Primary Children's Hospital

About: Primary Children's Hospital is a healthcare organization based out in Salt Lake City, Utah, United States. It is known for research contribution in the topics: Population & Health care. The organization has 1770 authors who have published 2594 publications receiving 107857 citations. The organization is also known as: Intermountain Primary Children's Medical Center & Intermountain Primary Children's Hospital.

Prolonged extracorporeal membrane oxygenation for children with respiratory failure.

Abstract: Objective: Extracorporeal membrane oxygenation is used to support children with respiratory failure. When extracorporeal membrane oxygenation duration is prolonged, decisions regarding ongoing support are difficult as a result of limited prognostic data. Design: Retrospective case series. Setting: Multi-institutional data reported to the Extracorporeal Life Support Organization Registry. Patients: Patients aged 1 month to 18 yrs supported with extracorporeal membrane oxygenation for respiratory failure from 1993 to 2007 who received support for ≥21 days. Interventions: None. Measurements and Main Results: Of the 3213 children supported with extracorporeal membrane oxygenation during the study period, 389 (12%) were supported ≥21 days. Median patient age was 9.1 months (interquartile range, 2.5–41.7 months). Median weight was 6.7 kg (interquartile range, 3.5–15.8 kg). Survival for this group was 38%, significantly lower than survival reported for children supported ≤14 days (61%, p < .001). Among children supported with extracorporeal membrane oxygenation for ≥21 days, no differences were found between survivors and nonsurvivors with regard to acute pulmonary diagnosis, pre-extracorporeal membrane oxygenation comorbidities, pre-extracorporeal membrane oxygenation adjunctive therapies, or pre-extracorporeal membrane oxygenation blood gas parameters. Only peak inspiratory pressure was significantly different in survivors. Complications occurring on extracorporeal membrane oxygenation were more common among nonsurvivors. The use of inotropic infusion (odds ratio 1.64; 95% confidence interval 1.07–2.52), acidosis (pH <7.2) during extracorporeal membrane oxygenation (odds ratio 2.62; 95% confidence interval 1.51–4.55), and male gender (odds ratio 1.95; 95% confidence interval 1.21–3.15) were independently as sociated with increased odds of death. Conclusion: Survival declines with duration of extracorporeal membrane oxygenation. Male gender and inadequate cardiorespiratory status during extracorporeal membrane oxygenation increased the risk of death. Prolonged support with extracorporeal membrane oxygenation appears reasonable unless multiorgan failure develops. (Pediatr Crit Care Med 2012; 13:e249–e254)

A new occipitocervical fusion construct in pediatric patients with occipitocervical instability: Technical note

Abstract: Posterior occipitocervical stabilization procedures were successfully performed in 10 patients (nine boys and one girl) 16 years of age or younger by using C1-2 transarticular screws coupled with a rigid occipitocervical construct. The average length of follow-up evaluation was 18.8 months (range 5-37 months). No implant failed and all fusions were successful without the use of an external orthotic halo device.

Adjustment and malfunction of a programmable valve after exposure to toy magnets. Case report.

Abstract: Inadvertent adjustments and malfunctions of programmable valves have been reported in cases in which patients have encountered powerful electromagnetic fields such as those involved in magnetic resonance imaging, but the effects of small magnetic fields are not well known. The authors present a case in which a child playing with a collection of commercially available toy magnets altered the pressure setting of an implanted valve and may have caused its permanent malfunction.

Is There a Predisposition Gene for Ewing's Sarcoma?

Abstract: Ewing's sarcoma is a highly malignant tumor of children and young adults. The molecular mechanisms that underlie Ewing's Sarcoma development are beginning to be understood. For example, most cases of this disease harbor somatic chromosomal translocations that fuse the EWSR1 gene on chromosome 22 with members of the ETS family. While some cooperative genetic events have been identified, such as mutations in TP53 or deletions of the CDKN2A locus, these appear to be absent in the vast majority of cases. It is therefore uncertain whether EWS/ETS translocations are the only consistently present alteration in this tumor, or whether there are other recurrent abnormalities yet to be discovered. One method to discover such mutations is to identify familial cases of Ewing's sarcoma and to then map the susceptibility locus using traditional genetic mapping techniques. Although cases of sibling pairs with Ewing's sarcoma exist, familial cases of Ewing's sarcoma have not been reported. While Ewing's sarcoma has been reported as a 2nd malignancy after retinoblastoma, significant associations of Ewing's sarcoma with classic tumor susceptibility syndromes have not been identified. We will review the current evidence, or lack thereof, regarding the potential of a heritable condition predisposing to Ewing's sarcoma.