Online Reviewer Thank You
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Reviewer Thank You Source Type: research

Online Abstract Translations
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Abstract Translations Source Type: research

Early Hyperoxemia and Outcome Among Critically Ill Children
Conclusions: A conventional threshold for hyperoxemia at presentation to the PICU was not associated with in-hospital mortality in a model using a calibrated acuity score. Extreme states of hyperoxemia (≥ 73.32 kPa) were significantly associated with in-hospital mortality. Prospective research is required to identify if hyperoxemia before and/or after PICU admission contributes to poor outcomes. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Brief Report Source Type: research

New or Persistent Right Ventricular Systolic Dysfunction Is Associated With Worse Outcomes in Pediatric Acute Respiratory Distress Syndrome
Conclusions: New or persistent right ventricular systolic dysfunction over the first week following pediatric acute respiratory distress syndrome onset is associated with worse patient outcomes, including decreased probability of extubation and higher PICU mortality. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Evaluation of a Multimodal Resuscitation Program and Comparison of Mouth-to-Mouth and Bag-Mask Ventilation by Relatives of Children With Chronic Diseases*
Conclusions: A standardized multimodal cardiopulmonary resuscitation training program for family members of chronically ill children is effective to teach good cardiopulmonary resuscitation performance and adherence to resuscitation guidelines. Laypersons could be successfully trained to equally perform mouth-to-mouth and bag-mask ventilation technique. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Stress Ulcer Prophylaxis in Critically Ill Children: A Multicenter Observational Study
Conclusions: Stress ulcer prophylaxis is common in Canadian PICUs. Clinically important gastrointestinal bleeding and C. difficile–associated diarrhea are rare, and the utility of routine prophylaxis should be examined. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
Conclusions: A large cohort of international experts was able to achieve consensus regarding many recommendations for the best care of children with sepsis, acknowledging that most aspects of care had relatively low quality of evidence resulting in the frequent issuance of weak recommendations. Despite this challenge, these recommendations regarding the management of children with septic shock and other sepsis-associated organ dysfunction provide a foundation for consistent care to improve outcomes and inform future research. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Online Special Article Source Type: research

Family Comes First: The Importance of High-Quality Cardiopulmonary Resuscitation Training for Caregivers*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Platelet Transfusion During Extracorporeal Membrane Oxygenation: Possible Harm, Ongoing Uncertainty*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Deconstructing the Syndrome of Acute Kidney Injury—What Are the Phenotypes?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Weighing the Balance of Fluids: Are Pediatric Neurotrauma Patients Different?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Could There Be a Biologically Plausible Niche for Polymyxin B-Immobilized Fiber Column Direct Hemoperfusion Treatment in Early Onset Neonatal Septic Shock?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Improving the Clinical Team’s Identification of Those at High Risk for Clinical Deterioration in the PICU*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Traumatic Brain Injury and Pediatric Acute Respiratory Distress Syndrome: Moving the Field Forward*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Grappling With Real-Time Diagnosis and Public Health Surveillance in Sepsis: Can Clinical Data Provide the Answer?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Executive Summary: Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Special Article Source Type: research

Platelet Transfusion Practice and Related Outcomes in Pediatric Extracorporeal Membrane Oxygenation*
Objective: To describe factors associated with platelet transfusion during pediatric extracorporeal membrane oxygenation and the relationships among platelet transfusion, complications, and mortality. Design: Secondary analysis of data collected prospectively by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014. Setting: Eight Collaborative Pediatric Critical Care Research Network–affiliated hospitals. Patients: Age less than 19 years old and treated with extracorporeal membrane oxygenation. Interventions: None. Measurements and Main Results: Of 511 c...
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Extracorporeal Support Source Type: research

Assessment of the Independent and Synergistic Effects of Fluid Overload and Acute Kidney Injury on Outcomes of Critically Ill Children*
Conclusions: The current study suggests the effects of significant fluid accumulation may be delineable from the effects of acute kidney injury. Concurrent fluid overload and acute kidney injury significantly worsen outcome. Correction of acute kidney injury assessment for net fluid balance may refine diagnosis and unmask acute kidney injury associated with deleterious downstream sequelae. The unique effects of fluid overload and acute kidney injury on outcome in critically ill patients warrant further study. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Renal Critical Care Source Type: research

Fluid Overload in Pediatric Severe Traumatic Brain Injury*
Conclusions: Patients with severe traumatic brain injury do have high rates of fluid overload. However, fluid overload did not contribute to mortality, longer days on the ventilator, increased risk of acute kidney injury, or increased PICU length of stay. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research

