Child Health
Using Machine Learning to Make Ventilator Support Safer for Children
Newswise — LOS ANGELES — Critically ill children on ventilator support can experience a mismatch between their breathing efforts and) the rhythm delivered by the ventilator. This mismatch, called patient-ventilator asynchrony (PVA), is difficult to detect and can worsen patient outcomes. PVA is commonly associated with longer stays on a ventilator for adults and can raise the risks of infection, lung injury and brain damage. However, little is known about PVA in children, where it could be just as, if not more, common. Robinder Khemani, MD, MsCI, Attending Physician in Pediatric Intensive Care at Children’s Hospital Los Angeles, is using machine learning to improve the outcomes of children put on ventilators.
A CHLA research team led by Dr. Khemani has received a $3.4 million grant from the National Institutes of Health to examine the frequency and risk factors for common types of PVA in critically ill children. Working with hospitals in Canada and the Netherlands, the researchers will investigate whether PVA is independently associated with poor clinical outcomes and determine the effects on the body when breathing doesn’t match the flow of air provided by the ventilator.
Children can need ventilator support for multiple reasons, including severe pneumonia or acute respiratory distress syndrome (ARDS), when infection or trauma causes swelling, inflammation and fluid buildup in the lungs. The body’s response to the initial injury can harm the lungs even more than the infection or trauma itself.
“Many of these very sick patients can develop unexpected complications from the very procedures that we use to help them,” says Dr. Khemani. Ventilator-induced lung injury can lead to heart and kidney damage, or can increase vulnerability to future lung disease, asthma or sleep-disordered breathing.
“Brain function can also be impaired by all the medications, anesthetics and sedation patients receive to help them to tolerate the ventilator,” says Dr. Khemani. “We weigh the risks and benefits to minimize potential harms and hopefully get them off the ventilator as soon as they are ready.”
Measuring patient-ventilator mismatch
“There are many types of PVA, but we still don’t know which PVA subtypes are most harmful or are the most frequent,” says Dr. Khemani. “We need to develop a common set of definitions and measurements, especially for pediatric patients.”
Mismatches between patient breathing and the rhythm the ventilator provides can occur in different ways, as children’s breathing varies according to their weight, size and age. Respiration patterns can also change during the course of a child’s stay in the pediatric intensive care unit. But existing studies use different definitions for PVA subtypes and no study so far has been large enough to evaluate the relationship between different types of PVA and patient outcomes, or has yet focused on the highest-risk patients.
Automating ventilator-patient breathing
“It takes a very highly trained human to recognize PVA,” says Dr. Khemani. “But computers can do this very well. Our colleagues at the Virtual Pediatric Intensive Care Unit (vPICU) here at CHLA have been working with us on this project for a few years and have developed machine-learning algorithms that can identify different types of breathing asynchronies in children on ventilators.”
The study team will collect measurements from 200 children and combine this data with the analysis of 350 children in other studies, including a clinical trial that is testing a novel ventilator strategy. “By the end of this project, we hope to have developed these algorithms and validate that they work in three different hospitals using data from many different children,” says Dr. Khemani. “Simultaneously we will build a tool to automatically detect PVA by analyzing ventilator data through machine-learning algorithms. We will test how well the tool helps providers to identify the minute-to-minute changes in patients and potentially alert the bedside team that an adjustment to the ventilator may be needed.”
To minimize the risks of ventilator support, medical teams want to keep patients participating in breathing for themselves as much as possible. “So that’s where this study really comes into play, by constantly tracking the interaction between the child and the ventilator to ask if the ventilator is supplying just the right amount of help, precisely when needed,” says Dr. Khemani.
About Children’s Hospital Los Angeles
Founded in 1901, Children’s Hospital Los Angeles is the largest provider of hospital care for children in California. Renowned pediatric experts work together across disciplines to deliver inclusive and compassionate health care to one of the world’s most diverse populations, driving advances that set child health standards across the nation and around the globe. With a mission to create hope and build healthier futures for children, the hospital consistently ranks in the top 10 in the nation, No. 1 in California and No. 1 in the Pacific U.S. region on U.S. News & World Report’s Honor Roll of Best Children’s Hospitals. The Saban Research Institute of Children’s Hospital Los Angeles supports the full continuum of child health research and is among the top 10 pediatric academic medical centers for National Institutes of Health funding, meaning physicians and scientists translate discoveries into treatments and bring answers to families faster. Home to one of the largest pediatric training programs in the United States, Children’s Hospital Los Angeles graduates a new class of physicians each year who have learned world-class children’s health care at the forefront of medicine. And as an anchor institution, the hospital strengthens the economic health of surrounding communities by fighting food insecurity, enhancing health education and literacy, and introducing early careerists to health care. To learn more, follow us on Facebook, Instagram, LinkedIn, YouTube and Twitter, and visit our blog at CHLA.org/blog.
