Pediatric Critical Care Medicine最新文献

{"title":"Red Cell Transfusion During Pediatric Intensive Care: A 28-Day Point Prevalence Study in Three European Countries in 2023.","authors":"Laura Butragueño-Laiseca, Samiran Ray, Avishay Sarfatti, Simon J Stanworth, Roi Campos Rodríguez, Ana Gómez-Zamora, Alexandra Hernández Yuste, Isabel Benítez Gómez, Gema de Lama Caro-Patón, Chiara Giorni, Elisabetta Lampugnani, Marco Daverio, Fabrizio Chiusolo","doi":"10.1097/PCC.0000000000003805","DOIUrl":"10.1097/PCC.0000000000003805","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the prevalence of RBC transfusion in children admitted to PICUs in three European countries and to determine hemoglobin threshold, triggers, and outcomes for transfusions.</p><p><strong>Design: </strong>International 4-week point prevalence study in 2023.</p><p><strong>Setting: </strong>Forty-four PICUs across Spain, the United Kingdom, and Italy.</p><p><strong>Patients: </strong>PICU patients 1 month to 17 years old receiving RBC transfusion.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>During four prespecified 7-day blocks (from March 2023 to July 2023), 348 of 2713 patients (12.8%) received at least one RBC transfusion, accounting for 527 transfusions. The proportion of patients receiving RBC transfusion in Italy, the United Kingdom, and Spain was 17.3% (66/382), 13.9% (166/1195), and 10.2% (116/1136), respectively. The primary indication for transfusion in the 527 transfusion events was hemoglobin level (54.6%), followed by bleeding (10.6%), cardiovascular instability (10.5%), and extracorporeal support (10.1%). In 45.1% of RBC transfusions, there was no other physiologic trigger apart from hemoglobin. The median (interquartile range [IQR]) hemoglobin level before transfusion was 8.3 g/dL (IQR, 7.2-9.9 g/dL), with median values varying significantly among Spain, the United Kingdom, and Italy, respectively, 7.8 vs. 8.6 vs. 8.9 g/dL ( p < 0.001). When excluding cardiac patients, overall median hemoglobin threshold was 7.4 g/dL (IQR, 6.8-8.6 g/dL) and was comparable across the three countries ( p > 0.05). The overall 28-day PICU mortality in 348 patients receiving transfusions was 10.7%. The number of transfusions was associated with mortality, even after adjusting for reason for admission and admission Pediatric Index of Mortality score.</p><p><strong>Conclusions: </strong>In 44 European PICUs in 28 days during 2023, 12.8% of critically ill children received one or more RBC transfusions during their PICU stay. Hemoglobin level was the primary determinant for transfusion, often exceeding the recommended 7.0 g/dL threshold. Other clinical triggers are rarely considered. Defining hemoglobin thresholds and adopting a goal-directed transfusion strategies may optimize clinical transfusion practices.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1231-e1241"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795022","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":"Stop the Clot: A Quality Improvement Initiative to Reduce the Rate of Venous Thromboembolism in the PICU.","authors":"Robert Murray, Jordan Brauner, Mike Welty, Jennifer Gauntt, Charles Treinen, Jennifer A Muszynski, Colleen Cloyd, Vilmarie Rodriguez","doi":"10.1097/PCC.0000000000003809","DOIUrl":"10.1097/PCC.0000000000003809","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to reduce the rate of hospital-acquired venous thromboembolism (HA-VTE) in the PICU by 50% from 2.07 to 1.04 venous thromboembolism (VTE) per 1000 patient days by June 2023 and sustain this change for 6 months.</p><p><strong>Design: </strong>Prospective quality improvement project.</p><p><strong>Setting: </strong>The PICU of an urban academic free-standing children's hospital in the United States.</p><p><strong>Patients: </strong>All patients admitted to the PICU between December 2020 and December 2023.</p><p><strong>Interventions: </strong>We identified key drivers including: provider knowledge gaps surrounding VTE risk in our patient population, identification of patients at risk of VTE, the absence of appropriate screening and prevention tools, and central venous line duration and location. These key drivers were each addressed with the most significant intervention being the creation of a simple screening tool to identify and provide thromboprophylaxis recommendations for patients most at risk for developing VTE.