Tanya Holt

University of Saskatchewan | U of S · Department of Pediatrics

Background: Pediatric intensive care units (PICUs) may not have timely access to therapeutic plasma exchange (TPE) for critically ill patients. The purpose of this study was to evaluate the common indications for TPE in a smaller tertiary PICU‑developed TPE program and to evaluate the associated predictors of mortality. We hypothesized that a PICU‑...

BACKGROUND Remote presence robotic technologies (RPRT) in medicine have been primarily utilized as a virtual clinical interface for geographically isolated or resource limited communities. However, its potential as an educational conduit is slowly beginning to be realized. OBJECTIVE To study the acceptability and perspectives of RPRT in acute pedi...

Background: The COVID-19 pandemic overwhelmed Canadian hospitals with adult admissions. A large number required critical care therapies, placing significant strain on hospital resources. In order to decompress adult Intensive Care Units (ICUs), Pediatric ICUs (PICUs) introduced adapted models of traditional care to lessen these burdens. Objective...

Background: With the legalization of cannabis in Canada, safety concerns for children should be considered. Despite packaging and dose regulations for edibles and inhaled cannabis, unintentional poisonings are a clinical risk, and its impact on pediatric healthcare resources have not been clearly delineated. Methods: This retrospective cross-secti...

BACKGROUND The COVID-19 pandemic overwhelmed Canadian hospitals with adult admissions. A large number required critical care therapies, putting significant strain on hospital resources. In order to decompress adult Intensive Care Units (ICUs), Pediatric ICUs (PICUs) introduced adapted models of traditional care to lessen these burdens. OBJECTIVE T...

In a community hospital setting, Remote Presence Robotic Technology (RPRT) has been used for pediatric intensive care consultations. Two casesare presented where RPRT was used for acute resuscitation, delivering bad news, and discussions regarding end-of-life care. Although the medical contexts of the cases differed, RPRT demonstrateda versatility...

In response to the burden of coronavirus disease 2019 (COVID-19) and overwhelmed intensive care unit (ICU) resources, some pediatric intensive care units (PICUs) have had to adapt. The purpose of this study was to assess the criticality, scope of diagnosis, and outcomes of an adult cohort admitted to a Canadian PICU. A retrospective chart review wa...

Objective: Severity of illness scoring during pediatric critical care transport may provide objective data to determine illness trajectory and disposition and contribute to quality assurance data for pediatric transport programs. The objective of this study was to ascertain the breadth of severity of illness scoring tool application among North Am...

Objective: Severity of illness scoring during pediatric critical care transport may provide objective data to determine illness trajectory and disposition and contribute to quality assurance data for pediatric transport programs. The objective of this study was to ascertain the breadth of severity of illness scoring tool application among North Ame...

Introduction Pediatric complex chronic care patients present unique challenges regarding healthcare provision: complex medical regimes, complicated family/provider dynamics, and multiple healthcare teams that can result in inconsistent care. This study examined subspecialty providers’ perspectives regarding pediatric complex chronic care patients a...

Objectives: The objective of this study was to evaluate serial Transport Risk Assessment in Pediatrics (TRAP) scoring during pediatric critical care transport as a potential measure for specialized pediatric transport teams (PTTs). Methods: This was a retrospective study with a provincial PTT from a tertiary hospital pediatric intensive care unit....

Continuous renal replacement therapy (CRRT) has become a pillar of care in pediatric intensive care units (PICUs) over the past few decades. Quality indicators (QIs) have been evaluated that reflect safe and accountable CRRT. However, there is a paucity of data on outcomes and QIs in smaller-volume CRRT programming. The purpose of this retrospectiv...

Background: As the majority of severe pediatric traumatic brain injuries (TBI) are received and managed in the emergency department (ED), the ED trauma center is vital to optimizing management. This study aimed to evaluate current management guidelines, and to recognize other high-risk components of TBI management.

Acute medical management of traumatic brain injury (TBI) can be challenging outside of the resuscitation bay, specifically while obtaining a computed tomography (CT) scan of the brain. We sought out to determine the management practices of Canadian traumatologists for pediatric patients with severe TBI requiring CT in the emergency department (ED)....

Objective: Timely detection of elevated intracranial pressure (ICP) in highrisk preterm infants may be critical to avoid permanent neurologic sequelae. Size of optic nerve sheath diameter (ONSD) is highly correlated with changes in ICP. Normal ultrasonographic ONSD values for preterm infants have been published. This study sought to compare these d...

Background Children with complex chronic conditions present unique challenges to the pediatric intensive care unit, including prolonged length of stay, complex medical regimens, and complicated family dynamics. Objectives To examine perspectives of pediatric intensive care unit health care providers regarding pedi- atric patients with complex chron...

Background: As the majority of severe pediatric traumatic brain injuries (TBI) are received and managed in the emergency department (ED), the ED trauma center is vital to optimizing management. This study aimed to evaluate current management guidelines, and to recognize other high-risk components of TBI management. Methods: A retrospective chart r...

