High-Frequency Utilization of the PICU*
CONCLUSIONS:
Children identified as having HFPICU account for 6.2% of children surviving an index ICU admission. They are a high-risk patient population with increased medical resource utilization during index and subsequent ICU admissions. Patients readmitted within 82 days of discharge should be considered at higher risk of HFPICU status. Further research, including validation and exploration of interventions that may be of use in this patient population, are necessary. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Tuning in to the Signal of Possible High-Frequency PICU Utilizers*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Evaluation of Machine Learning Models for Clinical Prediction Problems*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Prevalence and Time Course of Thiamine Deficiency in Critically Ill Children: A Multicenter, Prospective Cohort Study in Turkey
CONCLUSIONS:
In the PICU population in three centers in Turkey, the prevalence of TD in the sample of patients was 11.1%. In those TD patients who had serial studies, we also identified that by day 3 some continued to be TD, and some patients improved to normal thiamine status. Of concern, however, is the population who develop TD over the course of PICU stay. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Mini Symposium Source Type: research
Vitamin C Deficiency in Critically Ill Children: Prospective Observational Cohort Study
OBJECTIVES:
To evaluate the presence of vitamin C deficiency in critically ill children admitted to the PICU.
DESIGN:
Single-center prospective observational cohort study.
SETTING:
A 28-bed PICU and a pediatric outpatient sedation room of a tertiary-care teaching hospital.
PATIENTS:
Two pediatric patient groups 0–21 years old were studied: a PICU group and a group receiving deep sedation for elective outpatient procedures (noncritical care group).
INTERVENTIONS:
Vitamin C level was drawn for the PICU group within 24 hours of admission. Vitamin C level was drawn prior to start of deep sedat...
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Mini Symposium Source Type: research
Serum Ascorbic Acid and Thiamine Concentrations in Sepsis: Secondary Analysis of the Swiss Pediatric Sepsis Study
CONCLUSIONS:
In this cohort of newborns and children with sepsis, low and deficient VitC and VitB1 levels were frequently observed. Age, systemic inflammation, and vitamin supplementation were associated with vitamin levels during sepsis. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Mini Symposium Source Type: research
Resuscitation With Vitamins C and B1 in Pediatric Sepsis—Hold on to Your “HAT”
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Mini Symposium Source Type: research
Timing Is Everything
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: PCCM Narrative Source Type: research
Clinical Features Associated With Need for Mechanical Ventilation in Children With Guillain-Barré Syndrome: Retrospective Cohort From India
OBJECTIVES:
To analyze the clinical features associated with the need for mechanical ventilation (MV) in children with Guillain-Barré syndrome (GBS).
DESIGN:
Retrospective cohort study, 2010–2019.
SETTING:
PICU.
PATIENTS:
All children, 1 month to 12 years old, diagnosed with GBS in our single-center PICU.
Intervention:
Retrospective chart and data review.
MEASUREMENTS AND MAIN RESULTS:
Out of 189 children identified with a diagnosis of GBS, 130 were boys (69%). The median (interquartile range [IQR]) age was 6 years (3–9 yr). At admission, the Hughes disability score was 5 (4–5)...
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Neurocritical Care Source Type: research
Airway Characteristics of Patients With 22q11 Deletion Undergoing Pulmonary Artery Reconstruction Surgery: Retrospective Cohort Study
CONCLUSIONS:
Preexisting upper and lower airway pathologies are common in patients with a chromosome 22q11 deletion who undergo pulmonary artery reconstruction surgery. Despite similar postoperative hemodynamics and outcomes as their counterparts without 22q11 deletion, 22q11 deletion is associated with more postoperative respiratory complications not entirely explained by preexisting airway abnormalities. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research
Opioid Weaning Protocol Using Morphine Compared With Nonprotocolized Methadone Associated With Decreased Dose and Duration of Opioid After Norwood Procedure
OBJECTIVES:
Opioids are used to manage pain, comfort, maintain devices, and decrease oxygen consumption around Norwood palliation (NP), but in high dose and prolonged exposure, they increase risk of tolerance and iatrogenic withdrawal syndrome (IAWS). Variability in practice for IAWS prevention potentially increases opioid dose and duration. We hypothesize that protocolized weaning with morphine (MOR) versus nonprotocolized methadone (MTD) is associated with reduction in opioid exposure.
DESIGN:
A before-versus-after study of outcomes of patients weaned with protocolized MOR versus nonprotocolized MTD including ...
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Cardiac Intensive Care Source Type: research
Weaning Dexmedetomidine in Non-ICU Areas: An Implementation Effort
CONCLUSIONS:
Weaning dexmedetomidine in non-ICU areas is feasible and can be accomplished safely even among pediatric patients at high risk for withdrawal using standardized weaning guidelines. At our institution, implementation was associated with reduced ICU length of stay for patients recovering from critical illness. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Clinical Investigation Source Type: research
Dynamic Mortality Risk Predictions for Children in ICUs: Development and Validation of Machine Learning Models*
OBJECTIVES:
Assess a machine learning method of serially updated mortality risk.
DESIGN:
Retrospective analysis of a national database (Health Facts; Cerner Corporation, Kansas City, MO).
SETTING:
Hospitals caring for children in ICUs.
PATIENTS:
A total of 27,354 admissions cared for in ICUs from 2009 to 2018.
INTERVENTIONS:
None.
MAIN OUTCOME:
Hospital mortality risk estimates determined at 6-hour time periods during care in the ICU. Models were truncated at 180 hours due to decreased sample size secondary to discharges and deaths.
MEASUREMENTS AND MAIN RESULTS:
The Criticalit...
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Feature Article Source Type: research
In Memoriam: Hector R. Wong, MD (1963–2022)
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: In Memoriam Source Type: research
Editor’s Choice Articles for May
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - May 1, 2022 Category: Pediatrics Tags: Editor’s Choice Source Type: research
