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Pediatric Emergency and Critical Care Resources and Infrastructure in Resource-Limited Settings: A Multicountry Survey*
OBJECTIVES: To describe the infrastructure and resources for pediatric emergency and critical care delivery in resource-limited settings worldwide. DESIGN: Cross-sectional survey with survey items developed through literature review and revised following piloting. SETTING: The electronic survey was disseminated internationally in November 2019 via e-mail directories of pediatric intensive care societies and networks and using social media. PATIENTS: Healthcare providers who self-identified as working in resource-limited settings. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Res...
Source: Critical Care Medicine - March 25, 2021 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Peripheral and Central/Intraosseous Vasoactive Infusions During and After Pediatric Critical Care Transport: Retrospective Cohort Study of Extravasation Injury*
CONCLUSIONS: During pediatric critical care transport, we did not find a difference in prevalence of adverse events following the administration of vasoactive drugs via peripheral venous catheters or via central venous and intraosseous catheters.
Source: Pediatric Critical Care Medicine - August 1, 2022 Category: Pediatrics Tags: Clinical Investigations Source Type: research

Pediatric Critical Care Nursing Research Priorities in Asia: An eDelphi Study*
Conclusions: This first PICU nursing research prioritization exercise within Asia identified key nursing research themes that should be prioritized and provide a framework for future collaborative studies.
Source: Pediatric Critical Care Medicine - November 1, 2022 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Evolution of the Collaborative Pediatric Critical Care Research Network
This article describes the history of CPCCRN, discusses its financial and organizational structure, illustrates how funds were efficiently used to carry out studies, and describes CPCCRN public use datasets and future directions, concluding with the development of the PeRsonalizEd Immunomodulation in PediatriC SepsIS-InducEd MODS study.
Source: Pediatric Critical Care Medicine - December 1, 2022 Category: Pediatrics Tags: Mini Symposium Source Type: research

SCCM Pod-467 PCCM: AHA Guidelines Address Calcium During Pediatric Cardiopulmonary Arrest
The American Heart Association's (AHA) cardiopulmonary resuscitation guidelines recommend against the routine administration of IV calcium during pediatric cardiopulmonary arrest because of its association with worse outcomes. However, IV calcium is routinely used in children with heart disease who have cardiopulmonary arrest. Maureen A. Madden, DNP, RN, CPNP-AC, CCRN, FCCM, is joined by Gurpreet S. Dhillon, MD, to discuss the article, Calcium Administration During Cardiopulmonary Resuscitation for In-Hospital Cardiac Arrest in Children With Heart Disease is Associated With Worse Survival - A Report From the American Heart...
Source: SCCM PodCast - iCritical Care - December 21, 2022 Category: Intensive Care Authors: The Society of Critical Care Medicine (SCCM) Tags: Medicine Source Type: podcasts

The Fragility of Statistically Significant Findings in Pediatric Critical Care Randomized Controlled Trials*
This study aimed to assess the robustness of statistically significant results from pediatric critical care randomized controlled trials with dichotomous outcomes. Data Sources: A previously published scoping review of pediatric critical care randomized controlled trials (www.PICUtrials.net). Study Selection: A total of 342 trials were screened for inclusion. After applying inclusion/exclusion criteria, 43 fulfilled eligibility criteria and were included in the analysis. Data Extraction: Calculation of Fragility Index for trials reporting a statistically significant dichotomous outcome, and analysis of the relatio...
Source: Pediatric Critical Care Medicine - June 1, 2019 Category: Pediatrics Tags: Online Clinical Investigations Source Type: research

Gender and Authorship in Pediatric Critical Care Randomized Control Trials*
Objectives: To examine the gender distribution of authorship of pediatric critical care randomized control trials. Data Sources: The 415 randomized control trials in pediatric critical care published before 2019. Study Selection: We included all randomized control trials enrolling children in a PICU. We used PICUtrials.net, which uses comprehensive search strategies of multiple databases, to identify published randomized control trials. Data Extraction: We manually extracted the name and profession of each listed author from each publication and classified each author as male or female based on the...
Source: Pediatric Critical Care Medicine - December 1, 2020 Category: Pediatrics Tags: Feature Articles Source Type: research