Source: Children’s Hospital Los Angeles
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Lifestyle
Healthy Holiday Tips for Pregnant People
(Family Features) The holidays often bring colder weather and more indoor gatherings. Respiratory viruses like flu, COVID-19 and RSV are common this time of year.
Illness from these viruses can be dangerous for pregnant people and newborns. Staying up to date on vaccines for flu, COVID-19 and RSV during pregnancy can offer protection, and now is the time to get vaccinated if you haven’t already.
“During the holidays, pregnant people can help protect their health and the health of their baby by getting updated vaccines,” said Dr. Rachel Levine, assistant secretary for health at the U.S. Department of Health and Human Services (HHS). “During the holidays, you’re more likely to be exposed to flu, COVID-19 and RSV. Vaccination not only helps build up your immune system but can give protection for your little one.”
Here are some tips from the HHS Risk Less. Do More. public education campaign for a safe and festive holiday season:
Get vaccinated against flu and COVID-19. Getting sick with flu or COVID-19 can be dangerous for people who are pregnant and young infants. During pregnancy, there is a greater risk of flu or COVID-19 infections becoming severe and leading to hospitalization. Babies are also at risk of severe flu and COVID-19, but they cannot get vaccines until they are 6 months old. By getting vaccinated during pregnancy, you pass on antibodies that help protect your baby during the first few months of life.
Get vaccinated against RSV if you’re eligible. RSV is a common cause of severe respiratory illness in infants. In fact, it is the top reason babies in the United States are hospitalized each year. You can get an RSV vaccine if you are 32-36 weeks pregnant between September and January, the months when RSV spreads the most. The RSV vaccine helps your baby build protection from severe RSV before birth. If you do not get an RSV vaccine during pregnancy, your newborn can still get protection through a preventive antibody immunization soon after birth.
Stay home or change plans when ill. If you are not feeling well, stay home to avoid spreading illness. Also, if someone you plan to see is sick or respiratory viruses are surging in your community, consider staying home. You can also wear a mask or, if weather permits, move the gathering outdoors.
If you have questions or concerns, talk to your doctor. Knowing the facts about vaccines and pregnancy can offer confidence and comfort. Visit cdc.gov/RiskLessDoMore to learn more about getting your flu, COVID-19 and RSV vaccines before the holidays. Or visit vaccines.gov to get started.
Photo courtesy of Shutterstock
SOURCE:
United States Department of Health and Human Services
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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health and wellness
Take the Stress Out of Introducing Solid Foods to Baby: 6 pediatrician-recommended tips
Watching your baby learn and grow can provide some of the most rewarding moments in life, full of emotions from parents and babies alike.
(Family Features) Watching your baby learn and grow can provide some of the most rewarding moments in life, full of emotions from parents and babies alike. Some milestones are more stressful or frustrating than others and, during these moments of newness, seeking guidance from health care professionals can go a long way.
Healthy Baby
As the 2020-2025 Dietary Guidelines for Americans recognize, the time period from 6-24 months is when babies begin building healthy eating patterns and experience eating a variety of foods, including vegetables, fruits and whole grains. This journey can be stressful for parents as they begin to navigate what and how much is right to feed their babies. As parents begin to explore this fun and messy milestone, they often question what and how much is right to feed baby and seek guidance from experts.
While every child is different and parents should always defer to their pediatrician to be sure their baby is developmentally ready for solid foods, consider these six tips and tricks based on frequently asked questions for transitioning to solids from Dr. Whitney Casares, MD, MPH, pediatric medical consultant for Gerber.
- Make sure baby is ready: Most babies start solid foods between 4-6 months old. Watch for signs your baby is ready to start solids like good head control, sitting up with support and swallowing food instead of pushing it back out onto his or her chin. Don’t introduce solids to your baby before 4 months old. Your pediatrician can offer guidance about when the time is right for your little one.
- Timing is everything: When you’re first introducing solids, choose a moment in the day when your baby is happy and alert. Weekends tend to be easier times to start solid foods for families than busy weekdays. The more you can be in the moment with your child during those first feeding experiences, the better for you and him or her.
- Feed your baby the rainbow: Offer baby a diverse array of fruits, vegetables, iron-fortified whole grains and meats. Over the first six months of your baby’s feeding journey, iron-fortified cereals and purees can make feeding your baby convenient and simple. From apple and pear to zucchini, butternut squash and parsnips, Gerber’s 1st and 2nd foods lines offer a variety of purees that are just the right consistency for babies to practice tongue movements and advance their eating skills. Your baby’s first tries at swallowing solid foods may be awkward and require practice. Offering a small amount of breastmilk or formula before solids can help ensure he or she is not uncomfortably hungry.
