Extracorporeal Membrane Oxygenation Candidacy Decisions: An Argument for a Process-Based Longitudinal Approach*
Are all children extracorporeal membrane oxygenation (ECMO) candidates? Navigating ECMO decisions represents an enormous challenge in pediatric critical care. ECMO cannulation should not be a default option as it will not confer benefit for “all” critically ill children; however, “all” children deserve well-considered decisions surrounding their ECMO candidacy. The complexity of the decision demands a systematic, “well-reasoned” and “dynamic” approach. Due to clinical urgency, this standard cannot always be met prior to initiation of ECMO. We challenge the paradigm of “candidacy” as a singular decision ...
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Online PCCM Perspectives Source Type: research
Semiautomated Regional Citrate Anticoagulation for Continuous Kidney Replacement Therapy: An Observational Study in Young Children
CONCLUSIONS:
We have used saRCA for CKRT in children weighing less than 11 kg. A strict protocol and intensive training are required to minimize complications. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Online Brief Report Source Type: research
The Zonulin Pathway as a Potential Mediator of Gastrointestinal Dysfunction in Critical Illness
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Online Concise Clinical Science Review Source Type: research
Parent-Reported Experience Measures of Care for Children With Serious Illnesses: A Scoping Review
CONCLUSIONS:
Service providers should integrate PaREMs into their settings to track and improve the quality of care. Given the multidisciplinary nature of pediatric care and the often-unpredictable disease trajectories of seriously ill children, measures that are applicable to multiple providers and varying lengths of care are essential for standardized assessment of quality of care and coordination among providers. To improve future PaREM development, researchers should follow consistent and methodologically robust steps, ideally in more diverse sociocultural and health systems contexts. Future measures should widen t...
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Online Review Article Source Type: research
Enhanced Efficiency in Pediatric Interfacility Transport Through a Centralized Hospital System Communication Center
CONCLUSIONS:
A centralized communication center for pediatric hospital patient flow that included specialized critical care patient transport has increased transport capacity and enhanced efficiency throughout our multicampus hospital system. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Online Clinical Investigation Source Type: research
To Cannulate or Not to Cannulate: Are We Asking the Wrong Question?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Systemic-to-Pulmonary Artery Shunt Thromboprophylaxis: Searching for the Holy Grail*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Tracheostomy in Pulmonary Hypertension: Not for the Faint of Heart*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Monocyte Distribution Width: Another (Better?) Marker to Predict Sepsis?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Associations Between Early Corticosteroids, Pediatric Septic Shock, and Outcomes: Not a Simple Analysis*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Who Falls Under the Pediatric Neurocritical Care Umbrella?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
The Unequal Fight
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: PCCM Narrative Source Type: research
Protocol for a Randomized Multiple Center Trial of Conservative Versus Liberal Oxygenation Targets in Critically Ill Children (Oxy-PICU): Oxygen in Pediatric Intensive Care
OBJECTIVES:
Oxygen administration is a fundamental part of pediatric critical care, with supplemental oxygen offered to nearly every acutely unwell child. However, optimal targets for systemic oxygenation are unknown. Oxy-PICU aims to evaluate the clinical effectiveness and cost-effectiveness of a conservative peripheral oxygen saturation (Spo2) target of 88–92% compared with a liberal target of more than 94%.
DESIGN:
Pragmatic, open, multiple-center, parallel group randomized control trial with integrated economic evaluation.
SETTING:
Fifteen PICUs across England, Wales, and Scotland.
PATIENTS:
...
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: PCCM Trials Source Type: research
Exploratory Use of Glycoprotein IIb/IIIa Inhibition in Prevention of Blalock-Taussig Shunt Thrombosis*
OBJECTIVES:
Morbidity and mortality related to modified Blalock-Taussig shunt (mBTTS) thrombosis remain a significant risk. Platelet inhibition following mBTTS may reduce this risk. However, oral antiplatelet agents have variable absorption following surgery. We determine risk factors for mBTTS thrombosis and hypothesize that IV glycoprotein IIb/IIIa inhibitor (tirofiban) as a bridge to oral aspirin reduces the rate of shunt thrombosis in the immediate postoperative period. End points within the 14-day follow-up period include mBTTS thrombosis, overall thrombosis, bleeding, length of stay, and mortality.
DESIGN:
...
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Cardiovascular Critical Care Source Type: research
Outcomes for Children With Pulmonary Hypertension Undergoing Tracheostomy Placement: A Multi-Institutional Analysis*
CONCLUSIONS:
In the context of expanding utilization of tracheostomy and long-term ventilation, children with PH are among the highest risk cohorts for extended and repeated hospitalization and death. Tracheostomy placement during the index encounter was associated with fewer 30-day readmissions over the 2-year follow-up period. Further understanding of which subgroups may benefit from earlier intervention and which subgroups are at highest risk may offer important clinical insight when considering optimal timing of tracheostomy and may enhance informed decision-making for all stakeholders. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - September 1, 2022 Category: Pediatrics Tags: Cardiovascular Critical Care Source Type: research