</p><p><strong>Measurements and main results: </strong>We identified the monthly occurrence rate of VTE as our outcome measure, the provision of VTE thromboprophylaxis as our process measure and the presence of bleeding events as our balancing measure. The rate of VTE in PICU patients decreased from 2.07 to 1.14 per 1000 patient days. There was an increase in the provision of pharmacologic thromboprophylaxis during our intervention period from 36% to 42% with no change in the rate of mechanical thromboprophylaxis. There were only two instances of clinically relevant non-major bleeding as defined by the International Society of Thrombosis and Haemostasis definition in nonsurgical patients on anti-hemostatic agents during our intervention period. There was a decrease in central venous catheter days from 43% to 31% of PICU patient days during the intervention period.</p><p><strong>Conclusions: </strong>Upon implementing a protocolized screening and prevention tool for VTE, we observed a decreased occurrence of HA-VTE.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1208-e1217"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795023","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":"Old Tool-New Use.","authors":"Robert I Parker","doi":"10.1097/PCC.0000000000003820","DOIUrl":"10.1097/PCC.0000000000003820","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1294-e1295"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001261","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":"Early Rehabilitation Bundle in a Canadian PICU: Cost Analysis of Implementation in 2018-2020.","authors":"Shira Gertsman, Sureka Pavalagantharajah, Lindsey Falk, Sayem Borhan, Kevin Kennedy, Lehana Thabane, Feng Xie, Cynthia Cupido, Karen Choong","doi":"10.1097/PCC.0000000000003806","DOIUrl":"10.1097/PCC.0000000000003806","url":null,"abstract":"<p><strong>Objectives: </strong>First, to determine the resources and costs required to implement an early rehabilitation (ABCDEF) bundle. Second, to compare the impact of the bundle on costs pre- and post-implementation.</p><p><strong>Design and setting: </strong>Cost analysis was conducted as part of an implementation study at McMaster Children's Hospital PICU in 2018-2020.</p><p><strong>Measurements and main results: </strong>Resource estimates for all implementation activities from 2018 to 2020 were calculated from material costs and hours spent by personnel multiplied by wages. PICU and patient-level costs before (from January 2019 to March 2019) and after bundle implementation (from January 2020 to March 2020) were compared using case-costing data. Linear regression was used to analyze log-transformed costs adjusted for age, sex, and severity of illness score. Costs are reported in Canadian dollars (CAD). A total of 907 hours were spent over a 2-year implementation period, at an estimated cost of CAD 50,813. Physicians contributed the most hours, followed by the nurse educator and pharmacist. Material costs were CAD 860. There were 141 patients pre-implementation and 84 patients post-implementation in the analyses. Adjusted mean PICU cost per patient was CAD 17,342 and CAD 20,310, pre- to post-implementation, respectively; mean difference (95% CI) between post- and pre-implementation was 17% higher (95% CI, from 6.3% lower to 46% higher). Adjusted mean pharmacy cost per patient was CAD 834 pre-implementation and CAD 827 post-implementation; mean difference of 0.8% lower post-implementation (95% CI, from 27% lower to 35% higher).</p><p><strong>Conclusions: </strong>Implementation of the ABCDEF bundle requires significant time and collaboration of key stakeholders. There was no impact on PICU or patient costs following bundle implementation, but the period of observation was limited by COVID-19. Future studies should include cost analyses that incorporate longer-term, patient-centered health outcomes to determine whether this intervention is cost-effective.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1198-e1207"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795020","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":"Protocol for a Group-Sequential Two-Stratum Multicenter Open-Label Randomized Clinical Trial of Respiratory Support in Infants With Acute Bronchiolitis: Breathing Assistance in Children With Bronchiolitis (BACHb).","authors":"Isabel Johnson, Katy Bridges, Richard Cleaver, Rayka Malek, Mary Cross, Steve Cunningham, Katrina Cathie, Mark D Lyttle, Rebecca Mitting, Paul Mouncey, Damian Roland, Stephen Turner, Olu Onyimadu, Stavros Petrou, Debra Quantrill, Kate Chadwick, Leila Janani, Padmanabhan Ramnarayan","doi":"10.1097/PCC.0000000000003813","DOIUrl":"10.1097/PCC.0000000000003813","url":null,"abstract":"<p><strong>Objectives: </strong>The Breathing Assistance in Children with bronchiolitis (BACHb) trial aims to evaluate the clinical and cost-effectiveness of high-flow nasal cannula (HFNC) therapy compared with humidified standard oxygen (HSO) in infants with moderate bronchiolitis, and HFNC with continuous positive airway pressure (CPAP) in severe bronchiolitis.