Pediatric Critical Care Medicine最新文献

{"title":"The authors reply.","authors":"Jan C Clausen, Michael Emeis, Richard Hollander, Robert G T Blokpoel, Martin C J Kneyber","doi":"10.1097/PCC.0000000000003996","DOIUrl":"10.1097/PCC.0000000000003996","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1031-1033"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"At the Edge of Survival: Lessons From Extracorporeal Membrane Oxygenation Use in Pediatric Emergency Department Cardiac Arrest.","authors":"Danny Gil, Sebastian C Tume","doi":"10.1097/PCC.0000000000004000","DOIUrl":"10.1097/PCC.0000000000004000","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1014-1017"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"REstrictive versus StandarD FlUid Management in Mechanically Ventilated ChildrEn Admitted to PICU: a pilot randomized controlled trial (REDUCE-1).","authors":"Sainath Raman, Sarfaraz Rahiman, Melanie Kennedy, Eva Kühlwein, Renate Le Marsney, Adrian C Mattke, Craig A McBride, Quyen Tu, Prem Venugopal, Jemma Woodgate, Florian Zapf, Puneet Singh, Luregn J Schlapbach, Kristen S Gibbons","doi":"10.1097/PCC.0000000000003969","DOIUrl":"10.1097/PCC.0000000000003969","url":null,"abstract":"<p><strong>Objective: </strong>Fluid overload in PICU patients is associated with poor outcome. In 2021 we aimed to assess the feasibility of a randomized controlled trial (RCT) of restrictive IV fluid vs. usual IV fluids.</p><p><strong>Design: </strong>Pilot, parallel-arm, open-label RCT (Australian New Zealand Clinical Trials Registry, ACTRN12621001311842).</p><p><strong>Setting: </strong>Two PICUs in Australia and one in Switzerland.</p><p><strong>Patients: </strong>During 2021-2023, we recruited PICU patients aged younger than 18 years who were expected to be invasively ventilated or were already ventilated for greater than 6 hours.</p><p><strong>Interventions: </strong>Patients were randomly allocated to either a restrictive IV fluid strategy or usual care for 48 hours. The restrictive strategy included lower maintenance fluid, smaller fluid boluses and less drug dilution, and earlier diuretics or peritoneal dialysis.</p><p><strong>Measurements and main results: </strong>Of 1224 eligible patients, 235 parents were approached and 158 consented (i.e., 67%, one child excluded postrandomization; median [interquartile range, IQR] age was 1.3 yr [IQR 0.3, 7.0]), which meant that the trial did not meet the a priori target recruitment rate. The mean ( sd ) number of patients recruited per month was 6.8 ( sd 3.6). None of 80 patients recruited to the restrictive strategy attained a negative fluid balance greater than10% body weight within 24 hours, compared with 5/77 (6%) in the usual care arm. Median fluid balance at 48 hours postrandomization was 11.1 (IQR -13.7, 40.2) and 8.6 mL/kg (IQR -18.7, 38.8) in the restrictive strategy and usual care, respectively. Median survival free of the PICU for restrictive and usual care was, respectively: 25.0 days (IQR 21.3, 26.0) vs. 24.0 days (IQR 22.1, 26.0).</p><p><strong>Conclusions: </strong>This 2021-2023 pilot RCT shows that the restrictive vs. standard fluid management in mechanically ventilated children (REDUCE-1) protocol would not be feasible if extended to a full RCT, as currently designed. Future approaches may require stricter guidance regarding the intervention, or use of bundled care.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"998-1010"},"PeriodicalIF":4.9,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do I Stay or Do I Go?","authors":"Annie Laurie Gula","doi":"10.1097/PCC.0000000000004018","DOIUrl":"https://doi.org/10.1097/PCC.0000000000004018","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing Reliability and Timeliness of Appropriate Genetic Counseling Consultation in the Pediatric Cardiac ICU: Single-Center Quality Improvement Study, 2020-2024.","authors":"Briana L Sawyer, Melanie Emmerson, Jennifer Marietta, Joshua Kawasaki, Brittany Kent, Ivana Grbelja, Judson Moore","doi":"10.1097/PCC.0000000000003955","DOIUrl":"10.1097/PCC.0000000000003955","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiovascular genetics evaluation in the cardiac ICU (CICU) is essential for patient and family care. However, engaging genetic counseling (GC) consultation by frontline care teams in the CICU is challenging. This quality improvement (QI) project aimed to: 1) increase GC consultations for eligible CICU patients, 2) decrease time from admission to consultation, and 3) assess whether changes aligned with parental preferences.</p><p><strong>Design: </strong>Single-center QI study, from January 2020 to June 2024.</p><p><strong>Setting: </strong>Large tertiary care children's hospital in the United States.</p><p><strong>Patient cohort: </strong>Two hundred sixty-five patients with congenital heart defect (CHD).