Reviews on Recent Clinical Trials - Volume 12, Issue 4, 2017

Background: The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, have received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays. Objective: We aim to review recent literature on the management and outcomes o Read More

Background: The thirty-year-old term “apparent life-threatening event” (ALTE) is difficult to apply in clinical practice and research. The American Academy of Pediatrics now defines these events as brief resolved unexplained events (BRUEs), stratifies infants based on the risk of recurrence or of a serious underlying condition, and offers evidence-based management recommendations for infants at lower-risk. Objective: To revie Read More

Background: Despite development of risk stratification tools decades ago, the best strategy for evaluation and management of young infants with fever without a clear source remains uncertain. Objective: To describe the variability in current practice and review recently published evidence in three key areas: inflammatory markers were used as a tool for risk stratification, impact of viral testing, and optimal observation time o Read More

Background: Viral bronchiolitis is a common cause of hospitalization in young children, but despite a variety of therapeutic options, the mainstay of treatment remains supportive care. Objective: To examine the most recent evidence for supportive care measures and pharmacologic options in the treatment of bronchiolitis in the hospital setting. Method: MEDLINE search with expert medical librarian for publications on manage Read More

Background: Despite declining rates of community acquired pneumonia (CAP) in children, complicated pneumonia has been on the rise in the last two decades. The management of complicated pneumonia is challenging and continues to be an area of investigation. Despite recently published guidelines, many gaps exist and recent studies attempt to answer challenging questions. Objective: The aim was to review recently publi Read More

Background: Pediatric osteoarticular infections are relatively rare but important diseases to identify early and treat appropriately in order to avoid associated acute complications or long-term morbidity. Objective: To review the current epidemiology and etiology of pediatric osteoarticular infections as well as recent advances in the diagnosis and treatment of these infections. Methods: We searched PubMed (MEDLINE) and Read More

Background: Urinary Tract Infection (UTI) is a common cause of bacterial infection in young children, and accounts for a significant number of pediatric hospitalizations. Objective: To review recent publications focusing on the care of children hospitalized with their first febrile UTI. Methods: A PubMed search was performed including publications from 2011-2016 on first febrile UTI in childhood. Abstracts were reviewed for bei Read More

Background: Acute pain in hospitalized pediatric patients is prevalent. Recent shifts in the paradigm of pediatric acute pain management focus less on reliance on opioids, due to their adverse side effects and risk of dependence, and more on multimodal pain management. Objective: We sought to review the most recent studies on acute pain management in hospitalized pediatric patients. Method: We searched the Cochrane Dat Read More

Background: Fluid and electrolyte therapy is an important component in the care of the hospitalized child. Previous pediatric guidelines have followed the Holliday-Segar method of calculating and delivering maintenance IV fluids, using hypotonic fluids in maintenance therapy. However, research demonstrates that hypotonic fluids can lead to iatrogenic hyponatremia and that isotonic fluid is a safer alternative. Objective: Read More

Background: Concerns about the costs and quality of hospital care have led to increased interest in hospital readmissions in children. Children with medical complexity account for high proportions of inpatient utilization and have a higher risk of hospital readmission. Objective: To identify studies of discharge interventions to prevent hospital readmissions in children with medical complexity. Methods: We conducted a search to iden Read More