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  1. Article: Improving Noninvasive Ventilation for Bronchiolitis: It Is Here to Stay!

    Keim, Garrett / Nishisaki, Akira

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2024  Volume 25, Issue 3, Page(s) 274–275

    MeSH term(s) Humans ; Infant ; Noninvasive Ventilation ; Bronchiolitis/therapy ; Respiration, Artificial
    Language English
    Publishing date 2024-03-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003435
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5600: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 472: Show issues

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  2. Article ; Online: Understanding Challenges to High-quality Pediatric Out-of-Hospital Cardiac Arrest Resuscitation Performance.

    O'Halloran, Amanda / Nishisaki, Akira

    JAMA network open

    2023  Volume 6, Issue 5, Page(s) e2313931

    MeSH term(s) Child ; Humans ; Out-of-Hospital Cardiac Arrest/therapy ; Cardiopulmonary Resuscitation
    Language English
    Publishing date 2023-05-01
    Publishing country United States
    Document type Journal Article ; Comment
    ISSN 2574-3805
    ISSN (online) 2574-3805
    DOI 10.1001/jamanetworkopen.2023.13931
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Anticipating Pediatric Post-Extubation Risk: Calling All (North) Stars.

    Rappold, Thomas / Nishisaki, Akira

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2023  Volume 24, Issue 9, Page(s) 787–789

    MeSH term(s) Child ; Humans ; Airway Extubation/adverse effects
    Language English
    Publishing date 2023-09-05
    Publishing country United States
    Document type Editorial ; Comment
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003298
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5600: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  4. Article: Unplanned Extubations in the Cardiac ICU: Are We Missing the Beat?

    Harwayne-Gidansky, Ilana / Dominick, Cheryl / Nishisaki, Akira

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2023  Volume 24, Issue 7, Page(s) 617–619

    MeSH term(s) Humans ; Child ; Airway Extubation ; Intensive Care Units, Pediatric ; Respiration, Artificial ; Intensive Care Units ; Intubation, Intratracheal ; Risk Factors
    Language English
    Publishing date 2023-07-06
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003271
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 5600: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 472: Show issues

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  5. Article: The World Effort to Combat Pandemic-Simulate to Succeed!

    Nishisaki, Akira / Hales, Roberta L

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2021  Volume 22, Issue 6, Page(s) 590–592

    MeSH term(s) COVID-19 ; Child ; Disasters ; Health Personnel ; Humans ; Pandemics ; SARS-CoV-2
    Language English
    Publishing date 2021-05-03
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Comment
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002677
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    ab Jg. 2022: Lesesaal (EG)
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  6. Article ; Online: Implementing the Pediatric Ventilator Liberation Guidelines Using the Most Current Evidence.

    Loberger, Jeremy M / Steffen, Katherine / Khemani, Robinder G / Nishisaki, Akira / Abu-Sultaneh, Samer

    Respiratory care

    2024  

    Abstract: Invasive mechanical ventilation is prevalent and associated with considerable morbidity. Pediatric critical care teams must identify the best timing and approach to liberating (extubating) children from this supportive care modality. Unsurprisingly, ... ...

    Abstract Invasive mechanical ventilation is prevalent and associated with considerable morbidity. Pediatric critical care teams must identify the best timing and approach to liberating (extubating) children from this supportive care modality. Unsurprisingly, practice variation varies widely. As a first step to minimizing that variation, the first evidence-based pediatric ventilator liberation guidelines were published in 2023 and included 15 recommendations. Unfortunately, there is often a substantial delay before clinical guidelines reach widespread clinical practice. As such, it is important to consider barriers and facilitators using a systematic approach during implementation planning and design. In this narrative review, we will (1) summarize guideline recommendations, (2) discuss recent evidence and identify practice gaps relating to those recommendations, and (3) hypothesize about potential barriers and facilitators to their implementation in clinical practice.
    Language English
    Publishing date 2024-04-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.11708
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 2285: Show issues Location:
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  7. Article ; Online: Normal and difficult airways in children: "What's New"-Current evidence.

    Fiadjoe, John / Nishisaki, Akira

    Paediatric anaesthesia

    2020  Volume 30, Issue 3, Page(s) 257–263

    Abstract: Background: Pediatric difficult airway is one of the most challenging clinical situations. We will review new concepts and evidence in pediatric normal and difficult airway management in the operating room, intensive care unit, Emergency Department, and ...

    Abstract Background: Pediatric difficult airway is one of the most challenging clinical situations. We will review new concepts and evidence in pediatric normal and difficult airway management in the operating room, intensive care unit, Emergency Department, and neonatal intensive care unit.
    Methods: Expert review of the recent literature.
    Results: Cognitive factors, teamwork, and communication play a major role in managing pediatric difficult airway. Earlier studies evaluated videolaryngoscopes in a monolithic way yielding inconclusive results regarding their effectiveness. There are, however, substantial differences among videolaryngoscopes particularly angulated vs. nonangulated blades which have different learning and use characteristics. Each airway device has strengths and weaknesses, and combining these devices to leverage both strengths will likely yield success. In the pediatric intensive care unit, emergency department and neonatal intensive care units, adverse tracheal intubation-associated events and hypoxemia are commonly reported. Specific patient, clinician, and practice factors are associated with these occurrences. In both the operating room and other clinical areas, use of passive oxygenation will provide additional laryngoscopy time. The use of neuromuscular blockade was thought to be contraindicated in difficult airway patients. Newer evidence from observational studies showed that controlled ventilation with or without neuromuscular blockade is associated with fewer adverse events in the operating room. Similarly, a multicenter neonatal intensive care unit study showed fewer adverse events in infants who received neuromuscular blockade. Neuromuscular blockade should be avoided in patients with mucopolysaccharidosis, head and neck radiation, airway masses, and external airway compression for anticipated worsening airway collapse with neuromuscular blocker administration.
    Conclusion: Clinicians caring for children with difficult airways should consider new cognitive paradigms and concepts, leverage the strengths of multiple devices, and consider the role of alternate anesthetic approaches such as controlled ventilation and use of neuromuscular blocking drugs in select situations. Anesthesiologists can partner with intensive care and emergency department and neonatology clinicians to improve the safety of airway management in all clinical settings.
    MeSH term(s) Airway Management/methods ; Child ; Child, Preschool ; Critical Care/methods ; Emergency Medical Services/methods ; Emergency Service, Hospital ; Humans ; Infant ; Infant, Newborn ; Intensive Care Units ; Intensive Care Units, Neonatal ; Operating Rooms ; Respiratory Physiological Phenomena ; Respiratory System/physiopathology
    Language English
    Publishing date 2020-01-14
    Publishing country France
    Document type Journal Article ; Review
    ZDB-ID 1086049-6
    ISSN 1460-9592 ; 1155-5645
    ISSN (online) 1460-9592
    ISSN 1155-5645
    DOI 10.1111/pan.13798
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

