacy of milk and molasses enemas compared with sodium phosphate enemas for the treatment of constipation in a pediatric emergency department

Visit

Hansen SE, Whitehill JL, Goto CS, Quintero CA, Darling BE, Davis J

The purpose of this study was to determine the safety and efficacy of routine milk and molasses enemas (MME) compared with sodium phosphate enemas for the treatment of constipation in the pediatric emergency department (ED). A secondary objective included the identification of factors associated with enema selection in the pediatric ED.

Key Study: Rectal fecal impaction treatment in childhood constipation: enemas versus high doses oral PEG

Visit

Bekkali NL, van den Berg MM, Dijkgraaf MG, van Wijk MP, Bongers ME, Liem O, B...

This study tested the hypothesis that enemas and polyethylene glycol (PEG) would be equally effective in treating rectal fecal impaction (RFI) but enemas would be less well tolerated and colonic transit time (CTT) would improve during disimpaction.

Key Study: A randomized controlled trial of enemas in combination with oral laxative therapy for children with chronic constipation

Visit

Bongers ME, van den Berg MM, Reitsma JB, Voskuijl WP, Benninga MA

This randomized controlled trial compared the effects of additional treatment with rectal enemas (intervention) with conventional treatment alone (oral laxatives, control) in severely constipated children.

Key Study: PEG3350 in the treatment of childhood constipation: a multicenter, double-blinded, placebo-controlled trial

Visit

Nurko S, Youssef NN, Sabri M, Langseder A, McGowan J, Cleveland M, Di Lorenzo C

This study aimed to establish the efficacy and best starting dose of polyethylene glycol (PEG)3350 in the short-term treatment of children with functional constipation.

Key Study: Behavioral therapy for childhood constipation: a randomized, controlled trial

Visit

van Dijk M, Bongers ME, de Vries GJ, Grootenhuis MA, Last BF, Benninga MA

The aim of this study was to evaluate the clinical effectiveness of behavioral therapy with laxatives compared with conventional treatment in treating functional constipation in childhood.

Key Study: Functional defecation disorders in children: PACCT criteria versus Rome II criteria

Visit

Boccia G, Manguso F, Coccorullo P, Masi P, Pensabene L, Staiano A

The aim of this study was to evaluate the clinical validity and applicability of the Paris Consensus on Childhood Constipation Terminology (PACCT) versus the Rome II criteria for pediatric functional defecation disorders (FDDs).

Key Study: Emergency department management and short-term outcome of children with constipation

Visit

Miller MK, Dowd MD, Fraker M

The objective of this study was to describe variation in emergency department evaluation and treatment of children with constipation and characteristics and treatments associated with improvement.

Key Study: Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study

Visit

Thomson MA, Jenkins HR, Bisset WM, Heuschkel R, Kalra DS, Green MR, Wilson DC...

The objective of this study were to assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children.

Key Study: A randomized, prospective, comparison study of polyethylene glycol 3350 without electrolytes and milk of magnesia for children with constipation and fecal incontinence

Visit

Loening-Baucke V, Pashankar DS

The aim of this study was to compare 2 laxatives, namely, polyethylene glycol 3350 without electrolytes and milk of magnesia, evaluating the efficacy, safety, acceptance, and 1-year outcomes.

Key Study: Predictive factors for short-term symptom persistence in children after emergency department evaluation for constipation

Visit

Patel H, Law A, Gouin S

The objectives of this study were to describe the clinical characteristics of children presenting to the ED with constipation and the ED interventions; to measure short-term symptom resolution at 48 hours and 7 days after the ED visit; and to identify predictive factors associated with poor symptom resolution at 48 hours and 7 days after the ED visit.

Croup English (15) French All (15)

Key study: Efficacy of nebulized L-epinephrine for treatment of croup: a randomized, double-blind study

Visit

Eghbali A, Sabbagh A, Bagheri B, Taherahmadi H, Kahbazi M

Objective: The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children.

Key study: The comparative effectiveness of prednisolone and dexamethasone for children with croup: a community-based randomized trial

Visit

Garbutt JM, Conlon B, Sterkel R, Baty J, Schechtman KB, Mandrell K, Leege E, ...

