Online Abstract Translations
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Abstract Translations Source Type: research

Live Tweeting the Discovery of a New Coronavirus Disease 2019–Related Syndrome in Children
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Letter to the Editor Source Type: research

Randomized Controlled Trial of Negative Pressure Ventilation: We First Need Characterized Physiology
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online PCCM Viewpoints Source Type: research

Randomized Controlled Trial of Negative Pressure Ventilation: We First Need a National Patient Registry
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online PCCM Viewpoints Source Type: research

Use of Negative Pressure Ventilation in Pediatric Critical Care: Experience in 56 PICUs in the Virtual Pediatric Systems Database (2009–2019)
CONCLUSIONS: Negative pressure ventilation is being used in many PICUs, most commonly for pulmonary infections or cardiac disease, in children with high rates of subsequent intubation and mortality and with few documented adverse events. Use at individual centers is rare but increasing, suggesting need for prospective collaboration to better evaluate the role of negative pressure ventilation in the PICU. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Brief Report Source Type: research

Use of Honey Versus Standard Care for Hospital-Acquired Pressure Injury in Critically Ill Children: A Multicenter Randomized Controlled Trial
CONCLUSIONS: The use of medicated honey dressings decreased the time to wound healing in critically ill children with pressure injuries. There were no allergic reactions or secondary bacterial infections in any of these children. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Clinical Investigation Source Type: research

Brazilian Translation, Cross-Cultural Adaptation, Validity, and Reliability of the EMpowerment of PArents in THe Intensive Care 30 (EMPATHIC-30) Questionnaire to Measure Parental Satisfaction in PICUs
CONCLUSIONS: EMPATHIC-30 has been translated and culturally adapted for the Brazilian population. Validation demonstrated an above-average total content validity coefficient, confirming the instrument content validity. A sufficient reliability was observed in both analyzed coefficients. The results support the use of the Brazilian version of EMPATHIC-30 for the evaluation of parents’ satisfaction of children admitted to the PICU. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Clinical Investigation Source Type: research

Readiness for and Response to Coronavirus Disease 2019 Among Pediatric Healthcare Providers: The Role of Simulation for Pandemics and Other Disasters*
CONCLUSIONS: The swift incorporation of disease-specific sessions and the transition of standard education to virtual or hybrid simulation training modes occurred frequently. The approach used, however, depended heavily on local requirements, limitations, and circumstances. In particular, the use of telesimulation allowed education to continue while maintaining social distancing requirements. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Online Clinical Investigation Source Type: research

The World Effort to Combat Pandemic—Simulate to Succeed!*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Vitamin C, Quo Vadis?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Anticoagulation in Extracorporeal Membrane Oxygenation: A Dilemma Wrapped in an Enigma*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Ongoing Variability in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation Practices—Could Consensus Change the Next Survey Results?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Neural Networks for Mortality Prediction: Ready for Prime Time?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

It's Okay to Forget
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: PCCM Narrative Source Type: research

Statistical Note: Using Scoping and Systematic Reviews
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: PCCM Notes, Methods, and Statistics Source Type: research

Efficacy and Safety of Parenteral High-Dose Vitamin C Therapy in Pediatric Patients: A Scoping Review*
CONCLUSIONS: In 12 studies with 194 children treated with parenteral high-dose vitamin C, there was no evidence of clinical efficacy or inferior clinical outcomes in double-blind randomized controlled trials, and no reported harmful effects. These findings justify further investigations of this treatment in children. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Feature Review Articles Source Type: research

Quality Assessment of the Literature on Quality Improvement in PICUs: A Systematic Review
CONCLUSIONS: The number of publications, including high-quality publications, on quality improvement interventions in PICUs has been increasing. However, low-quality articles continue to be published, even in recent years. Therefore, there is room for improvement in the quality of reporting. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Feature Review Articles Source Type: research

Coagulations Studies Do Not Correlate With Each Other or With Hematologic Complications During Pediatric Extracorporeal Membrane Oxygenation*
OBJECTIVES: Anticoagulation plays a key role in the management of children supported with extracorporeal membrane oxygenation. However, the ideal strategy for monitoring anticoagulation remains unclear. Our objective was to evaluate the utility of laboratory measures of anticoagulation in pediatric extracorporeal membrane oxygenation. DESIGN: Retrospective cohort study. SETTING: Quaternary care academic children’s hospital. PATIENTS: Children in a noncardiac PICU cannulated to extracorporeal membrane oxygenation in 2010—2016. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS:...
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Anticoagulation and Transfusion Management During Neonatal and Pediatric Extracorporeal Membrane Oxygenation: A Survey of Medical Directors in the United States*
CONCLUSIONS: Compared with the 2013 pediatric population, extracorporeal membrane oxygenation center anticoagulation and blood transfusion approaches continue to vary widely. Most report continued use of heparin as their primary anticoagulant and follow a combination of monitoring assays with the majority using the antifactor Xa assay in their practices, a significant shift from prior results. Antithrombin activity levels and viscoelastic tests are followed by a growing number of centers. Platelet transfusion thresholds continue to vary widely. Future research is needed to establish optimal anticoagulation and blood tr...
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Continuous Prediction of Mortality in the PICU: A Recurrent Neural Network Model in a Single-Center Dataset*
OBJECTIVES: Develop, as a proof of concept, a recurrent neural network model using electronic medical records data capable of continuously assessing an individual child’s risk of mortality throughout their ICU stay as a proxy measure of severity of illness. DESIGN: Retrospective cohort study. SETTING: PICU in a tertiary care academic children’s hospital. PATIENTS/SUBJECTS: Twelve thousand five hundred sixteen episodes (9,070 children) admitted to the PICU between January 2010 and February 2019, partitioned into training (50%), validation (25%), and test (25%) sets. INTERVENTIONS: ...
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Editor’s Choice Articles for June
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - June 1, 2021 Category: Pediatrics Tags: Editor’s Choice Source Type: research