</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>In 2022, we introduced a standardized admission process for admissions with CHD, including: electronic medical record (EMR) notifications, accurate diagnostics, improved referral workflow and collaboration with fetal cardiology clinic, and parent surveys. A before-vs.-after analysis showed an associated increase in GC consultation from 76% to 94%; the mean time from admission to consultation decreased from 6 to 3 days. Post-introduction, there was reduced variability and less delay compared with pre-implementation. A needs assessment survey via a parent-support group had 151 responses, which indicated that 83% of families wanted genetic testing. Sixty-nine percent of families wanted to discuss genetic testing through in-person consultation during their child's initial inpatient admission. Thirty-two percent of families preferred contact as soon as possible and 47% preferred contact before cardiac surgery. Last, 75% of parents with a fetal diagnosis of CHD expressed interest in discussing testing while pregnant.</p><p><strong>Conclusions: </strong>In our pre- vs. post-introduction of a QI intervention, we found that eligible CICU patients are more reliably and promptly identified for GC consultation by leveraging the EMR and partnering with CICU staff and fetal cardiology. Parents supported genetic testing, typically delivered through integrated GC consultations in both the fetal and inpatient settings.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"845-854"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Acute Respiratory Distress Syndrome After Cardiopulmonary Bypass for Congenital Heart Disease Surgery: Postoperative Changes in Endothelial Glycocalyx Degradation.","authors":"Xiu-Hua Chen, Shu-Ting Huang, Jia-Jia Lin, Yi-Rong Zheng","doi":"10.1097/PCC.0000000000003968","DOIUrl":"10.1097/PCC.0000000000003968","url":null,"abstract":"<p><strong>Objectives: </strong>We have investigated postoperative dynamic changes in endothelial glycocalyx (EG) degradation markers in infants who have undergone cardiopulmonary bypass (CPB) for congenital heart disease (CHD) surgery, and related the observations to the development of pediatric acute respiratory distress syndrome (PARDS).</p><p><strong>Design: </strong>Single-center prospective, case-control study, June to December 2024.</p><p><strong>Setting: </strong>Twenty-bed to a pediatric cardiac ICU (CICU) in a tertiary hospital in China.</p><p><strong>Patients: </strong>Overall, 45 infants (age range 121-351 d) undergoing nonemergency CPB for CHD were recruited; 15 with PARDS and 30 matched non-PARDS cases.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>PARDS patients in comparison with non-PARDS patients had higher glycocalyx degradation markers at CICU admission (T 1 ): syndecan-1, 199.2 ± 22.1 vs. 118.6 ± 6.2 ng/mL ( p < 0.05); heparan sulfate (HS), 105.7 ± 11.9 vs. 79.1 ± 6.8 ng/mL ( p < 0.05); and hyaluronic acid (HA), 53.6 ± 10.5 vs. 40.4 ± 4.7 ng/mL ( p < 0.05). Biomarkers were highest at T 1 , fell at postoperative day 1 (T 2 ), and returned to baseline by day 5 (T 3 ) in both groups, with levels consistency higher in PARDS infants. The PARDS group also had longer median duration of mechanical ventilation (48 vs. 24 hr, p < 0.001), CICU stay (7.0 vs. 4.0 d), and hospital stay (18.5 vs. 12.0 d), with T 1 biomarker levels correlated with duration of mechanical ventilation (r = 0.52-0.68) and CICU length of stay (r = 0.61-0.71; all p < 0.05).</p><p><strong>Conclusions: </strong>In CHD infants admitted to the CICU after surgery involving CPB, PARDS cases exhibit an associated EG injury. Monitoring of the peak levels of degradation markers (syndecan-1, HS, and HA) at admission to the CICU may help identify those at most risk of PARDS.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"872-881"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147942273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Adjunctive Train-of-Four Monitoring Using Peripheral Nerve Stimulation on Neuromuscular Blocking Agent Dose in PICU Patients: A Randomized Crossover Study.","authors":"Kawewan Limprayoon, Thakoon Butpech, Suwannee Phumeetham, Thaneeporn Intra, Nutnicha Preeprem, Suvikrom Law","doi":"10.1097/PCC.0000000000003939","DOIUrl":"10.1097/PCC.0000000000003939","url":null,"abstract":"<p><strong>Objective: </strong>Continuous neuromuscular blocking agent (NMBA) infusion is common in the PICU. There are no pediatric trials evaluating the effect of train-of-four (TOF) monitoring on NMBA dosing. We therefore aimed to determine the effect of adjunctive TOF monitoring using peripheral nerve stimulation on NMBA dosing compared with clinical assessment alone in PICU patients.</p><p><strong>Design: </strong>Randomized crossover study (Thai Clinical Trial Registry, TCTR20240328002).</p><p><strong>Setting: </strong>Fourteen-bed general PICU.