Objective: Our objective was to compare the effectiveness of prednisolone 2 mg/kg for 3 days, a treatment regimen already commonly prescribed by pediatricians in our community; with one dose of dexamethasone 0.6 mg/kg, a treatment regimen known to be effective in the ED setting, for children with mild or moderate croup diagnosed at an office visit.

Key study: The comparison of oral and IM dexamethasone efficacy in croup treatment

Visit

Soleimani G, Daryadel A, Ansari Moghadam A, Sharif MR

Objective: In this study, the efficacies of intramuscular and oral dexamethasone administration are compared for treatment of croup.

Key study: How fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial

Visit

Dobrovoljac M, Geelhoed GC

Objective: For children with croup controversy remains over dosage and time to onset of action of oral steroids. The Cochrane Collaboration and other reviews have suggested 0.6 mg/kg dexamethasone be used (despite some evidence that 0.15 mg/kg is effective) with no expectation of benefit before 4-6 h. This randomized double-blinded clinical trial examines whether 0.15 mg/kg dexamethasone works by 30 min. Published: 2012.

Key study: Seasonality patterns in croup presentations to emergency departments in Alberta, Canada: a time series analysis

Visit

Rosychuk RJ, Klassen TP, Voaklander DC, Senthilselvan A, Rowe BH

Objective: We examine the monthly patterns of young children who made croup-related visits to EDs in Alberta, Canada.

Key study: The effectiveness of local corticosteroids therapy in the management of mild to moderate viral croup

Visit

Eboriadou M, Chryssanthopoulou D, Stamoulis P, Damianidou L, Haidopoulou K

Objective: The purpose of this study was to determine whether local anti-inflammatory therapy with inhaled beclomethasone dipropionate is effective in the outpatient management of acute viral croup.

Key study: Croup presentations to emergency departments in Alberta, Canada: a large population-based study

Visit

Rosychuk RJ, Klassen TP, Metes D, Voaklander DC, Senthilselvan A, Rowe BH

Objective: The objective of this study was to describe the epidemiology of croup presentations to EDs made by infants (

Key study: A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup

Visit

Chub-Uppakarn S, Sangsupawanich P

Objective: The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup.

Key Study: Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: a randomized controlled trial

Visit

Scolnik, D, Coates, AL, Stephens, D, Da Silva, Z, Lavine, E, Schuh, S,

Objective: To determine whether a significant difference in the clinical Westley croup score exists in children with moderate to severe croup who were admitted to the emergency department and who received either 100% humidity or 40% humidity via nebulizer or blow-by humidity.

Key Study: A randomized trial of a single dose of oral dexamethasone for mild croup

Visit

Bjornson, CL, Klassen, TP, Williamson, J, Brant, R, Mitton, C, Plint, A, Bull...

Objective: The primary outcome was a return to a medical care provider for croup within seven days after treatment. The secondary outcome was the presence of ongoing symptoms of croup on days 1, 2, and 3 after treatment. Other outcomes included economic costs, hours of sleep lost by the child, and stress on the part of the parent in relation to the child's illness.

Key Study: Outpatient treatment of moderate croup with dexamethasone: intramuscular versus oral dosing

Visit

Rittichier, KK, Ledwith, CA,

Objective: Steroid use for the treatment of croup has been supported by several studies, although few have addressed the use of oral dexamethasone for outpatient management. The efficacy of oral (PO) versus intramuscular (IM) dosing of dexamethasone in the outpatient treatment of moderate croup are compared in this study.

Key Study: A comparison of nebulized budesonide, intramuscular dexamethasone, and placebo for moderately severe croup

Visit

Johnson, DW, Jacobson, S, Edney, PC, Hadfield, P, Mundy, ME, Schuh, S,

Objective: To study how budesonide compares with dexamethasone, the conventional therapy for croup, and whether either reduces the rate of hospitalization.

Key Study: Nebulized budesonide and oral dexamethasone for treatment of croup: a randomized controlled trial

Visit

Klassen, TP, Craig, WR, Moher, D, Osmond, MH, Pasterkamp, H, Sutcliffe, T, Wa...

Objective: To determine the effectiveness of 3 glucocorticoid regimens in patients with croup.

Key Study: Oral and inhaled steroids in croup - A randomized, placebo-controlled trial

Visit

Geelhoed, GC, Macdonald, WB,

Objective: To compare the efficacy of oral dexamethasone and inhaled budesonide in children hospitalized with croup, using a three-way, double blind, randomized, placebo-controlled clinical trial design.