The authors reply
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Correspondence Source Type: research

Ultrasound Options for Measuring Optic Nerve Sheath Diameter in Children
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Correspondence Source Type: research

Ultrasound-Guided Postpyloric Feeding Tube Placement in Critically Ill Pediatric Patients*
The objective of this study was to evaluate the effect of ultrasound-guided postpyloric feeding tube placement in critically ill children. DESIGN: Single-center retrospective observational study. SETTING: PICU of tertiary children’s hospital. PATIENTS: Children under the age of 16 who underwent postpyloric feeding tube placement in our PICU between September 2017 and August 2019. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A total of 115 patients were included in this study: 30 patients underwent ultrasound-guided postpyloric feeding tube placement and 85 patients underwent ...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Brief Report Source Type: research

Decreased Human Leukocyte Antigen DR on Circulating Monocytes Expression After Severe Pediatric Trauma: An Exploratory Report
CONCLUSIONS: Pediatric severe trauma induced an early and dramatic decrease in human leukocyte antigen-DR on circulating monocytes expression. This alteration of innate immunity was not associated with the occurrence of secondary infection, possibly due to a lack of statistical power. However, human leukocyte antigen-DR on circulating monocytes at Day 3 is a potential indicator of those at high risk of secondary infection and worse outcomes. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Health-Related Quality of Life After Community-Acquired Septic Shock in Children With Preexisting Severe Developmental Disabilities
OBJECTIVES: To serially evaluate health-related quality of life during the first year after community-acquired septic shock in children with preexisting severe developmental disabilities and explore factors associated with health-related quality of life changes in these children. DESIGN: Secondary analysis of the Life after Pediatric Sepsis Evaluation investigation. SETTING: Twelve academic PICU in the United States. PATIENTS: Children greater than or equal to 1 month and less than 18 years old identified by their family caregiver (e.g., parent/guardian) as having severe developmental disability pr...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Research Priorities for U.K. Pediatric Critical Care in 2019: Healthcare Professionals’ and Parents’ Perspectives
CONCLUSIONS: This is the first research prioritization exercise within U.K. PICU setting to include parents’ and families’ perspectives and compare these with healthcare professional. Results will guide both funders and future researchers. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Association Between Treatments and Short-Term Biochemical Improvements and Clinical Outcomes in Post-Severe Acute Respiratory Syndrome Coronavirus-2 Inflammatory Syndrome
OBJECTIVES: To 1) analyze the short-term biochemical improvements and clinical outcomes following treatment of children with post-severe acute respiratory syndrome coronavirus-2 inflammatory syndrome (multisystem inflammatory syndrome in children/pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2) admitted to U.K. PICUs and 2) collate current treatment guidance from U.K. PICUs. DESIGN: Multicenter observational study. SETTING: Twenty-one U.K. PICUs. PATIENTS: Children ( (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Postpyloric Feeding Tube Placement Under Ultrasound Guidance: Is It Moving Forward?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Improving “Neuro Checks” in Neonatal ICU and PICU Is a Serial Neurologic Assessment in Pediatrics*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Postextubation Respiratory Support: Is High-Flow Oxygen Therapy the Answer?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Screening Criteria for Palliative Care Consultation? Leave It to the PICU Team*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

There’s No Place Like Home*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

Linking Hyperoxia and Harm: Consequence or Merely Subsequence?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editorials Source Type: research

The Words We Say
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: PCCM Narrative Source Type: research

Statistical Note: Confounding and Causality in Observational Studies
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: PCCM Notes, Methods, and Statistics Source Type: research

