Monroe Carell Jr. Children's Hospital at Vanderbilt

About: Monroe Carell Jr. Children's Hospital at Vanderbilt is a based out in . It is known for research contribution in the topics: Population & Medicine. The organization has 1046 authors who have published 1262 publications receiving 28063 citations. The organization is also known as: Vanderbilt Children's Hospital.

The impact of cognitive delay on pediatric heart transplant outcomes.

Abstract: The presence of CD may be viewed as a relative contraindication to transplantation; however, its impact on pediatric HTx outcomes is poorly characterized. The aim of this study was to assess the impact of CD on pediatric HTx outcomes using academic progress as a surrogate measure of cognitive performance. The OPTN database was queried for all pediatric HTx recipients (2004-2014) with reported academic progress. Multivariable analysis assessed the impact of DGL and the need for SE on post-HTx graft survival. A total of 2245 children were included: 1707 (76%) within grade level, 269 (12%) with DGL, and 269 (12%) who required SE. The need for SE was not a risk factor for post-HTx mortality; however, DGL was an independent risk factor for worse post-HTx outcomes (AHR 1.4, 95% CI 1.02, 1.79, P=.03). Patients who require SE have similar outcomes compared to those without CD, likely secondary to significant parental involvement. Children with DGL demonstrate inferior post-HTx survival, which could result from less parental oversight in children perceived to maintain compliance. Ensuring adequate social support for patients with evidence of CD may help to improve outcomes.

Multidisciplinary Perioperative Care for Children with Neuromuscular Disorders.

Abstract: Children with neuromuscular diseases present unique challenges to providing safe and appropriate perioperative care Given the spectrum of disease etiologies and manifestations, this is a population that often requires specialized multidisciplinary care from pediatricians, geneticists, neurologists, dieticians, and pulmonologists which must also be coordinated with surgeons and anesthesiologists when these patients present for surgery Several of these diseases also have specific pharmacologic implications for anesthesia, most notably mitochondrial disease and muscular dystrophies, which put them at additional risk during the perioperative period particularly in patients presenting without a formal diagnosis Techniques and strategies to fully evaluate and optimize these patients preoperatively, manage them safely intraoperatively, and return them to their baseline status postoperative are particularly important in this vulnerable group of patients Utilizing a review of inherited neuromuscular conditions, generalized perioperative concerns, and specific complications related to anesthesia, this article provides an overview of pertinent considerations and recommends a framework for management of these patients

Improvements in Antimicrobial Prescribing and Outcomes in Pediatric Complicated Appendicitis.

Abstract: Background:Complicated appendicitis, characterized by perforation and/or peritonitis, is common in children, and late infectious complications are frequent. The best antibiotic treatment approach is unknown, resulting in substantial variation in care. We evaluated the effects of 2 successive interve