Key Study: Placebo-controlled trial of prednisolone in children intubated for croup

Visit

Tibballs, J, Shann, FA, Landau, LI,

Objective: To study the effect of prednisolone on two clinical endpoints--the duration of intubation and the need for reintubation.

Key study: Efficacy of nebulized L-epinephrine for treatment of croup: a randomized, double-blind study

Visit

Eghbali A, Sabbagh A, Bagheri B, Taherahmadi H, Kahbazi M

Objective: The objective of this study was to compare the effect of L-epinephrine plus dexamethasone vs. dexamethasone for treatment of croup in children.

Key study: The comparative effectiveness of prednisolone and dexamethasone for children with croup: a community-based randomized trial

Visit

Garbutt JM, Conlon B, Sterkel R, Baty J, Schechtman KB, Mandrell K, Leege E, ...

Objective: Our objective was to compare the effectiveness of prednisolone 2 mg/kg for 3 days, a treatment regimen already commonly prescribed by pediatricians in our community; with one dose of dexamethasone 0.6 mg/kg, a treatment regimen known to be effective in the ED setting, for children with mild or moderate croup diagnosed at an office visit.

Key study: The comparison of oral and IM dexamethasone efficacy in croup treatment

Visit

Soleimani G, Daryadel A, Ansari Moghadam A, Sharif MR

Objective: In this study, the efficacies of intramuscular and oral dexamethasone administration are compared for treatment of croup.

Key study: How fast does oral dexamethasone work in mild to moderately severe croup? A randomized double-blinded clinical trial

Visit

Dobrovoljac M, Geelhoed GC

Objective: For children with croup controversy remains over dosage and time to onset of action of oral steroids. The Cochrane Collaboration and other reviews have suggested 0.6 mg/kg dexamethasone be used (despite some evidence that 0.15 mg/kg is effective) with no expectation of benefit before 4-6 h. This randomized double-blinded clinical trial examines whether 0.15 mg/kg dexamethasone works by 30 min. Published: 2012.

Key study: Seasonality patterns in croup presentations to emergency departments in Alberta, Canada: a time series analysis

Visit

Rosychuk RJ, Klassen TP, Voaklander DC, Senthilselvan A, Rowe BH

Objective: We examine the monthly patterns of young children who made croup-related visits to EDs in Alberta, Canada.

Key study: The effectiveness of local corticosteroids therapy in the management of mild to moderate viral croup

Visit

Eboriadou M, Chryssanthopoulou D, Stamoulis P, Damianidou L, Haidopoulou K

Objective: The purpose of this study was to determine whether local anti-inflammatory therapy with inhaled beclomethasone dipropionate is effective in the outpatient management of acute viral croup.

Key study: Croup presentations to emergency departments in Alberta, Canada: a large population-based study

Visit

Rosychuk RJ, Klassen TP, Metes D, Voaklander DC, Senthilselvan A, Rowe BH

Objective: The objective of this study was to describe the epidemiology of croup presentations to EDs made by infants (

Key study: A randomized comparison of dexamethasone 0.15 mg/kg versus 0.6 mg/kg for the treatment of moderate to severe croup

Visit

Chub-Uppakarn S, Sangsupawanich P

Objective: The aim of this study was to investigate the effectiveness of dexamethasone 0.15 mg/kg single dose compared with the recommended dose of 0.6 mg/kg for treatment of hospitalized children with moderate to severe croup.

Key Study: Controlled delivery of high vs low humidity vs mist therapy for croup in emergency departments: a randomized controlled trial

Visit

Scolnik, D, Coates, AL, Stephens, D, Da Silva, Z, Lavine, E, Schuh, S,

Objective: To determine whether a significant difference in the clinical Westley croup score exists in children with moderate to severe croup who were admitted to the emergency department and who received either 100% humidity or 40% humidity via nebulizer or blow-by humidity.

Key Study: A randomized trial of a single dose of oral dexamethasone for mild croup

Visit

Bjornson, CL, Klassen, TP, Williamson, J, Brant, R, Mitton, C, Plint, A, Bull...

