Online Abstract Translations
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Abstract Translations Source Type: research

Effect of a Sepsis Educational Intervention on Hospital Stay*
Conclusions: Adherence to a bundle strategy is low following an educational intervention. However, when patients are managed after instruction in guideline recommendations, hospital stay may be significantly reduced. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Hospital Variation in Intensive Care Resource Utilization and Mortality in Newly Diagnosed Pediatric Leukemia*
Conclusions: Wide hospital-level variability in ICU resource utilization and mortality exists in the care of children with leukemia requiring ICU support. Hospital payer mix is associated with some mortality variability. Additional study into how ICU support could be standardized through clinical practice guidelines, impact of payer mix on hospital resources allocation to the ICU, and subsequent impact on patient outcomes is warranted. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Interhospital Transport of Critically Ill Children to PICUs in the United Kingdom and Republic of Ireland: Analysis of an International Dataset*
Conclusions: Variations exist in United Kingdom and Ireland services for critically ill children needing interhospital transport. Future studies should assess the impact of these variations on long-term patient outcomes taking into account treatment provided prior to transport. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Ceftaroline for Suspected or Confirmed Invasive Methicillin-Resistant Staphylococcus aureus: A Pharmacokinetic Case Series
Conclusions: These data suggest the pharmacokinetics of ceftaroline in PICU patients is different than healthy pediatric and adult patients, most notably a faster clearance and larger volume of distribution. A higher mg/kg dose and a more frequent dosing interval for ceftaroline may be needed in PICU patients to provide appropriate pharmacodynamic exposures. Larger pharmacokinetic, pharmacodynamic, and interventional treatment trials in the PICU population are warranted. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Neutrophil Extracellular Traps in Children With Meningococcal Sepsis
Objectives: Children with meningococcal sepsis are highly at risk for fulminant disease, multiple organ failure, and death. Recently, neutrophil extracellular traps levels have been indicated as a marker for severity in different kinds of sepsis. Our aim was to study the role of neutrophil extracellular traposis in meninogococcal sepsis in children. Design: We measured myeloperoxidase-DNA, a marker for neutrophil extracellular traps, in serum of meningococcal sepsis patients upon admission to PICU, at 24 hours, and at 1 month and studied the association with clinical outcome. Subsequently, we tested whether Neisseria ...
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Epidemiology of Pediatric Critical Care Transport in Northern Alberta and the Western Arctic
Conclusions: The current transport system has multiple priorities with regard to efficiency and quality. The medical services at referral hospitals may affect the likelihood of PICU admission and subsequent PICU length of stay; however, no negative impact was observed in other outcomes including mortality. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Performance Under Stress Conditions During Multidisciplinary Team Immersive Pediatric Simulations*
Objectives: The primary objective was to determine whether technical and nontechnical performances were in some way correlated during immersive simulation. Performance was measured among French Emergency Medical Service workers at an individual and a team level. Secondary objectives were to assess stress response through collection of physiologic markers (salivary cortisol, heart rate, the proportion derived by dividing the number of interval differences of successive normal-to-normal intervals> 50 ms by the total number of normal-to-normal intervals [pNN50], low- and high-frequency ratio) and affective data (s...
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Achievement of Therapeutic Vancomycin Exposure With Continuous Infusion in Critically Ill Children*
Conclusions: The current continuous infusion of vancomycin dosing scheme used in our population was inappropriate and led to underexposure. Using pharmacokinetic approaches such as covariate-adjusted initial dosing and Bayesian estimation of exposure should prove useful for achieving the pharmacokinetic target. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

The authors reply
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Letters to the Editor Source Type: research

Challenges in Electronic Medical Record Implementation in the PICU
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Letters to the Editor Source Type: research

Reconciling Conflicting Results From Pediatric Sepsis Studies: The Need for Context-Specific Sepsis Bundles*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Are We the Best We Can Be?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

The Quest to Optimize Pediatric Interhospital Transport*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Reflections on the First 50 Years of Human Patient Simulation: Mission Accomplished?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Vancomycin Dosing: One Size Does Not Fit All*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Education and Training in Pediatric Cardiac Critical Care*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

The Ongoing Evolution of the Truth*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Is the Use of Cricoid Pressure During PICU Intubations a Matter of Perspective or Training?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Antimicrobials in the PICU: An Unresolved and Serious Matter*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