Socioeconomic Disadvantage and Distance to Pediatric Critical Care*
OBJECTIVES: To describe the geography of pediatric critical care services and the relationship between poverty and distance to these services across the United States. DESIGN: Retrospective, cross-sectional study. SETTING: Contiguous United States. PATIENTS: Children less than 18 years as represented in the 2016 American Community Survey. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Pediatric critical care services were geographically concentrated within urban areas, with half of all PICUs located within 9.5 miles of another (interquartile range, 3.4–51.5 miles). Median dista...
Source: Pediatric Critical Care Medicine - December 1, 2021 Category: Pediatrics Tags: Feature Articles Source Type: research

Human Factors Analysis of Latent Safety Threats in a Pediatric Critical Care Unit*
CONCLUSIONS: Latent safety threats span various pediatric critical care activities and are attributable to many underlying work system factors. Latent safety threats are present both when staff comply with and deviate from policies and protocols, suggesting that simply reinforcing compliance with existing policies and protocols, the common default intervention imposed by healthcare organizations, will be insufficient to mitigate safety threats. Rather, interventions must be designed to address the underlying work system threats. This human factors informed framework analysis of observational data is a useful approach t...
Source: Pediatric Critical Care Medicine - March 1, 2022 Category: Pediatrics Tags: Feature Articles Source Type: research

Pediatric Intensive Care Physician-Placed Broviac CathetersPediatric Intensive Care Physician-Placed Broviac Catheters
Are pediatric critical care physicians on par with surgeons -- when it comes to placing Broviac catheters? Pediatric Critical Care Medicine
Source: Medscape Critical Care Headlines - January 27, 2014 Category: Intensive Care Tags: Critical Care Journal Article Source Type: news

Pediatric Triage in a Severe Pandemic: Maximizing Survival by Establishing Triage Thresholds*
Objectives: To develop and validate an algorithm to guide selection of patients for pediatric critical care admission during a severe pandemic when Crisis Standards of Care are implemented. Design: Retrospective observational study using secondary data. Patients: Children admitted to VPS-participating PICUs between 2009–2012. Interventions: A total of 111,174 randomly selected nonelective cases from the Virtual PICU Systems database were used to estimate each patient’s probability of death and duration of ventilation employing previously derived predictive equations. Using real and projected statistics for the State...
Source: Critical Care Medicine - August 16, 2016 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Ventilation Rates and Pediatric In-Hospital Cardiac Arrest Survival Outcomes*
The objective of this study was to associate ventilation rates during in-hospital cardiopulmonary resuscitation with 1) arterial blood pressure during cardiopulmonary resuscitation and 2) survival outcomes. Design: Prospective, multicenter observational study. Setting: Pediatric and pediatric cardiac ICUs of the Collaborative Pediatric Critical Care Research Network. Patients: Intubated children (≥ 37 wk gestation and
Source: Critical Care Medicine - October 12, 2019 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research

Being and Becoming: Narrative Records of Pediatric Critical Care Clinicians
Medical humanities initiatives have been integrated in our Pediatric Critical Care program to help clinicians make meaning of key experiences in their professional and personal journeys. In particular, narrative medicine and clinicians’ writings illuminate and commemorate these journeys and increase our understanding of our profession in its full complexity. In this piece, we provide an example of a medical humanities curriculum and a selection of pieces written by several participants in it. These pieces form a collective narrative, portraying aspects of our individual and collective biography.
Source: Pediatric Critical Care Medicine - October 1, 2022 Category: Pediatrics Tags: PCCM Perspectives Source Type: research

Making Decisions About Medications in Critically Ill Children: A Survey of Canadian Pediatric Critical Care Clinicians
Conclusions: The relative importance of many factors that clinicians consider when making decisions about medications varies by demographics, and depends on the clinical problem. This variability should be considered in quality improvement and knowledge translation interventions in this setting.
Source: Pediatric Critical Care Medicine - January 1, 2015 Category: Pediatrics Tags: Feature Articles Source Type: research

Outcomes for Children Receiving Noninvasive Ventilation as the First-Line Mode of Mechanical Ventilation at Intensive Care Admission: A Propensity Score-Matched Cohort Study*
Conclusions: Use of noninvasive ventilation as first-line mode of mechanical ventilation in critically ill children admitted to PICU in an unplanned fashion may be associated with significant clinical benefits. Further high-quality evidence regarding optimal patient selection and timing of initiation of noninvasive ventilation could lead to less variability in clinical care between institutions and improved patient outcomes.
Source: Critical Care Medicine - May 17, 2017 Category: Emergency Medicine Tags: Pediatric Critical Care Source Type: research