Objective: The primary outcome was a return to a medical care provider for croup within seven days after treatment. The secondary outcome was the presence of ongoing symptoms of croup on days 1, 2, and 3 after treatment. Other outcomes included economic costs, hours of sleep lost by the child, and stress on the part of the parent in relation to the child's illness.

Key Study: Outpatient treatment of moderate croup with dexamethasone: intramuscular versus oral dosing

Visit

Rittichier, KK, Ledwith, CA,

Objective: Steroid use for the treatment of croup has been supported by several studies, although few have addressed the use of oral dexamethasone for outpatient management. The efficacy of oral (PO) versus intramuscular (IM) dosing of dexamethasone in the outpatient treatment of moderate croup are compared in this study.

Key Study: A comparison of nebulized budesonide, intramuscular dexamethasone, and placebo for moderately severe croup

Visit

Johnson, DW, Jacobson, S, Edney, PC, Hadfield, P, Mundy, ME, Schuh, S,

Objective: To study how budesonide compares with dexamethasone, the conventional therapy for croup, and whether either reduces the rate of hospitalization.

Key Study: Nebulized budesonide and oral dexamethasone for treatment of croup: a randomized controlled trial

Visit

Klassen, TP, Craig, WR, Moher, D, Osmond, MH, Pasterkamp, H, Sutcliffe, T, Wa...

Objective: To determine the effectiveness of 3 glucocorticoid regimens in patients with croup.

Key Study: Oral and inhaled steroids in croup - A randomized, placebo-controlled trial

Visit

Geelhoed, GC, Macdonald, WB,

Objective: To compare the efficacy of oral dexamethasone and inhaled budesonide in children hospitalized with croup, using a three-way, double blind, randomized, placebo-controlled clinical trial design.

Key Study: Placebo-controlled trial of prednisolone in children intubated for croup

Visit

Tibballs, J, Shann, FA, Landau, LI,

Objective: To study the effect of prednisolone on two clinical endpoints--the duration of intubation and the need for reintubation.

Diabetic ketoacidosis English (16) French All (16)

Key Study: Effect of potassium infusion on serum levels in children during treatment of diabetic ketoacidosis

Visit

Musaitif R and Basnet S

Objectives: to determine the effect of 40 mEq/L and 60 mEq/L infusions on potassium levels in children during treatment of DKA.

Key Study: Improving Emergency Department Management of Diabetic Ketoacidosis in Children

Visit

Baumer-Mouradian SH, Gray MP, Wolfgram PM, Kopetsky M, Chang F, Brousseau DC,...

Objectives: To use point-of-care (POC) testing to reduce DKA determination time from 86 to 30 minutes and to reduce IV placements in patients without DKA from 85% to 20% over 18 months.

Key Study: Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program

Visit

Abulebda K, Whitfill T, Montgomery EE, Kirby ML, Ahmed RA, Cooper DD, Nitu ME...

Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs.

Key Study: Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis

Visit

Kuppermann N, Ghetti S, Schunk JE, et al

Background: Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute to these injuries has been debated for decades. Methods: This 13-center, randomized, controlled trial examined the effects of the rate of administration and the sodium chloride content of intravenous fluids on neurologic outcomes in children with diabetic ketoacidosis.

Key Study: Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital

Visit

Ronsley R, Islam N, Ronsley C, Metzger DL, and Panagiotopoulos C

Objective: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion.

Key Study: Resuscitation With Ringer's Lactate Compared With Normal Saline for Pediatric Diabetic Ketoacidosis

Visit

Bergmann KR, Abuzzahab MJ, Nowak J, Arms J, Cutler G, Christensen E, Finch M,...

Objective: The aims of this study were to describe the use of Ringer's lactate (LR) or normal saline (NS) for resuscitation among children with diabetic ketoacidosis (DKA) and compare the effect of fluid type on cost, length of stay, and rate of cerebral edema (CE).

Key Study: Controlled trial of Hartmann's solution versus 0.9% saline for diabetic ketoacidosis

Visit

Yung M, Letton G, and Keeley S

Objective: We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS).

Key Study: How can cerebral edema during treatment of diabetic ketoacidosis be avoided?

Visit

Watts W, and Edge JA

This article discusses how DKA might be prevented from occurring in the first instance, known risk factors for cerebral edema, fluid and insulin management, the importance of careful monitoring during DKA treatment, and the importance of recognizing and acting on the earliest symptoms to prevent long-term harm.