- Supervise baby: Babies should always be supervised and seated in a secured highchair when eating, and parents should avoid choking hazards like whole grapes, nuts or cherry tomatoes. Use a soft, rubber-tipped spoon and start by guiding the spoon to his or her mouth with both your hand and your child’s hand on the spoon.
- Baby-led feeding: Consider baby-led feeding as a way to capitalize on the best aspects of baby-led weaning and spoon-feeding. Offer small amounts of nutritious foods in soft, easy-to-pick-up chunks appropriate for your baby’s developmental stage in addition to purees by pre-loading the spoon with your baby’s favorite puree or infant cereal for him or her to self-feed. As your baby gets older, look for baby-led friendly snacks, such as Gerber Lil’ Crunchies, that are specifically designed for babies to self-feed and fortified with key nutrients.
- Don’t get discouraged: Just because your baby makes a “yuck” face after trying a food for the first time doesn’t mean you should give up on it. Babies often need to try solid foods several times before they grow accustomed to them. Don’t be discouraged if your first attempt with a food seems less than successful; it’s all part of the process.
For more expert tips and resources for introducing solid foods, visit Gerber.com/learning-center.
Photos courtesy of Getty Images
SOURCE:
Gerber
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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health and wellness
5 Tips to Keep Kids Healthy During the Holidays
(Family Features) As the year comes to a close, the weather gets colder and indoor festivities ramp up. Keeping children and their families healthy during the holidays should be a priority for everyone.
Healthy Kids
“While gathering with friends and loved ones is an exciting and important part of the holiday season, staying healthy should still be on top of your ‘to-do’ list,” said Drs. Tress Goodwin and Joelle Simpson, KinderCare medical advisors. “Simple actions can be some of the most effective at keeping everyone healthy to ensure this season is a joyous one.”
Consider these five tips from KinderCare’s medical experts to keep in mind throughout the holidays.
- Wash hands regularly. One of the simplest ways to prevent germ spreading is to wash your and your children’s hands often using soap and water or an alcohol-based sanitizer. Try to remember to wash your hands after leaving public places, before eating and after any diaper change or restroom visit. If someone in your home is not feeling well, wash your hands more often.
- Share joy, not germs. Try to distance yourself from anyone who is sick (like those with coughs and colds) and avoid close contact with others when you or your child are sick. Encourage children to cough or sneeze into their elbows if no tissues are available. As a good at-home practice, regularly clean and disinfect commonly touched surfaces such as toys, cabinet and doorknobs, counters and tabletops.
- Keep meals well-balanced. Offer a healthy snack before holiday treats or make healthier versions of holiday favorites. Consider healthy snack options like fresh vegetables, fruits and dip, dried fruits, nuts or roasted sweet potatoes that can boost immunity for children and help balance out sugary treats. It’s also important to remember to eat healthy portion sizes and encourage children to listen to their bodily cues for hunger and fullness. Avoid juices or other sugary drinks and encourage children to drink plenty of water.
- Schedule personal time and get plenty of rest. Festivities can be merry but also overwhelming, especially for young children. Loud music, bright lights, lots of people and changes in schedules can leave them feeling overstimulated, which can lead to emotional outbursts. Make sure to leave some time in your week for simple joys, like cuddling up to read a book together or quiet play with immediate family members, so children have a chance to step out of the hustle and bustle. Remember holidays are meant to be fun, not stressful. While it may be tempting to pack every day with fun-filled activities, try to maintain children’s routines, including nap and bedtime schedules.
- Stay active. No matter what the weather is like, kids still need time to be physically active. Indoor play can be just as effective as time spent on the playground. Get creative with at-home winter fun with activities like dance parties, scavenger hunts and kids’ yoga. You can also visit indoor locations such as malls and museums to get those legs moving.
For more information or tips on holiday eating, indoor exercise and keeping children safe during the holidays, visit KinderCare.com.
SOURCE:
KinderCare
Our Lifestyle section on STM Daily News is a hub of inspiration and practical information, offering a range of articles that touch on various aspects of daily life. From tips on family finances to guides for maintaining health and wellness, we strive to empower our readers with knowledge and resources to enhance their lifestyles. Whether you’re seeking outdoor activity ideas, fashion trends, or travel recommendations, our lifestyle section has got you covered. Visit us today at https://stmdailynews.com/category/lifestyle/ and embark on a journey of discovery and self-improvement.
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