Biomedical subjects

Karen Selwood

Publications and source records attributed to Karen Selwood.

3 recordsLinked to original sources

PubMed2006

The use of blood products in paediatric oncology units in the UK.

AIM: The clinical practice group of the Royal College of Nursing paediatric oncology nurses' forum carried out an exploratory study to examine practice in administration of blood products in children's cancer centres across the UK to identify any variances in practice. METHOD: A questionnaire covering the use and administration of red cells, platelets and other supportive measures was distributed to each of the 22 UK Children's Cancer Study Groups centres of which 14 responded (63 per cent). FINDINGS: Variations among the units were found in all aspects of blood product administration including decisions about when to transfuse, methods of transfusion, treatment of adverse reactions and use of supportive products. There were some differences between the practices reported and guidance for transfusion in neonates and older children published by the British Committee for Standards in Haematology Transfusion Task Force (2004); many of these differences were attributable to the specific needs of oncology patients. CONCLUSION: The development of national guidance or minimum safe standards specifically for paediatric oncology patients could assist in reducing practice variations. This study was undertaken in children's cancer units where administration of blood products is a daily occurrence. Variations in practice that were identified here are likely to be found in non oncology/haematology settings.

Blood Component Transfusion↗

PubMed2005

Constipation in paediatric oncology.

Constipation is a common problem encountered by many children during treatment for childhood cancer. It can be distressing and impact on the quality of life for the child. However, the advice and information they and their families receive can vary enormously. The clinical practice group (a subgroup of the paediatric oncology nurses forum (PONF)) decided to examine the management of constipation throughout the paediatric oncology units in the UK. This paper presents the findings and the subsequent action taken and highlights the need for further work.

Cathartics↗

PubMed2005

Once-daily netilmicin for neutropenic pyrexia in paediatric oncology.

AIM: To establish the safety and efficacy of single daily intravenous netilmicin 6 mg/kg with piperacillin 100 mg/kg every 8 h for empirical, first-line management of children with neutropenic pyrexia following cytotoxic chemotherapy. METHODS: Observational study of children admitted to a regional oncology unit from October 1999-April 2002. Primary outcome measure was temperature 72 h after commencing antibiotic therapy; secondary measures were mortality, nephrotoxicity, symptomatic ototoxicity and serum netilmicin levels. RESULTS: 280 episodes for 128 patients (median age 7.1 y) were documented, and 248 episodes were evaluated and compared with a previous cohort of 100 episodes for which the only difference was administration of netilmicin three times daily. Twenty-seven per cent of single-dose netilmicin episodes remained febrile at 72 h compared to 32% in the comparator group (difference -4.7%; 95 % CI: -6.8% to 16.2%; p = 0.41). No patients died and we were unable to find evidence of nephrotoxicity or ototoxicity. Eighty-nine per cent of "peak" serum netilmicin levels measured 30 min after infusion were 10 mg/l or greater, and 94% and 86% measured 12-16 h after the first and third dose, respectively, were 1 mg/l or less. Peak serum netilmicin level measurements and 12-16-h measurements after the first dose were abandoned after the first 180 episodes. CONCLUSIONS: Netilmicin can safely be given as a single daily dose to children with febrile neutropenia who do not have biochemical evidence of nephrotoxicity. Monitoring peak serum levels of netilmicin is unnecessary. Levels taken 12-16 h after the third dose are adequate to monitor therapy if used in conjunction with a therapeutic guideline detailing the response to abnormal serum creatinine and netilmicin levels.

Adolescent↗