Key Study: Subclinical cerebral edema in children with diabetic ketoacidosis randomized to 2 different rehydration protocols

Visit

Glaser NS, Wootton-Gorges SL, Buonocore MH, Tancredi DJ, Marcin JP, Caltagiro...

Previous studies show that vasogenic cerebral edema (CE) occurs during diabetic ketoacidosis (DKA) treatment in children, but the role of intravenous fluids in contributing to CE is unclear. We used magnetic resonance diffusion weighted imaging to quantify subclinical CE in children with DKA randomized to 2 intravenous fluid regimens.

Key Study: Dehydration in children with diabetic ketoacidosis: A prospective study

Visit

Sottosanti M, Morrison GC, Singh RN, Sharma AP, Fraser DD, Alawi K, Seabrook ...

Objective: To investigate the association between the degree of patient dehydration on presentation with diabetic ketoacidosis (DKA) and clinical and laboratory parameters obtained on admission.

Key Study: Measured degree of dehydration in children and adolescents with type 1 diabetic ketoacidosis

Visit

Ugale J, Mata A, Meert KL, and Sarnaik AP

Objectives: 1) measure the degree of dehydration in children with type 1 diabetes mellitus and diabetic ketoacidosis based on change in body weight; and 2) investigate the relationships between measured degree of dehydration and clinically assessed degree of dehydration, severity of diabetic ketoacidosis, and routine serum laboratory values.

Key Study: Initial fluid resuscitation for patients with diabetic ketoacidosis: how dry are they?

Visit

Fagan MJ, Avner J, and Khine H

A prospective consecutive case series of patients aged 5 to 20 years who presented to a pediatric emergency department with diabetic ketoacidosis (DKA) was studied to determine the actual percent loss of body weight during an episode of DKA to determine the degree of dehydration and thereby provide a guide for hydration therapy during such an episode.

Key Study: Conscious level in children with diabetic ketoacidosis is related to severity of acidosis and not to blood glucose concentration

Visit

Edge JA, Roy Y, Bergomi A, Murphy NP, Ford-Adams ME, Ong KK, and Dunger DB

Objective: To ascertain whether initial depression of conscious level in children with diabetic ketoacidosis (DKA) is related to hyperosmolality, acidosis or other factors.

Key Study: The UK case-control study of cerebral oedema complicating diabetic ketoacidosis in children

Visit

Edge JA, Jakes RW, Roy Y, Hawkins M, Winter D, Ford-Adams ME, Murphy NP, Berg...

Cerebral oedema complicating diabetic ketoacidosis (DKA) remains the major cause of morbidity and mortality in children with type 1 diabetes, but its aetiology remains unknown. Our objective was to determine the impact of baseline biochemical factors and of treatment-related variables on risk of the development of cerebral oedema in children with DKA.

Key Study: Population-based study of incidence and risk factors for cerebral edema in pediatric diabetic ketoacidosis

Visit

Lawrence SE, Cummings EA, Gaboury I, and Daneman D

Objectives: To determine incidence, outcomes, and risk factors for pediatric cerebral edema with diabetic ketoacidosis (CEDKA) in Canada.

Key Study: Risk factors for cerebral edema in children with diabetic ketoacidosis. The Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics

Visit

Glaser N, Barnett P, McCaslin I, Nelson D, Trainor J, Louie J, Kaufman F, Qua...

Cerebral edema is an uncommon but devastating complication of diabetic ketoacidosis in children. Risk factors for this complication are defined in this multicenter study.

Key Study: Effect of potassium infusion on serum levels in children during treatment of diabetic ketoacidosis

Visit

Musaitif R and Basnet S

Objectives: to determine the effect of 40 mEq/L and 60 mEq/L infusions on potassium levels in children during treatment of DKA.

Key Study: Improving Emergency Department Management of Diabetic Ketoacidosis in Children

Visit

Baumer-Mouradian SH, Gray MP, Wolfgram PM, Kopetsky M, Chang F, Brousseau DC,...

Objectives: To use point-of-care (POC) testing to reduce DKA determination time from 86 to 30 minutes and to reduce IV placements in patients without DKA from 85% to 20% over 18 months.

