Can You Hold Him?
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: PCCM Narrative Source Type: research
Implementation of a Pediatric Neurocritical Care Program for Children With Status Epilepticus: Adherence to Continuous Electroencephalogram Monitoring
CONCLUSIONS:
The implementation of a PNCC program with initiatives in care delivery, allocation of resources, and education was associated with increased adherence to best care practices for the management of SE. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Neurocritical Intensive Care Source Type: research
Validation of a Computational Phenotype to Identify Acute Brain Dysfunction in Pediatric Sepsis
OBJECTIVES:
To validate a computational phenotype that identifies acute brain dysfunction (ABD) based on clinician concern for neurologic or behavioral changes in pediatric sepsis.
DESIGN:
Retrospective observational study.
SETTING:
Single academic children’s hospital.
PATIENTS:
Four thousand two hundred eighty-nine index sepsis episodes.
INTERVENTIONS:
None.
MEASUREMENTS AND MAIN RESULTS:
An existing computational phenotype of ABD was optimized to include routinely collected variables indicative of clinician concern for acute neurologic or behavioral change (completion of CT or MRI...
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Neurocritical Intensive Care Source Type: research
Derivation and Validation of Vasoactive Inotrope Score Trajectory Groups in Critically Ill Children With Shock
OBJECTIVES:
To determine whether there are clinically relevant and reproducible Vasoactive Inotrope Score (VIS) trajectories in children with shock during the acute phase of critical illness.
DESIGN:
Retrospective, observational cohort study.
SETTING:
Two tertiary, academic PICUs.
PATIENTS:
Children ( (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research
Prolonged Mechanical Ventilation in Pediatric Trauma Patients in a Combat Zone
CONCLUSIONS:
In this analysis of factors associated with PMV in pediatric trauma patients in a combat zone, in addition to severe injury to skin and thorax, we found that administration of crystalloids, colloids, and platelets was independently associated with greater odds of PMV. Our findings will help inform resource planning and suggest potential resuscitation strategies for future studies. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research
Clinical Challenges in Pediatric Ventilation Liberation: A Meta-Narrative Review
CONCLUSIONS:
Current literature suggests using a structured approach that includes a daily assessment of patient’s readiness to extubate may reduce total ventilation time. Increasing evidence indicates that such daily assessments needs to include SBTs without added pressure support. Measures of elevated load as well as measures of impaired respiratory muscle capacity are independently associated with extubation failure in children, indicating that these should also be assessed as part of ERT. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Feature Review Article Source Type: research
Fluid Accumulation in Mechanically Ventilated, Critically Ill Children: Retrospective Cohort Study of Prevalence and Outcome
OBJECTIVES:
To describe the prevalence, patterns, explanatory variables, and outcomes associated with fluid accumulation (FA) in mechanically ventilated children.
DESIGN:
Retrospective cohort study.
SETTING:
Tertiary PICU.
PATIENTS:
Children mechanically ventilated for greater than or equal to 24 hours.
INTERVENTIONS:
None.
MEASUREMENTS AND MAIN RESULTS:
Between July 2016 and July 2021, 1,636 children met eligibility criteria. Median age was 5.5 months (interquartile range [IQR], 0.7–46.5 mo), and congenital heart disease was the most common diagnosis. Overall, by day 7 of admission...
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research
Mid-Regional Pro-Adrenomedullin in Combination With Pediatric Early Warning Scores for Risk Stratification of Febrile Children Presenting to the Emergency Department: Secondary Analysis of a Nonprespecified United Kingdom Cohort Study*
OBJECTIVES:
Current sepsis guidelines do not provide good risk stratification of subgroups in whom prompt IV antibiotics and fluid resuscitation might of benefit. We evaluated the utility of mid-regional pro-adrenomedullin (MR-proADM) in identification of patient subgroups at risk of requiring PICU or high-dependency unit (HDU) admission or fluid resuscitation.
DESIGN:
Secondary, nonprespecified analysis of prospectively collected dataset.
SETTING:
Pediatric Emergency Department in a United Kingdom tertiary center.
PATIENTS:
Children less than 16 years old presenting with fever and clinical indicat...
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research
Mortality Risk in Pediatric Sepsis Based on C-reactive Protein and Ferritin Levels
CONCLUSIONS:
Bedside CRP and ferritin levels can be used together to distinguish groups of children with sepsis who have different systemic inflammation cytokine responses and mortality risks. These data suggest future potential value in personalized clinical trials with specific targets for anti-inflammatory therapies. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research
Editor’s Choice Articles for December
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Editor’s Choice Source Type: research
2022 In Review
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Foreword Source Type: research
Screening for Social Needs in Critically Ill Patients: Addressing More Than Health Conditions
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Letter to the Editor Source Type: research
Factors Associated With Mechanical Ventilation Duration in Pediatric Burn Patients in a Regional Burn Center in the United States*
Conclusions:
The presence of inhalational injury and burns to the head and neck region were associated with a longer duration of mechanical ventilation. Older age and male gender were associated with a shorter duration of mechanical ventilation. These factors should help clinicians better estimate a burned child’s expected trajectory and resource-intensive needs upon arrival to a burn center. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research
Characteristics and Outcomes of Critically Ill Children With Multisystem Inflammatory Syndrome
Conclusions:
Overall mortality from MIS-C was low, but the disease burden was high. There was a peak in MIS-C cases during Q1 of 2021, following a shift in viral strains in Q1 of 2021. However, an improvement in MIS-C outcomes starting in Q4 of 2020 suggests that viral strain was not the driving factor for outcomes in this population. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research
Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A Systematic Review and Meta-Analysis
Conclusions:
Antifibrinolytics are effective at decreasing blood loss and blood product requirement in children undergoing cardiac surgery with CPB although the quality of evidence is only moderate. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Cardiac Intensive Care Source Type: research
