Extracorporeal Membrane Oxygenation Then and Now; Broadening Indications and Availability
Extracorporeal membrane oxygenation (ECMO) is a life support technology provided to children to support respiratory failure, cardiac failure, or cardiopulmonary resuscitation after failure of conventional management. Over the decades, ECMO has expanded in use, advanced in technology, shifted from experimental to a standard of care, and evidence supporting its use has increased. The expanded ECMO indications and medical complexity of children have also necessitated focused studies in the ethical domain such as decisional authority, resource allocation, and equitable access. (Source: Critical Care Clinics)
Source: Critical Care Clinics - December 22, 2022 Category: Intensive Care Authors: Blythe E. Pollack, Roxanne Kirsch, Rachel Chapman, Robert Hyslop, Graeme MacLaren, Ryan P. Barbaro Source Type: research

Cytokine Release Syndrome in the Pediatric Population and Implications for Intensive Care Management
Cytokine release syndrome represents a spectrum of disease varying from fever alone to multiorgan system failure. Most commonly seen following treatment with chimeric antigen receptor T  cell therapy, it is increasingly being described with other immunotherapies as well as following hematopoietic stem cell transplant. As its symptoms are nonspecific, awareness is key to timely diagnosis and initiation of treatment. Given the high risk of cardiopulmonary involvement, critical care providers must be familiar with the cause, symptoms, and therapeutic options. Current treatment modalities focus on immunosuppression and target...
Source: Critical Care Clinics - November 17, 2022 Category: Intensive Care Authors: Juliana Romano, Eric Wilsterman, Megan Toal, Christine Joyce Source Type: research

Screening for Social Determinants of Health in the Pediatric Intensive Care Unit
Social determinants of health (SDoH) play a significant role in the health and well-being of children in the United States. Disparities in the risk and outcomes of critical illness have been extensively documented but are yet to be fully explored through the lens of SDoH. In this review, we provide justification for routine SDoH screening as a critical first step toward understanding the causes of, and effectively addressing health disparities affecting critically ill children. Second, we summarize important aspects of SDoH screening that need to be considered before implementing this practice in the pediatric critical car...
Source: Critical Care Clinics - November 17, 2022 Category: Intensive Care Authors: Manzilat Akande, Erin T. Paquette, Paula Magee, Mallory A. Perry-Eaddy, Ericka L. Fink, Katherine N. Slain Source Type: research

Youth Firearm Injury
Firearms are now the leading cause of death among youth in the United States, with rates of homicide and suicide rising even more steeply during the SARS-CoV-2 pandemic. These injuries and deaths have wide-ranging consequences for the physical and emotional health of youth and families. While pediatric critical care clinicians must treat the injured survivors, they can also play a role in prevention by understanding the risks and consequences of firearm injuries; taking a trauma-informed approach to the care of injured youth; counseling patients and families on firearm access; and advocating for youth safety policy and pro...
Source: Critical Care Clinics - November 14, 2022 Category: Intensive Care Authors: Elinore J. Kaufman, Therese S. Richmond, Katelin Hoskins Source Type: research

Pediatric Critical Care in the Twenty-first Century and Beyond
Pediatric critical care addresses prevention, diagnosis, and treatment of organ dysfunction in the setting of increasingly complex patients, therapies, and environments. Soon burgeoning data science will enable all aspects of intensive care: driving facilitated diagnostics, empowering a learning health-care environment, promoting continuous advancement of care, and informing the continuum of critical care outside the intensive care unit preceding and following critical illness/injury. Although novel technology will progressively objectify personalized critical care, humanism, practiced at the bedside, defines the essence o...
Source: Critical Care Clinics - November 14, 2022 Category: Intensive Care Authors: Mary Dahmer, Aimee Jennings, Margaret Parker, Lazaro N. Sanchez-Pinto, Ann Thompson, Chani Traube, Jerry J. Zimmerman Source Type: research

Translating Guidelines into Practical Practice
Point-of-care ultrasound (POCUS) is now transitioning from an emerging technology to a standard of care for critically ill children. POCUS can provide immediate answers to clinical questions impacting management and outcomes within this fragile population. Recently published international guidelines specific to POCUS use in neonatal and pediatric critical care populations now complement previous Society of Critical Care Medicine guidelines. The authors review consensus statements within guidelines, identify important limitations to statements, and provide considerations for the successful implementation of POCUS in the ped...
Source: Critical Care Clinics - November 3, 2022 Category: Intensive Care Authors: Mark D. Weber, Joel K.B. Lim, Sarah Ginsburg, Thomas Conlon, Akira Nishisaki Source Type: research

Quality Improvement in Neurocritical Care
Quality improvement is key to advancing outcomes for neurocritically ill patients. Variation in neurocritical care practice can lead to differences in health outcomes and contribute to health disparities. The implementation of evidence-based best practice standards represents a major opportunity to improve their care. Neurocritical care performance measures have recently been developed and may be used to target high priority areas for improvement. In addition, neurocritical care clinicians should be aware of the heavily weighted pay-for-performance and publicly reported performance measures that are directly relevant to ne...
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Casey Olm-Shipman, Asma M. Moheet Source Type: research

Neurocritical Care Past, Present, and Future
In this issue, we have attempted to portray the evolution of both the science and the field of Neurocritical Care from its organic origins out of the polio epidemic to its reemergence as one of the burgeoning subspecialities in the landscape of modern critical care. Despite the remarkable growth in number of board-certified neurointensivists, specialty trained advanced practice providers, pharmacists, nurses, respiratory therapists, and other allied health care professionals, there continues to be a severe shortage of neurocritical care programs throughout the world. (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Deepa Malaiyandi, Lori Shutter Tags: Preface Source Type: research

Neurocritical Care
CRITICAL CARE CLINICS (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Deepa Malaiyandi, Lori Shutter Source Type: research

Copyright
ELSEVIER (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Source Type: research

Contributors
GREGORY S. MARTIN, MD, MSC (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Source Type: research

Contents
Deepa Malaiyandi and Lori Shutter (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Source Type: research

Forthcoming Issues
Pediatric Critical Care (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Source Type: research

Transfusion Strategies in the 21st Century
The transfusion of all blood components (red blood cells, plasma, and platelets) has been associated with increased morbidity and mortality in children. It is essential that pediatric providers weigh the risks and benefits before transfusing a critically ill child. A growing body of evidence has demonstrated the safety of restrictive transfusion practices in critically ill children. (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Jennifer Shenker, Hiba Abuelhija, Oliver Karam, Marianne Nellis Source Type: research

Pediatric Critical Care Outcomes
Children who survive the pediatric intensive care unit (PICU) are at risk of developing post-intensive care syndrome in pediatrics (PICS-p). PICS-p, defined as new physical, cognitive, emotional, and/or social health dysfunction following critical illness, can affect the child and family. Historically, synthesizing PICU outcomes research has been challenging due to inconsistency in study design and in outcomes measurement. PICS-p risk may be mitigated by implementing intensive care unit best practices that limit iatrogenic injury and by supporting the resiliency of critically ill children and their families. (Source: Critical Care Clinics)
Source: Critical Care Clinics - November 2, 2022 Category: Intensive Care Authors: Mallory A. Perry-Eaddy, Leslie A. Dervan, Joseph C. Manning, R. Scott Watson, Martha A.Q. Curley Source Type: research