Key Study: Improving Pediatric Diabetic Ketoacidosis Management in Community Emergency Departments Using a Simulation-Based Collaborative Improvement Program

Visit

Abulebda K, Whitfill T, Montgomery EE, Kirby ML, Ahmed RA, Cooper DD, Nitu ME...

Objectives: The majority of pediatric patients with diabetic ketoacidosis (DKA) present to community emergency departments (CEDs) that are less prepared to care for acutely ill children owing to low pediatric volume and limited pediatric resources and guidelines. This has impacted the quality of care provided to pediatric patients in CEDs. We hypothesized that a simulation-based collaborative program would improve the quality of the care provided to simulated pediatric DKA patients presenting to CEDs.

Key Study: Clinical Trial of Fluid Infusion Rates for Pediatric Diabetic Ketoacidosis

Visit

Kuppermann N, Ghetti S, Schunk JE, et al

Background: Diabetic ketoacidosis in children may cause brain injuries ranging from mild to severe. Whether intravenous fluids contribute to these injuries has been debated for decades. Methods: This 13-center, randomized, controlled trial examined the effects of the rate of administration and the sodium chloride content of intravenous fluids on neurologic outcomes in children with diabetic ketoacidosis.

Key Study: Adherence to a pediatric diabetic ketoacidosis protocol in children presenting to a tertiary care hospital

Visit

Ronsley R, Islam N, Ronsley C, Metzger DL, and Panagiotopoulos C

Objective: To review adherence to a provincial diabetic ketoacidosis (DKA) protocol and to assess factors associated with intravenous fluid administration and the length time on an insulin infusion.

Key Study: Resuscitation With Ringer's Lactate Compared With Normal Saline for Pediatric Diabetic Ketoacidosis

Visit

Bergmann KR, Abuzzahab MJ, Nowak J, Arms J, Cutler G, Christensen E, Finch M,...

Objective: The aims of this study were to describe the use of Ringer's lactate (LR) or normal saline (NS) for resuscitation among children with diabetic ketoacidosis (DKA) and compare the effect of fluid type on cost, length of stay, and rate of cerebral edema (CE).

Key Study: Controlled trial of Hartmann's solution versus 0.9% saline for diabetic ketoacidosis

Visit

Yung M, Letton G, and Keeley S

Objective: We aimed to determine whether using a balanced salt solution, Hartmann's solution (HS), in diabetic ketoacidosis (DKA) shortens the time to normalise acid-base status through the avoidance of hyperchloremic metabolic acidosis compared with 0.9% normal saline (NS).

Key Study: How can cerebral edema during treatment of diabetic ketoacidosis be avoided?

Visit

Watts W, and Edge JA

This article discusses how DKA might be prevented from occurring in the first instance, known risk factors for cerebral edema, fluid and insulin management, the importance of careful monitoring during DKA treatment, and the importance of recognizing and acting on the earliest symptoms to prevent long-term harm.

Key Study: Subclinical cerebral edema in children with diabetic ketoacidosis randomized to 2 different rehydration protocols

Visit

Glaser NS, Wootton-Gorges SL, Buonocore MH, Tancredi DJ, Marcin JP, Caltagiro...

Previous studies show that vasogenic cerebral edema (CE) occurs during diabetic ketoacidosis (DKA) treatment in children, but the role of intravenous fluids in contributing to CE is unclear. We used magnetic resonance diffusion weighted imaging to quantify subclinical CE in children with DKA randomized to 2 intravenous fluid regimens.

Key Study: Dehydration in children with diabetic ketoacidosis: A prospective study

Visit

Sottosanti M, Morrison GC, Singh RN, Sharma AP, Fraser DD, Alawi K, Seabrook ...

Objective: To investigate the association between the degree of patient dehydration on presentation with diabetic ketoacidosis (DKA) and clinical and laboratory parameters obtained on admission.

Key Study: Measured degree of dehydration in children and adolescents with type 1 diabetic ketoacidosis

Visit

Ugale J, Mata A, Meert KL, and Sarnaik AP

Objectives: 1) measure the degree of dehydration in children with type 1 diabetes mellitus and diabetic ketoacidosis based on change in body weight; and 2) investigate the relationships between measured degree of dehydration and clinically assessed degree of dehydration, severity of diabetic ketoacidosis, and routine serum laboratory values.

Key Study: Initial fluid resuscitation for patients with diabetic ketoacidosis: how dry are they?