Differences in the Genomic Profiles of Immunoparalyzed and Nonimmunoparalyzed Children With Sepsis: A Pilot Study*
OBJECTIVES:
Sepsis-induced immunoparalysis represents a pathologic downregulation of leukocyte function shown to be associated with adverse outcomes, although its mechanisms remain poorly understood. Our goal was to compare genome-wide gene expression profiles of immunoparalyzed and nonimmunoparalyzed children with sepsis to identify genes and pathways associated with immunoparalysis.
DESIGN:
Prospective observational study.
PATIENTS:
Twenty-six children with lower respiratory tract infection meeting criteria for sepsis, severe sepsis, or septic shock admitted to the PICU.
SETTING:
Two tertiary car...
Source: Pediatric Critical Care Medicine - February 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research
Editor’s Choice Articles for February
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - February 1, 2022 Category: Pediatrics Tags: Editor’s Choice Source Type: research
Suicide and Self-Harm in Children and Adolescents Admitted to PICUs in the United States
CONCLUSIONS:
PICU admissions due to self-harm increased for all age groups during the study period. Females accounted for most of these admissions, whereas males accrued most of the in-hospital deaths. Intentional drug ingestion was the most common mode of self-harm and was rarely fatal, whereas asphyxia and firearms were the mechanisms associated with the highest mortality. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research
The Use of Extracorporeal Life Support in Children With Immune-Mediated Diseases
CONCLUSIONS:
Children with immune-mediated conditions can be successfully supported with extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation use has increased over time, and survival varies considerably by diagnosis. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research
Transport Medical Control Education for Pediatric Critical Care Fellows: A National Needs Assessment Study
CONCLUSIONS:
Transport medical control responsibilities are common for Pediatric Critical Care Medicine fellows, but training is inconsistent, assessment is not standardized, and supervision may be lacking. Fellow performance in transport medical control may help inform assessment in multiple domains of competencies. Further study is needed to identify effective methods for transport medical control education. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Brief Reports Source Type: research
Derivation and Validation of the Critical Bronchiolitis Score for the PICU
CONCLUSIONS:
The Critical Bronchiolitis Score performed better than PICU mortality-based scores in measuring expected duration of ICU-level respiratory support and ICU length of stay. This score may have utility to enrich interventional trials and adjust for illness severity in observational studies in this very common PICU condition. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Prediction Model Performance With Different Imputation Strategies: A Simulation Study Using a North American ICU Registry
CONCLUSIONS:
Analyses of large observational studies are likely to encounter the issue of missing data, which are likely not missing at random. Researchers should always consider multiple imputation by chained equations (or similar imputation approaches) when encountering even only small proportions of missing data in their work. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Pediatric Sepsis Biomarker Risk Model Biomarkers and Estimation of Myocardial Dysfunction in Pediatric Septic Shock
CONCLUSIONS:
A newly derived Pediatric Sepsis Biomarker Risk Model biomarker-based model reliably estimates risk of sepsis-associated myocardial dysfunction in pediatric septic shock, but independent prospective validation is needed. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
Characteristics and Physiologic Changes After 4% Albumin Fluid Boluses in a PICU
CONCLUSIONS:
Fluid boluses of 4% albumin were common and predominantly in children with cardiac disease and sepsis with a median dose of 10 mL/kg given over half an hour. Such treatment was associated with significant hemodynamic changes only in children less than 12 months old, and we failed to identify an association with urine output. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
A New Risk Assessment Model for Hospital-Acquired Venous Thromboembolism in Critically Ill Children: A Report From the Children’s Hospital-Acquired Thrombosis Consortium
CONCLUSIONS:
Using the multicenter Children’s Hospital-Acquired Thrombosis registry, we identified five independent risk factors for hospital-acquired venous thromboembolism in critically ill children, deriving a new hospital-acquired venous thromboembolism risk assessment model. A prospective validation study is underway to define a high-risk group for risk-stratified interventional trials investigating the efficacy and safety of prophylactic anticoagulation in critically ill children. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research
It Is Time to Raise the Bar With a Board*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Should We Embrace Mechanical Power to Understand the Risk of Ventilator-Induced Lung Injury in Children?*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Playing the Long Game: Therapeutic Hypothermia’s Impact on Quality-of-Life After Pediatric Cardiac Arrest*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Optimizing Human Performance in ICUs*
No abstract available (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Editorials Source Type: research
Standardized Training for Physicians Practicing Pediatric Cardiac Critical Care
CONCLUSIONS:
In the current era of increasing specialized care in pediatric cardiac critical care, standardized training for pediatric cardiac critical care is paramount to optimizing outcomes. (Source: Pediatric Critical Care Medicine)
Source: Pediatric Critical Care Medicine - January 1, 2022 Category: Pediatrics Tags: Special Article Source Type: research