What Goes Up, Must Go Down?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Ventilator-Associated Conditions: Are the New Definitions “Eliminating the Noise” or Ignoring Important Preconditions?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Practice Change From Intermittent Medication Boluses to Bolusing From a Continuous Infusion in Pediatric Critical Care: A Quality Improvement Project
Conclusions: Implementation of bolus medications from continuous infusion in PICUs significantly decreased time to begin a bolus dose and increased nursing satisfaction. The practice change also improved medication utilization without negatively impacting patient safety. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Quality and Safety Source Type: research

A Multi-Institutional Simulation Boot Camp for Pediatric Cardiac Critical Care Nurse Practitioners*
Objectives: Assess the effect of a simulation “boot camp” on the ability of pediatric nurse practitioners to identify and treat a low cardiac output state in postoperative patients with congenital heart disease. Additionally, assess the pediatric nurse practitioners’ confidence and satisfaction with simulation training. Design: Prospective pre/post interventional pilot study. Setting: University simulation center. Subjects: Thirty acute care pediatric nurse practitioners from 13 academic medical centers in North America. Interventions: We conducted an expert opinion survey to guide curriculu...
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Useful References in Pediatric Cardiac Intensive Care: The 2017 Update*
Conclusions: This article contains a compilation of useful references for the critical care of children with congenital and acquired heart disease published in the last 5 years. In conjunction with the prior version of this update in 2012, this article may be used as an educational reference in pediatric cardiac intensive care. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Characteristics, Risk Factors, and Outcomes of Extracorporeal Membrane Oxygenation Use in Pediatric Cardiac ICUs: A Report From the Pediatric Cardiac Critical Care Consortium Registry
Objectives: Cardiopulmonary failure in children with cardiac disease differs from the general pediatric critical care population, yet the epidemiology of extracorporeal membrane oxygenation support in cardiac ICUs has not been described. We aimed to characterize extracorporeal membrane oxygenation utilization and outcomes across surgical and medical patients in pediatric cardiac ICUs. Design: Retrospective analysis of the Pediatric Cardiac Critical Care Consortium registry to describe extracorporeal membrane oxygenation frequency and outcomes. Within strata of medical and surgical hospitalizations, we identified risk ...
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: WFPICCS Late Breaker Articles Source Type: research

Management of Pediatric Delirium in Pediatric Cardiac Intensive Care Patients: An International Survey of Current Practices
Conclusions: Clinicians responding to the survey reported a range of delirium assessment and management practices in postoperative pediatric cardiac surgery patients. Study results highlight the need for improvement in delirium education for pediatric cardiac intensive care clinicians as well as the need for systematic evaluation of current delirium assessment and management practices. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: WFPICCS Late Breaker Articles Source Type: research

Cricoid Pressure During Induction for Tracheal Intubation in Critically Ill Children: A Report From National Emergency Airway Registry for Children*
Objectives: Cricoid pressure is often used to prevent regurgitation during induction and mask ventilation prior to high-risk tracheal intubation in critically ill children. Clinical data in children showing benefit are limited. Our objective was to evaluate the association between cricoid pressure use and the occurrence of regurgitation during tracheal intubation for critically ill children in PICU. Design: A retrospective cohort study of a multicenter pediatric airway quality improvement registry. Settings: Thirty-five PICUs within general and children’s hospitals (29 in the United States, three in Canada, o...
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: WFPICCS Late Breaker Articles Source Type: research

Variability in Antibiotic Use Across PICUs*
Conclusions: The wide variation in antibiotic use observed across children’s hospital PICUs suggests inappropriate antibiotic use. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Feature Articles Source Type: research

Cardiac Index Changes With Fluid Bolus Therapy in Children With Sepsis—An Observational Study*
Conclusions: Fluid bolus therapy for pediatric sepsis is associated with a transient increase in cardiac index. Fluid responsiveness is variable and, when present, not sustained. The efficacy of fluid bolus therapy for achieving a sustained increase in cardiac index in children with sepsis is limited. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Feature Articles Source Type: research

Retrospective Application of New Pediatric Ventilator-Associated Pneumonia Criteria Identifies a High-Risk Population*
Conclusions: Few children with ventilator-associated pneumonia diagnosis met the proposed PVAP criteria. PVAP was associated with increased morbidity and mortality. This work suggests that additional study is required before new definitions for ventilator-associated pneumonia are introduced for children. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2018 Category: Pediatrics Tags: Feature Articles Source Type: research

