Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children

Bonafide, Christopher P.; Brady, Patrick; Keren, Ron; Conway, Patrick H.; Marsolo, Keith; Daymont, Carrie

doi:10.1542/peds.2012-2443

Cited by 187 publications

(180 citation statements)

References 29 publications

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“…And as indicated in our results, enhanced respiratory support, usually in the form of high-flow nasal cannula, can occasionally be administered on specific units familiar with these therapies. With these ,.001 b a RR and HR are presented as percentiles (range 0-1) corresponding to age-standardized Z scores, as described in Bonafide et al 10 In the case of a 10-y-old presenting to the ED, the difference in median RR between the intermittent (0.93) and continuous (0.97) groups corresponds to an RR of 30 vs 36. b P value results of Wilcoxon Mann-Whitney rank sum tests including all observations. RR, respiratory rate; HR, Heart rate.…”

Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Continuous Aerosolized Albuterol in the Non–Intensive Care Setting

Kenyon¹,

Fieldston²,

Luan³

et al. 2014

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT: Continuously aerosolized albuterol been shown to be safe and effective for the treatment of severe status asthmaticus in the emergency department and ICU. Little evidence supports its use in the non-intensive care setting. WHAT THIS STUDY ADDS:With the appropriate resources and support, continuous albuterol may be administered in the non-ICU setting with a low incidence of clinical deterioration and adverse effects. Certain clinical factors may help identify which patients may benefit from higher acuity care. abstract OBJECTIVE: To describe the design features, utilization, and outcomes of a protocol treating children with status asthmaticus with continuous albuterol in the inpatient setting. METHODS:We performed a retrospective cohort analysis of children ages 2 to 18 treated in the non-intensive care, inpatient setting on a standardized treatment protocol for status asthmaticus from July 2011 to June 2013. We assessed characteristics associated with continuous albuterol therapy and, for those treated, duration of therapy and the proportion who clinically deteriorated (ICU transfer or progression to enhanced respiratory support) or who were identified as having hypokalemia or an arrhythmia. Using multivariable logistic regression, we determined which factors were associated with clinical deterioration or prolonged (.24 hours) continuous albuterol. RESULTS:Of 3003 children meeting study criteria, 1298 (43%) received continuous albuterol. Older age, black race, lower initial oxygen saturation, and higher initial age-standardized heart rate and respiratory rate were associated with initiation of continuous albuterol therapy (P , .001 for all). Median duration of therapy was 14.4 hours (interquartile range, 7.7, 24.6); 340 children (26%) experienced prolonged therapy. Seventy children (5%) experienced clinical deterioration, and 33 children (3%) had identified hypokalemia or arrhythmia. Comorbid pneumonia and emergency department administration of intravenous magnesium or subcutaneous terbutaline were associated with prolonged therapy and clinical deterioration. CONCLUSIONS:With appropriate support structures and care processes, continuous albuterol can be delivered effectively in the non-ICU, inpatient setting with low rates of adverse outcomes. Certain initial clinical characteristics may help identify patients needing more intensive therapy. Pediatrics 2014;134:e976-e982 AUTHORS:

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Section: Discussionmentioning

confidence: 99%

Safety and Effectiveness of Continuous Aerosolized Albuterol in the Non–Intensive Care Setting

Kenyon¹,

Fieldston²,

Luan³

et al. 2014

Pediatrics

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“…The results of several recent large‐scale studies456, 457, 458, 459 examining normal heart rate and respiratory rate in children are not reflected in the threshold values for respiratory rate and heart rate.…”

Section: Introductionmentioning

confidence: 94%

“…There is no basis for requiring the inclusion of body temperature or white blood cell count.The threshold value for respiratory rate overlaps with the normal range.The results of several recent large‐scale studies456, 457, 458, 459 examining normal heart rate and respiratory rate in children are not reflected in the threshold values for respiratory rate and heart rate. …”

Section: Introductionmentioning

confidence: 99%

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Nishida

Ogura

Egi

et al. 2018

Acute Medicine & Surgery

157

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Background and PurposeThe Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG 2016), a Japanese‐specific set of clinical practice guidelines for sepsis and septic shock created jointly by the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine, was first released in February 2017 in Japanese. An English‐language version of these guidelines was created based on the contents of the original Japanese‐language version.MethodsMembers of the Japanese Society of Intensive Care Medicine and the Japanese Association for Acute Medicine were selected and organized into 19 committee members and 52 working group members. The guidelines were prepared in accordance with the Medical Information Network Distribution Service (Minds) creation procedures. The Academic Guidelines Promotion Team was organized to oversee and provide academic support to the respective activities allocated to each Guideline Creation Team. To improve quality assurance and workflow transparency, a mutual peer review system was established, and discussions within each team were open to the public. Public comments were collected once after the initial formulation of a clinical question (CQ), and twice during the review of the final draft. Recommendations were determined to have been adopted after obtaining support from a two‐thirds (>66.6%) majority vote of each of the 19 committee members.ResultsA total of 87 CQs were selected among 19 clinical areas, including pediatric topics and several other important areas not covered in the first edition of the Japanese guidelines (J‐SSCG 2012). The approval rate obtained through committee voting, in addition to ratings of the strengths of the recommendation and its supporting evidence were also added to each recommendation statement. We conducted meta‐analyses for 29 CQs. Thirty seven CQs contained recommendations in the form of an expert consensus due to insufficient evidence. No recommendations were provided for 5 CQs.ConclusionsBased on the evidence gathered, we were able to formulate Japanese‐specific clinical practice guidelines that are tailored to the Japanese context in a highly transparent manner. These guidelines can easily be used not only by specialists, but also by non‐specialists, general clinicians, nurses, pharmacists, clinical engineers, and other healthcare professionals.

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“…As demonstrated in Fig 2, among a Denotes a continuous predictor: to calculate aORs for these predictors, ≥1 value was selected for comparison against a reference value; for predictors that included an interaction term with age (heart rate, respiratory rate, and systolic blood pressure), the 50th percentile value was compared with the 95th percentile (heart rate and respiratory rate) 20 or 5th percentile (systolic blood pressure) 21 value at 1, 2, 5, and 10 y of age.…”

Section: Prognostic Model Performancementioning

confidence: 99%

Predicting Severe Pneumonia Outcomes in Children

Williams

Zhu

Grijalva³

et al. 2016

Pediatrics

107

106

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Development of Heart and Respiratory Rate Percentile Curves for Hospitalized Children

Cited by 187 publications

References 29 publications

Safety and Effectiveness of Continuous Aerosolized Albuterol in the Non–Intensive Care Setting

Safety and Effectiveness of Continuous Aerosolized Albuterol in the Non–Intensive Care Setting

The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2016 (J‐SSCG2016)

Predicting Severe Pneumonia Outcomes in Children

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