Serial Neurologic Assessment in Pediatrics (SNAP): A New Tool for Bedside Neurologic Assessment of Critically Ill Children*
OBJECTIVES: We developed a tool, Serial Neurologic Assessment in Pediatrics, to screen for neurologic changes in patients, including those who are intubated, are sedated, and/or have developmental disabilities. Our aims were to: 1) determine protocol adherence when performing Serial Neurologic Assessment in Pediatrics, 2) determine the interrater reliability between nurses, and 3) assess the feasibility and acceptability of using Serial Neurologic Assessment in Pediatrics compared with the Glasgow Coma Scale. DESIGN: Mixed-methods, observational cohort. SETTING: Pediatric and neonatal ICUs. SUBJECTS: ...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Prevalence of Reintubation Within 24 Hours of Extubation in Bronchiolitis: Retrospective Cohort Study Using the Virtual Pediatric Systems Database*
CONCLUSIONS: In this secondary analysis of a multicenter database of children with bronchiolitis, extubation to high-flow nasal cannula was associated with a lower prevalence of reintubation within 24 hours compared with noninvasive positive pressure ventilation in both unmatched and propensity-matched analysis. Prospective trials are needed to determine if post-extubation support modality can mitigate the risk of extubation failure. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Variation in Pediatric Palliative Care Allocation Among Critically Ill Children in the United States*
The objectives are as follows: 1) estimate palliative care consult rates and trends among critically ill children and 2) characterize which children receive palliative care consults, including those meeting previously proposed ICU-specific palliative care screening criteria. DESIGN: Retrospective cohort. SETTING: Fifty-two United States children’s hospitals participating in the Pediatric Health Information Systems database. PATIENTS: Hospitalized children with nonneonatal ICU admissions from 2007 to 2018. MEASUREMENTS AND MAIN RESULTS: The primary outcome was palliative care consultation, ...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

A Framework for Pediatric Intensivists Providing Compassionate Extubation at Home*
For families facing end-of-life decisions for their critically ill children, compassionate extubation at home is a valuable service that pediatric intensivists can provide. Compassionate extubation at home is resource intensive and can be logistically challenging. Discouragingly, guidance on compassionate extubation at home in the literature is limited. We developed an evidence- and experience-based framework for compassionate extubation at home addressing common planning challenges and resource management. Our objective is to share this framework and an accompanying checklist, so that pediatric intensivists in other insti...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Hyperoxia During Cardiopulmonary Bypass Is Associated With Mortality in Infants Undergoing Cardiac Surgery*
OBJECTIVES: Patients undergoing cardiac surgery using cardiopulmonary bypass have variable degrees of blood oxygen tension during surgery. Hyperoxia has been associated with adverse outcomes in critical illness. Data are not available regarding the association of hyperoxia and outcomes in infants undergoing cardiopulmonary bypass. We hypothesize that among infants undergoing cardiac surgery, hyperoxia during cardiopulmonary bypass is associated with greater odds of morbidity and mortality. DESIGN: Retrospective study. SETTING: Single center at an academic tertiary children’s hospital. PATIENTS: ...
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Editor’s Choice Articles for May
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2021 Category: Pediatrics Tags: Editor’s Choice Source Type: research

The Role of Therapeutic Plasma Exchange in the Treatment of Childhood Intoxication: A Single-Center Experience: Erratum
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Erratum Source Type: research

Online Abstract Translations
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Abstract Translations Source Type: research

Food Insecurity in Families With Critically Ill Children: A Single-Center Observational Study in Pittsburgh
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Letters to the Editor Source Type: research

Traumatic Brain Injury Practice Guidelines: Variability in U.K. PICUs
Conclusions: Significant variability in pediatric traumatic brain injury management guidelines exists. Despite the heterogeneity, we have highlighted a few points of consistency within the key topic areas of pediatric traumatic brain injury management. We anticipate that this provides impetus for further work around standardization. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Brief Report Source Type: research

Sedation With Midazolam After Cardiac Surgery in Children With and Without Down Syndrome: A Pharmacokinetic-Pharmacodynamic Study
Conclusions: The majority of children with and without Down syndrome required additional sedation after cardiac surgery. This pharmacokinetic and pharmacodynamic analysis does not provide evidence for different dosing of midazolam in children with Down syndrome after cardiac surgery. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Regulating Critical Care Ultrasound, It Is All in the Interpretation
Point-of-care ultrasound (POCUS) use is rapidly expanding as a practice in adult and pediatric critical care environments. In January 2020, the Joint Commission endorsed a statement from the Emergency Care Research Institute citing point-of-care ultrasound as a potential hazard to patients for reasons related to training and skill verification, oversight of use, and recordkeeping and accountability mechanisms for clinical use; however, no evidence was presented to support these concerns. Existing data on point-of-care ultrasound practices in pediatric critical care settings verify that point-of-care ultrasound use continue...
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online PCCM Perspectives Source Type: research

Therapeutic Alliance Between Bereaved Parents and Physicians in the PICU
Conclusions: Among parents bereaved in the PICU, therapeutic alliance with physicians is moderately high. Future research should identify strategies to strengthen therapeutic alliance with Black parents and examine the role of alliance on bereaved parents’ health outcomes. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Early Mobilization in a PICU: A Qualitative Sustainability Analysis of PICU Up!*
Conclusions: Three years after implementation, PICU Up! remains well-received by staff, positively influencing role satisfaction and PICU team dynamics. Furthermore, patients and family members are perceived to be enthusiastic about mobility efforts, driving staff support. Through an ongoing focus on stakeholder buy-in, interprofessional engagement, and bundled care to promote mobility, the program has become part of the culture in the Johns Hopkins Hospital PICU. However, several barriers remain that prevent consistent execution of early mobility, including challenges with resource management, sedation decisions, and ...
Source: Pediatric Critical Care Medicine - April 1, 2021 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research