Background: As the majority of severe pediatric traumatic brain injuries (TBI) are received and managed in the emergency department (ED), the ED trauma center is vital to optimizing management. This study aimed to evaluate current management guidelines, and to recognize other high-risk components of TBI management. Methods: A retrospective chart r...

Objectives: The objective of this study was to evaluate serial Transport Risk Assessment in Pediatrics (TRAP) scoring during pediatric critical care transport as a potential measure for specialized pediatric transport teams (PTTs). Methods: This was a retrospective study with a provincial PTT from a tertiary hospital pediatric intensive care unit....

Background: To characterize pediatric patients supported with continuous positive airway pressure and bilevel positive airway pressure (CPAP/BiPAP) or high flow nasal cannula (HFNC) during interfacility transport (IFT). Methods: A retrospective study with a provincial pediatric transport team from a tertiary hospital pediatric intensive care unit....

The diagnosis of brain death (BD †) is legally and medically accepted. Recently, several high-profile cases have led to discussions regarding the integrity of current criteria, and many physiologic problems have been identified to support the necessity for their reevaluation. These include a global variability of the criteria, the suggestion of a c...

Titrating ventilator settings to minimize pulmonary arterial pressures and optimize both ventilation and oxygen delivery can be challenging following cardiac arrest. Erroneous ventilator adjustments can lead to unnecessary strain on the right ventricle that may be particularly vulnerable during the acute recovery. We report a child with fulminant m...

Objective: In preterm infants, early diagnosis and management of a raised intracranial pressure (ICP) may be important to improve neurodevelopmental outcomes. While invasive ICP monitoring is not recommended, ultrasonography of the optic nerve sheath diameter (ONSD) could provide a noninvasive alternative to evaluate ICP. The objective of this pil...

Background: Delivery of noninvasive ventilation commonly occurs in the pediatric intensive care unit (PICU). With the advent of high flow nasal cannula (HFNC), patients with respiratory distress may be rescued on the ward without a PICU admission. We evaluated our ward HFNC algorithm to determine its safety profile and independent predictors for no...

Pediatric ARDS continues to be a management challenge in the ICU with prolonged hospitalizations and high mortality. Thromboembolic pulmonary embolism and in situ pulmonary artery thrombosis might represent underappreciated thrombotic processes for a subset of these patients. Although well described in the adult literature, descriptions of pulmonar...

Objectives: Despite published clinical practice guidelines in pediatrics for the use of a standardized diabetic ketoacidosis (DKA) protocol, our centre lacked an accepted, evidence-informed protocol for pediatric DKA management. Our primary aim was to attain broad clinical uptake of a DKA order set. Secondary aims included improved standard-of-car...

Indigenous children living in rural and remote Canada have limited access to paediatric specialty services. As such, they experience a high rate of medical transport out of their home communities. The Truth and Reconciliation Commission’s calls to action has prioritized access to health care that is culturally safe and community directed. Remote pr...

Objective: Determining care disposition for pediatric patients during interfacility transport is often challenging. Severity of illness scoring can assist with this process. The purpose of this retrospective study was to compare currently utilized scoring systems and their ability to reliably match pediatric transport patients' severity of illness...

BACKGROUND Diabetic ketoacidosis (DKA) is a common clinical presentation in new and previously diagnosed paediatric patients with type 1 diabetes. In contrast to other Canadian tertiary paediatric hospitals, our center lacked a physician-endorsed evidence-informed care pathway for management of DKA. In the absence of a standardized approach to DKA,...

Mechanical ventilation strategies in pediatric acute respiratory distress syndrome (pARDS) continue to advance. Optimizing positive end expiratory pressure (PEEP) and ventilation to recruitable lung can be difficult to clinically achieve. This is in part, due to disease evolution, unpredictable changes in lung compliance, and the inability to asses...

Objective: Determining pediatric severity of ill- ness in referring centers may be useful for establishing appropriate patient disposition and interfacility trans- port. For this retrospective review, the authors evalu- ated the Canadian Paediatric Triage and Acuity Scale (PaedCTAS) tool in regards to individual patient dis- position and outcomes....

Background: Providing acutely ill children in isolated communities access to specialized care is challenging. This study aimed to evaluate remote presence robotic technology (RPRT) for enhancing pediatric remote assessments, expediting initiation of treatment, refining triaging, and reducing the need for transport. Methods: We conducted a pilot...

To determine the accuracy of arterial blood pressure monitoring using 1) direct arterial; 2) automated oscillometric; and 3) sphygmomanometer/Doppler ultrasound measurements in pediatric intensive care patients comparing methods 1) and 2) with 3), the gold standard used to define normal blood pressure. Prospective observational study. Pediatric int...

We set out to test whether premature infants were able to be fed orally on feeding cues and be discharged home earlier than infants fed by traditional feeding regimens. Attainment of adequate growth, adverse events, and nursing time to provide care were also assessed. After screening, the recruited premature infants (< 36 wks post-conceptual age [P...