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    Zs.A 3306: Show issues Location:
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  8. Article ; Online: Noninvasive Ventilation for Pediatric Acute Respiratory Distress Syndrome: Is It Worth the Risk?

    Harwayne-Gidansky, Ilana / Emeriaud, Guillaume / Nishisaki, Akira

    Critical care medicine

    2021  Volume 49, Issue 5, Page(s) 873–875

    MeSH term(s) Child ; Humans ; Noninvasive Ventilation ; Respiration, Artificial/adverse effects ; Respiratory Distress Syndrome/therapy
    Language English
    Publishing date 2021-03-29
    Publishing country United States
    Document type Editorial ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Comment
    ZDB-ID 197890-1
    ISSN 1530-0293 ; 0090-3493
    ISSN (online) 1530-0293
    ISSN 0090-3493
    DOI 10.1097/CCM.0000000000004855
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 1261: Show issues Location:
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  9. Article ; Online: Outcomes of Unplanned Extubations in a Large Children's Hospital.

    Dominick, Cheryl L / Blanke, Brooke N / Simmons, Emily M / Traynor, Danielle M / Fowler, Madeline / Nishisaki, Akira / Napolitano, Natalie

    Respiratory care

    2024  Volume 69, Issue 2, Page(s) 184–190

    Abstract: Background: Unplanned extubation (UE) is defined as unintentional dislodgement of an endotracheal tube (ETT) from the trachea. UEs can lead to instability, cardiac arrest, and may require emergent tracheal re-intubation. As part of our hospital-wide ... ...

    Abstract Background: Unplanned extubation (UE) is defined as unintentional dislodgement of an endotracheal tube (ETT) from the trachea. UEs can lead to instability, cardiac arrest, and may require emergent tracheal re-intubation. As part of our hospital-wide quality improvement (QI) work, a multidisciplinary committee reviewed all UEs to determine contributing factors and evaluation of clinical outcomes to develop QI interventions aimed to minimize UEs. The objective was to investigate occurrence, contributing factors, and clinical outcomes of UEs in the pediatric ICU (PICU), cardiac ICU (CICU), and neonatal ICU (NICU) in a large academic children's hospital. We hypothesized that these would be substantially different across 3 ICUs.
    Methods: A single-center retrospective review of UEs in the PICU, CICU, and NICU was recorded in a prospective database for the last 5 y. Consensus-based standardized operational definitions were developed to capture contributing factors and adverse events associated with UEs. Data were extracted through electronic medical records by 3 respiratory therapists and local Virtual Pediatric Systems (VPS) database. Consistency of data extraction and classification were evaluated.
    Results: From January 2016-December 2021, 408 UEs in 339 subjects were reported: PICU 52 (13%), CICU 31 (7%), and NICU 325 (80%). The median (interquartile range) of age and weight was 2.0 (0-4.0) months and 5.3 (3.0-8.0) kg. Many UE events were not witnessed (54%). Common contributing factors were routine nursing care (no. = 70, 18%), ETT retaping (no. = 62, 16%), and being held (no. = 15, 3.9%). The most common adverse events with UE were desaturation < 80% (33%) and bradycardia (22.8%). Cardiac arrest occurred in 12%. Sixty-seven percent of UEs resulted in re-intubation within 72 h. The proportion of re-intubation across 3 units was significantly different: PICU 62%, CICU 35%, NICU 71%,
    Conclusions: UEs occurred commonly in a large academic children's hospital. Whereas UE was associated with adverse events, re-intubation rates within 72 h were < 70% and variable across the units.
    MeSH term(s) Infant, Newborn ; Humans ; Child ; Airway Extubation/methods ; Risk Factors ; Intensive Care Units, Neonatal ; Intensive Care Units, Pediatric ; Intubation, Intratracheal/adverse effects ; Heart Arrest/therapy
    Language English
    Publishing date 2024-01-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603252-7
    ISSN 1943-3654 ; 0098-9142 ; 0020-1324
    ISSN (online) 1943-3654
    ISSN 0098-9142 ; 0020-1324
    DOI 10.4187/respcare.10904
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Harnessing simulation to drive system-focused change.

    Daly Guris, Rodrigo J / Nishisaki, Akira / Nadkarni, Vinay M / Wolfe, Heather

    Pediatric quality & safety

    2021  Volume 6, Issue 5, Page(s) e458

    Language English
    Publishing date 2021-08-26
    Publishing country United States
    Document type Journal Article
    ISSN 2472-0054
    ISSN (online) 2472-0054
    DOI 10.1097/pq9.0000000000000458
    Database MEDical Literature Analysis and Retrieval System OnLINE

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