</p><p><strong>Patients: </strong>Age 30 days to 18 years who received continuous cisatracurium infusion and were expected to continue the infusion for the next 48 hours.</p><p><strong>Interventions: </strong>Patients were randomized to start day-1 intervention with either adjunctive TOF or clinical assessment. Crossover occurred each morning between adjunctive TOF and clinical assessment. On adjunctive TOF day, patients received TOF monitoring, and the results were reported to the clinical team. The clinical team used TOF results together with clinical assessment of the depth of paralysis to adjust cisatracurium dosing on adjunctive TOF day. On the clinical assessment day, patients received TOF monitoring but the results were concealed from the clinical team. The clinical team used only clinical assessment of the depth of paralysis to adjust cisatracurium dosing on the clinical assessment day.</p><p><strong>Measurements and main results: </strong>Pairwise comparison was made between the consecutive adjunctive TOF day and clinical assessment day in the same patient. Sixteen patients completed the study. There were no significant differences on adjunctive TOF day vs. clinical assessment day for total daily cisatracurium dose (median [interquartile range]: 34.0 mg [20.0, 72.8] vs. 35.4 mg [16.8, 59.0], p = 0.87) and for average cisatracurium dose (mean ± sd : 2.36 ± 1.21 vs. 2.41 ± 1.35 µg/kg/min; mean difference -0.06 [95% CI -0.22 to 0.11] µg/kg/min, p = 0.48).</p><p><strong>Conclusions: </strong>Adjunctive TOF monitoring did not lead to significant difference in cisatracurium dosing compared with clinical assessment alone.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"882-890"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-Time Assessment of Factors Impacting Prognostic Predictions After Pediatric Cardiac Arrest: A Single-Center Prospective Study.","authors":"Megan L McSherry, Bingqing Zhang, Lauren Louderback, Aubree Little, Kathleen E Walsh, Craig A Press, Jennifer McGuire, Rebecca Ichord, Matthew P Kirschen, Charlotte Woods-Hill, Alexis Topjian","doi":"10.1097/PCC.0000000000003965","DOIUrl":"10.1097/PCC.0000000000003965","url":null,"abstract":"<p><strong>Objectives: </strong>Children who suffer cardiac arrest are at risk of mortality and morbidity, with survivors often experiencing a severe decline in neurobehavioral function. Despite challenges in neuroprognostication, providers frequently make predictions regarding patient recovery that influence outcomes. We aimed to determine the clinical factors providers report using in real time to predict patient survival and neurologic outcomes at discharge, and how these factors differ by provider and patient characteristics, and time from arrest.</p><p><strong>Design: </strong>Single center prospective observational study.</p><p><strong>Setting: </strong>The Children's Hospital of Philadelphia PICU over 12 months, 2023-2024.</p><p><strong>Patients: </strong>Children resuscitated from in-hospital cardiac arrest and out-of-hospital cardiac arrest (OHCA) who received post-arrest care in the PICU.</p><p><strong>Subjects: </strong>Multidisciplinary providers of post-cardiac arrest patients.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Multidisciplinary team members completed questionnaires on post-arrest days 1, 2, 3, and 7, eliciting demographic data and factors used to form their prediction. Descriptive statistics summarized patient characteristics, provider demographics, and survey data. Mixed-effect models explored changes in factors used for the prediction of patient discharge outcome over survey time points, as well as differences by provider and patient characteristics. Overall, 64 patients (median age, 4.1 yr [interquartile range, 1.2-9.4 yr]; 60% OHCA; and 55% pre-arrest Pediatric Cerebral Performance Category = 1) were analyzed. Five hundred forty-eight questionnaires were completed by 245 unique providers. Across all time points, baseline neurologic function and clinical neurologic examination were the most frequently reported factors used to inform prognosis. Use of intra-arrest factors decreased, while reliance on neuromonitoring and neuroimaging increased over time. Factor use varied by provider discipline and patient and arrest characteristics.</p><p><strong>Conclusions: </strong>Prognostic predictions after pediatric cardiac arrest were dynamic and influenced by both patient characteristics and provider discipline. Future efforts should aim to understand how the integration of patient data impacts prognostic accuracy and clarify how prognostic impressions shape communication and decision-making with caregivers.