Why We Shout
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: PCCM Narrative Source Type: research

Multisystem Inflammatory Syndrome in Children: Host Immunologic Responses
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Concise Clinical Science Review Source Type: research

Acute and Posttraumatic Stress in Family Members of Children With a Prolonged Stay in a PICU: Secondary Analysis of a Randomized Trial
CONCLUSIONS: Meeting screening criteria for PTSD was associated with demographic, length of stay, and family relationships among family members of seriously ill children. PTSD outcomes were higher among family members whose child died. This study helps identify risk factors that can be used to target needed psychosocial screening, monitoring and support during and following a prolonged PICU admission, as well as family-centered interventions and supportive bereavement intervention for the family members of a deceased child. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Preload Dependence Fails to Predict Hemodynamic Instability During a Fluid Removal Challenge in Children*
CONCLUSIONS: Preload dependence is not accurate to predict hemodynamic instability during an FRC. Our data do not support a reduction in intravascular volume being mainly responsible for the reduction in arterial pressure during an FRC in children. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Screening for Factors Influencing Parental Psychological Vulnerability During a Child’s PICU Admission*
OBJECTIVES: To identify the risks of developing post-traumatic stress disorder (PTSD) and/or depression in parents following their child’s PICU admission using a brief screening instrument and to examine the associations with these risks. DESIGN: A cross-sectional parental survey. SETTING: A general 13-bed PICU at a large teaching hospital. SUBJECTS: One hundred and seven parents of 75 children admitted to the PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: All parents completed the 10-item Posttraumatic Adjustment Screen (PAS) before discharge. The PAS assesses risk facto...
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Peripheral IV Administration of Hypertonic Saline: Single-Center Retrospective PICU Study*
CONCLUSIONS: HTS administered through a PIVC infrequently infiltrates in critically ill pediatric patients. The infiltration rate was low when HTS is administered as a bolus but higher when given as a continuous infusion. However, no patient suffered an extravasation injury or long-term morbidity from any infiltration. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
CONCLUSIONS: Tracheostomies during ECMO were uncommon in children. One in four patients who received a tracheostomy on ECMO had surgical site bleeding. Children who had tracheostomies placed after 14 days were younger and had worse outcomes, potentially representing tracheostomy as a “secondary” strategy for prolonged ECMO support. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Critical Care Unit Organizational and Personnel Factors Impact Cardiac Arrest Prevention and Rescue in the Pediatric Cardiac Population
OBJECTIVES: Patient-level factors related to cardiac arrest in the pediatric cardiac population are well understood but may be unmodifiable. The impact of cardiac ICU organizational and personnel factors on cardiac arrest rates and outcomes remains unknown. We sought to better understand the association between these potentially modifiable organizational and personnel factors on cardiac arrest prevention and rescue. DESIGN: Retrospective analysis of the Pediatric Cardiac Critical Care Consortium registry. SETTING: Pediatric cardiac ICUs. PATIENTS: All cardiac ICU admissions were evaluated for cardi...
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research

Characterization of Inhaled Nitric Oxide Use for Cardiac Indications in Pediatric Patients*
OBJECTIVES: Characterize the use of inhaled nitric oxide (iNO) for pediatric cardiac patients and assess the relationship between patient characteristics before iNO initiation and outcomes following cardiac surgery. DESIGN: Observational cohort study. SETTING: PICU and cardiac ICUs in seven Collaborative Pediatric Critical Care Research Network hospitals. PATIENTS: Consecutive patients, less than 18 years old, mechanically ventilated before or within 24 hours of iNO initiation. iNO was started for a cardiac indication and excluded newborns with congenital diaphragmatic hernia, meconium aspiration s...
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding*
CONCLUSIONS: In injured children, balanced resuscitation may improve early survival according to this hypothesis generating study. Multicenter clinical trials are needed to assess whether clinicians should target ratios and deficits as optimal pediatric hemostatic resuscitation practice. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Editor’s Choice Articles for April
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - April 1, 2022 Category: Pediatrics Tags: Editor’s Choice Source Type: research

Anthropology in the PICU: Addressing the Local Worlds of Families in an Otherwise Foreign Land
Critical illness is a scary, and often previously unknown, experience for children and their families. To best assist pediatric critically ill patients and their caregivers, it is imperative to understand their local worlds outside of the PICU and what matters to them most. Anthropology, and its ethnographic lens and mode of inquiry, is an underutilized aspect of multidisciplinary care and research in pediatric critical care but has much to offer as exemplified herein. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online PCCM Perspectives Source Type: research

Developmental Care Practice and Documentation Variability in the Cardiac ICU
CONCLUSIONS: There are significant, quantifiable variations in documented developmental care practices at both the individual and site level. More reliable documentation of developmental care practices is required to associate these variables with later outcomes and investigate disparities in individualized developmental care practices. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Oral Aversion in Infants With Congenital Heart Disease: A Single-Center Retrospective Cohort Study*
OBJECTIVES: Neonates undergoing cardiac surgery are at risk for oral aversion (OA). OA is not well described outside of the index hospitalization and impacts patients and families. We evaluated the prevalence of OA at 1 year old after neonatal cardiopulmonary bypass (CPB) surgery. DESIGN: Retrospective cohort study. SETTING: Single quaternary care hospital. SUBJECTS: Our cohort included 157 neonates who underwent CPB surgery from 2014 to 2017 and had follow-up data available at 1 year old. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Three feeding experts reviewed the medical r...
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research

Postoperative Acute Kidney Injury in Williams Syndrome Compared With Matched Controls
CONCLUSIONS: The OR of CS-AKI is increased in pediatric patients with WS compared with controls. CS-AKI was associated with VIS at the sixth postoperative hour. Increases in RPP and mean arterial pressure were associated with decreased odds of CS-AKI. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research