Fifty Years of Pediatric Critical Care: An Interview With Dr. Jack Downes
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online PCCM Perspectives Source Type: research

In Vitro Adsorption of Analgosedative Drugs in New Extracorporeal Membrane Oxygenation Circuits
Conclusions: Loss of highly lipophilic drugs in the extracorporeal membrane oxygenation circuits at 24 hours was remarkable. Drug loss is comparable with other hollow fiber extracorporeal membrane oxygenation systems but less than in silicone-based membranes especially in the first hours after injection. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Laboratory Investigation Source Type: research

Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs
Objectives: As of July 2013, pediatric resident trainee guidelines in the United States no longer require proficiency in nonneonatal tracheal intubation. We hypothesized that laryngoscopy by pediatric residents has decreased over time, with a more pronounced decrease after this guideline change. Design: Prospective cohort study. Setting: Twenty-five PICUs at various children’s hospitals across the United States. Patients: Tracheal intubations performed in PICUs from July 2010 to June 2016 in the multicenter tracheal intubation database (National Emergency Airway Registry for Children). Intervention: Non...
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Early Noninvasive Ventilation and Nonroutine Transfusion for Acute Chest Syndrome in Sickle Cell Disease in Children: A Descriptive Study
Conclusions: Early noninvasive ventilation combined with nonroutine transfusion is well tolerated in acute chest syndrome in children and may spare transfusion in some patients. Early recognition of patients still requiring transfusion is essential and warrants further studies. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Hemoglobin Levels Across the Pediatric Critical Care Spectrum: A Point Prevalence Study*
Objectives: To determine the prevailing hemoglobin levels in PICU patients, and any potential correlates. Design: Post hoc analysis of prospective multicenter observational data. Settings: Fifty-nine PICUs in seven countries. Patients: PICU patients on four specific days in 2012. Interventions: None. Measurements and Main Results: Patients’ hemoglobin and other clinical and institutional data. Two thousand three hundred eighty-nine patients with median age of 1.9 years (interquartile range, 0.3–9.8 yr), weight 11.5 kg (interquartile range, 5.4–29.6 kg), and preceding PICU st...
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Characteristics of Infants With Congenital Diaphragmatic Hernia Who Need Follow-Up of Pulmonary Hypertension
Objectives: Pulmonary hypertension is one of the main causes of mortality and morbidity in patients with congenital diaphragmatic hernia. Currently, it is unknown whether pulmonary hypertension persists or recurs during the first year of life. Design: Prospective longitudinal follow-up study. Setting: Tertiary university hospital. Patients: Fifty-two congenital diaphragmatic hernia patients admitted between 2010 and 2014. Interventions: None. Measurements and Main Results: Pulmonary hypertension was measured using echocardiography and electrocardiography at 6 and 12 months old. Characteristics of patients ...
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Blood Cultures Drawn From Arterial Catheters Are Reliable for the Detection of Bloodstream Infection in Critically Ill Children
Conclusion: Cultures of arterial catheter–drawn blood are reliable for the detection of bloodstream infection in PICUs. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Low-Dose Epinephrine Boluses: No Risk of Arrhythmias?
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Letters to the Editor Source Type: research

The author replies
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Letters to the Editor Source Type: research

Distinguishing the Effects of Inhaled Nitric Oxide and Lung Recruitment in Pediatric Acute Respiratory Distress Syndrome: Scope for Further Improvement
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Letters to the Editor Source Type: research

The Importance of Study Sample in a Point Prevalence Study on Hemoglobin Levels in International Pediatric Intensive Care*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Grab Your Fitbit—Let Us Move Forward*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Intraosseous Access During Newborn Resuscitation: It May Be Fast, But Is It Safe?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Do We Have the Answer? Ventricular Assist Device Versus Medical Management Pretransplant*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Near-Infrared Spectroscopy Monitoring After Pediatric Cardiac Surgery: Time for an Intervention?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

How Bad Is It to Fail at Pushing Hard and Fast in Pediatric Cardiopulmonary Resuscitation?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Success of a Patient- and Family-Centered Pediatric Specialty Care Model for Management of Chronic Respiratory Failure*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Good Sounding: The Use of Ultrasound to Assess Diaphragmatic Atrophy*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research

Hypofibrinogenemia and Pediatric Sepsis: Another Piece of the Puzzle!*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2018 Category: Pediatrics Tags: Editorials Source Type: research