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"835-844"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13682271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discontinuation of Routine Surveillance Cultures During Extracorporeal Membrane Oxygenation in Pediatric Patients: A Single-Center \"Before Versus After\" Experience, 2022-2025.","authors":"Ethan L Gillett, Chapel N Shults, Ashley L Lynch, Franscesca Miquel Verges, Matthew P Malone","doi":"10.1097/PCC.0000000000003967","DOIUrl":"10.1097/PCC.0000000000003967","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate our \"before vs. after\" change in practice of stopping routine surveillance cultures in pediatric patients supported with extracorporeal membrane oxygenation (ECMO), by examining patient outcomes, reviewing antimicrobial prescription, and costs.</p><p><strong>Design: </strong>Retrospective before vs. after study.</p><p><strong>Setting: </strong>PICU, neonatal ICU, and cardiac ICU in a quaternary children's hospital.</p><p><strong>Patients: </strong>Critically ill patients younger than 18 years supported on ECMO between October 2022 and March 2025.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Patients supported on ECMO in the 12 months following the practice change in March 2024 were compared with the same number of ECMO patients from before the practice change (47 in each group). Removal of routine daily blood culture and every-other-day urine and respiratory culture orders in ECMO order sets was associated with a reduction in cultures obtained: from mean ( sd ) 1.8 (± 0.22) to 0.4 (± 0.19) per ECMO day ( p < 0.0001). We failed to identify an associated change in average ECMO run duration (211 vs. 181 hr; p = 0.48) or 30-day mortality (15/47 vs. 15/47). There was an associated decrease in antimicrobial prescriptions, quantified as a percentage of all ECMO days with prescription: (366/414 [88%] vs. 247/356 [69%]; mean difference, 19% [95% CI of the difference 13-25%]; p = 0.002). We estimate that using 2024 prices, there was a cost reduction of $136,000 in the 12 months following the change in practice.</p><p><strong>Conclusions: </strong>Our experience of introducing in March 2024 a change in using surveillance or scheduled cultures in pediatric ECMO patients in our center is that there was an associated reduction in microbiology cultures, improved antimicrobial stewardship, and cost-savings. In comparison with our experience before the change in practice, we failed to identify any associated negative effects such as increased duration of ECMO support or 30-day survival.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"866-871"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children From Families Speaking Languages Other Than English or Spanish, Medical Complexity and PICU Utilization: Single-Center Retrospective Study, 2015-2022.","authors":"Zachary Pitkowsky, Amanda Warniment, Joelle Kane, Andrew F Beck, Joanna Thomson, Carlie N Myers","doi":"10.1097/PCC.0000000000003964","DOIUrl":"10.1097/PCC.0000000000003964","url":null,"abstract":"<p><strong>Objectives: </strong>Children with medical complexity (CMC) account for a disproportionate share of PICU utilization. Children from families speaking languages other than English (LOE) face barriers that may influence critical-care needs. We sought to evaluate the intersection of language and PICU utilization of CMC.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Large quaternary children's hospital in the United States, from 2015 to 2022.</p><p><strong>Patients: </strong>CMC, defined as having two or more body systems involved in a complex chronic condition (CCC), admitted to a children's hospital. Patient family language categorized as English, Spanish, or languages other than English or Spanish (LOES).</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We identified 3096 unique CMC (54% male) accounting for 9297 hospital encounters (mean age 8.2 yr). Among patient families, 7.2% had a preferred LOE, with 2.7% speaking Spanish and 4.6% speaking LOES. Around one-third (35%) of patients had a PICU admission during at least one encounter. Mixed-effects regressions with patient-specific random effects were used to model associations. LOES was associated with greater odds of PICU admission (adjusted odds ratio 1.58; 95% CI, 1.1-2.2) and longer PICU length of stay (incidence-rate ratio 2.4; 95% CI, 1.7-3.5) after adjusting for age, sex, race, Child Opportunity Index (COI) and the number of CCC.</p><p><strong>Conclusions: </strong>In patients admitted to our children's hospital (2015-2022), the CMC from families speaking a LOES represented a vulnerable subgroup, with associated greater odds of PICU admission and longer stays. These disparities persisted after accounting for CCCs and COI. Timely, language-concordant communication-especially for less common languages-may mitigate aspects of critical care admission in this population.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"825-834"},"PeriodicalIF":4.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13678516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147964391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}