Clinical Effects and Outcomes After Polymyxin B–Immobilized Fiber Column Direct Hemoperfusion Treatment for Septic Shock in Preterm Neonates*
Conclusions: Polymyxin B–immobilized fiber column direct hemoperfusion treatment for preterm infants with septic shock due to early-onset sepsis is associated with earlier hemodynamic and respiratory status improvements and with lower mortality than that due to late-onset sepsis. Early neonatal septic shock detection and polymyxin B–immobilized fiber column direct hemoperfusion induction may improve the prognosis of affected infants. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Neonatal Intensive Care Source Type: research

Vacuum-Assisted Closure for the Treatment of Deep Sternal Wound Infection After Pediatric Cardiac Surgery
Conclusions: Vacuum-assisted closure is a feasible treatment option of deep sternal wound infection after pediatric cardiac surgery and was not associated with independent morbidity. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Association of Duration of Hypotension With Survival After Pediatric Cardiac Arrest
Conclusions: After successful resuscitation from pediatric cardiac arrest, systolic hypotension was common (55%). A higher burden of postresuscitation hypotension within the first 72 hours of ICU postresuscitation care was associated with significantly decreased discharge survival, after accounting for potential confounders including number of doses of epinephrine, arrest location, and arrest etiology due to airway obstruction or trauma. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Feature Articles Source Type: research

Parental Conflict, Regret, and Short-term Impact on Quality of Life in Tracheostomy Decision-Making
Conclusions: The decision to pursue tracheostomy among parents of critically ill children is fraught with conflict with worsening regret and quality of life over time. Strategies to reduce contributing factors may improve parental outcomes after this life-changing decision. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Feature Articles Source Type: research

Performance of a Clinical Decision Support Tool to Identify PICU Patients at High Risk for Clinical Deterioration*
Conclusions: Performance of a clinical decision support translation of a paper-based tool showed inferior test characteristics. Improved feasibility of identification of high-risk patients using automated tools must be balanced with performance. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Feature Articles Source Type: research

Clinical Characteristics, Major Morbidity, and Mortality in Trauma-Related Pediatric Acute Respiratory Distress Syndrome*
Objectives: To determine the presence, central characteristics, and impact on major morbidity and mortality of trauma-related pediatric acute respiratory distress syndrome. Design: Retrospective review of a prospective trauma database. Setting: American College of Surgeons verified level 1 trauma center in an urban setting. Patients: Trauma patients age 0 to 18 years old inclusive. Interventions: None. Measurements and Main Results: Of the 7,382 patients presenting within the 10-year study period, 646 met study criteria for inclusion in the analysis. Trauma-related pediatric acute respiratory distress synd...
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Congress Late-Breaker Articles Source Type: research

Identification of Pediatric Sepsis for Epidemiologic Surveillance Using Electronic Clinical Data*
Objectives: A method to identify pediatric sepsis episodes that is not affected by changing diagnosis and claims-based coding practices does not exist. We derived and validated a surveillance algorithm to identify pediatric sepsis using routine clinical data and applied the algorithm to study longitudinal trends in sepsis epidemiology. Design: Retrospective observational study. Setting: Single academic children’s hospital. Patients: All emergency and hospital encounters from January 2011 to January 2019, excluding neonatal ICU and cardiac center. Exposure: Sepsis episodes identified by a surveillance al...
Source: Pediatric Critical Care Medicine - February 1, 2020 Category: Pediatrics Tags: Congress Late-Breaker Articles Source Type: research

Effect of Endotracheal Tube Size, Respiratory System Mechanics, and Ventilator Settings on Driving Pressure
Objectives: We sought to investigate factors that affect the difference between the peak inspiratory pressure measured at the Y-piece under dynamic flow conditions and plateau pressure measured under zero-flow conditions (resistive pressure) during pressure controlled ventilation across a range of endotracheal tube sizes, respiratory mechanics, and ventilator settings. Design: In vitro study. Setting: Research laboratory. Patients: None. Interventions: An in vitro bench model of the intubated respiratory system during pressure controlled ventilation was used to obtain the difference between peak inspiratory p...
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Laboratory Investigation Source Type: research

Validity and Reliability of the Brazilian Portuguese Version of the Pediatric Confusion Assessment Method for the ICU
Conclusions: The Brazilian Portuguese version of the Pediatric Confusion Assessment Method for the ICU is a valid and reliable tool for diagnosing delirium in pediatric patients 5–17 years old who are spontaneously breathing and not pharmacologically sedated in Brazilian PICUs. The implementation of this tool may be useful to reduce underdiagnosis, ensure monitoring and earlier intervention, provide a better prognosis, and improve research on delirium in this age group in Brazil. Further studies are necessary to test the psychometric properties of the Brazilian Portuguese version of the Pediatric Confusion Assessme...
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Changes in Provider Perceptions Regarding Early Mobility in the PICU*
Objectives: Early mobility in the PICU is safe and feasible. However, PICUs continue to meet barriers to implementing early mobility. PICU providers were surveyed before and after initiating an early mobility protocol to determine perceived barriers and continued challenges in performing early mobility. Design: This single-center prospective study surveyed PICU providers regarding 26 potential barriers to early mobility using a five-point Likert scale. A survey was distributed 1 month prior to and 6 months after beginning an early mobility protocol. Setting: Free-standing academic tertiary care children’s hos...
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Practices, Perceptions, and Attitudes in the Evaluation of Critically Ill Children for Bacteremia: A National Survey*
Conclusions: There is variation in blood culture practices in the PICU. Fear and reflexive habits are common drivers of cultures. These practices may contribute to over-testing for bacteremia. Further investigation of how to optimize blood culture use is warranted. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Catheter-Directed Pharmacologic Thrombolysis for Acute Submassive and Massive Pulmonary Emboli in Children and Adolescents—An Exploratory Report
Conclusions: Pulmonary artery catheter-directed thrombolysis is a technically feasible therapeutic option for children and adolescents with submassive and massive pulmonary emboli. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Effect of Personalized Music Intervention in Mechanically Ventilated Children in the PICU: A Pilot Study*
Objectives: To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU. Design: Pilot study with a quasi-experimental design. Setting: Tertiary children’s hospital in China with a 40-bed PICU. Patients: Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (n = 25) and control group (n = 25). Interventions: Children in the music group received their own favorite music and listened for 60 minutes three times a day. The control group receive routine care without music. Measurements and Main Results: ...
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Provider Consensus on Candidate Protective and Risk Factors for Adverse Psychosocial Outcomes Following Discharge From a PICU: A Modified Delphi Study*
Conclusions: Consensus on candidate risk and protective factors for post-ICU psychosocial challenges and candidate pediatric palliative care-sensitive variables were identified. Further research is needed to operationalize and optimize a screening tool based on these consensus items and test it prospectively. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Downward Trend in Pediatric Resident Laryngoscopy Participation in PICUs: Erratum
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Erratum Source Type: research

The authors reply
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Letters to the Editor Source Type: research

Clonidine Doses For Sedation in the PICU
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Online Letters to the Editor Source Type: research

The Time Is Now for Early Mobility—Learning From Shared Staff Experiences and Common Staff Preconceptions to Maximize Successful Implementation*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Obtaining Blood Cultures in Critically Ill Children: The Need for a Cultural Change*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

A Note on Comfort in Pediatric Critical Care: Music and Mechanical Ventilation*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Provider Consensus on Factors Affecting Psychosocial Outcomes: A First Step Toward a Multifaceted Approach to Caring for Children and Families After an ICU Stay*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Pediatric Acute Kidney Injury: The Young Syndrome Has Grown Up*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Transcranial Doppler Sonography in the PICU*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

PIRSE: Philosophical Investigations in Refractory Status Epilepticus*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

High Incidence of Pediatric Delirium in PICU; Time for Action!*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Bursting Our Clinical Trial Bubbles*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Therapeutic Hypothermia After Pediatric Cardiac Arrest—Call Me on My Cell Phone?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Editorials Source Type: research

Population-Based Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill Children*
Conclusions: The population-level burden of acute kidney injury and its attributable risks are considerable among critically ill children. These findings emphasize the need for enhanced surveillance for acute kidney injury, identification of modifiable risks, and evaluation of interventional strategies. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Renal Critical Care Source Type: research

Mortality and Factors Associated With Hemorrhage During Pediatric Extracorporeal Membrane Oxygenation
Objectives: To quantify and identify factors associated with bleeding events during pediatric extracorporeal membrane oxygenation. Design: Retrospective cohort study with primary outcome of bleeding days on extracorporeal membrane oxygenation. Setting: Single tertiary care children’s hospital. Subjects: One-hundred twenty-two children supported with extracorporeal membrane oxygenation for greater than 12 hours during January 2015 through December 2016. Interventions: Bleeding days were identified if mediastinal or cannula site exploration, activated factor VII administration, gastrointestinal, pulmonary...
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Extracorporeal Support Source Type: research

Transcranial Doppler Ultrasound During Critical Illness in Children: Survey of Practices in Pediatric Neurocritical Care Centers*
Conclusions: At least 27 pediatric neurocritical care centers use transcranial Doppler during clinical care. In the majority of centers, studies are performed and interpreted by credentialed personnel, and findings are used to guide clinical management. Further studies are needed to standardize these practices. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research

New-Onset Refractory Status Epilepticus in Children: Etiologies, Treatments, and Outcomes*
Conclusions: In this single-center cohort, more than half of the children with new-onset refractory status epilepticus did not have an identifiable etiology. Unlike adult patients, the presence of positive neuronal antibody syndrome was rare. There was no difference in outcome between those with or without an identifiable etiology. As expected, patients with super-refractory status epilepticus had worse functional and neurocognitive outcomes. More standardized diagnostic and treatment algorithms are needed along with prospective multicenter studies. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2020 Category: Pediatrics Tags: Neurocritical Care Source Type: research