</p><p><strong>Design: </strong>Pragmatic, group-sequential, two-stratum, multicenter, open-label randomized clinical trial.</p><p><strong>Setting: </strong>Fifty hospitals across England, Scotland, and Wales.</p><p><strong>Patients: </strong>Hospitalized infants younger than 12 months old with a clinical diagnosis of bronchiolitis, assessed at least twice 15 minutes apart to fulfill criteria for either severe bronchiolitis (one or more of: respiratory rate > 70 breaths/min, grunting, marked chest recession, recurrent short apneas) or moderate bronchiolitis (lack of response to low-flow oxygen, indicated by persistent hypoxemia and/or moderate respiratory distress).</p><p><strong>Interventions: </strong>\"Moderate bronchiolitis stratum\": HFNC at a flow rate of 2 L/kg/min vs. HSO through a facemask or headbox at a flow rate up to 15 L/min. \"Severe bronchiolitis stratum\": HFNC at a flow rate of 2 L/kg/min vs. CPAP pressure set at 6-8 cm H 2 O.</p><p><strong>Measurements and main results: </strong>In each stratum, eligible infants will be randomly allocated on a 1:1 basis to the trial treatments using a web-based system by permuted block randomization, stratified by site of recruitment and age (< 6 wk and ≥ 6 wk). Due to the emergency nature of the treatments, written informed consent will be deferred. The primary outcome is time from randomization to hospital discharge within 30 days. Baseline clinical characteristics and hospital course, including details of respiratory support, and discharge and cost-effectiveness outcomes will be collected. The trial received Health Research Authority and Research Ethics Committee approval from the Yorkshire and The Humber-South Yorkshire Research Ethics Committee on August 3, 2023 (reference: 23/YH/0166). The trial registration is ISRCTN52937119.</p><p><strong>Conclusions: </strong>Trial findings will be disseminated in national and international conferences, in peer-reviewed journals and through social media.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1275-e1285"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12502951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855963","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":"Presence of Families at the Bedside in the PICU: Prospective, Mixed-Methods Study of Race and Insurance Disparities.","authors":"Michelle R Mayeda, Samuel Rosenblatt, Dorene F Balmer, Wynne Morrison, Paula Magee, Veronica Kirchner, Nadir Yehya","doi":"10.1097/PCC.0000000000003808","DOIUrl":"10.1097/PCC.0000000000003808","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether patient race, ethnicity, preferred language, insurance type, and social deprivation index (SDI) are associated with differences in caregiver presence in the PICU and to explore caregiver perspectives on decision-making about time spent at and away from bedside.</p><p><strong>Design: </strong>Single-center prospective, concurrent mixed-methods study including: 1) a quantitative point prevalence study of caregiver bedside presence, and 2) a qualitative study of interviews with caregivers.</p><p><strong>Setting: </strong>Seventy-five-bed PICU in a quaternary children's hospital in Philadelphia, PA.</p><p><strong>Patients: </strong>Over the period 2022-2023, we enrolled: 1) children with anticipated moderate-to-long PICU length of stay and 2) adult caregivers of children in our PICU.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Multivariable regression tested associations between caregiver presence and race, ethnicity, preferred language, insurance type, and SDI. Semi-structured interviews with caregivers were evaluated using thematic analysis. Among 159 subjects, Black patient race relative to White, and public insurance relative to private, were associated with 18 and 10 fewer hours of caregiver presence during a 48-hour period, respectively. Caregivers nearly universally shared a desire to be present, yet the ability to be present was affected by practical limitations, including job flexibility and family availability.</p><p><strong>Conclusions: </strong>Public insurance and Black patient race were associated with decreased caregiver presence, disparities that may be explained by practical limitations. Additional work is necessary to explore ways to mitigate barriers to presence and equitable family-centered care and to investigate potential impacts of caregiver presence on health outcomes.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1253-e1263"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775975","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":"B-Type Natriuretic Peptide in Critically Ill Children: Single-Center Retrospective Study of Levels in the First 72 Hours of PICU Admission and Outcome.","authors":"Yulia Shtanko, Abhinav Totapally, Prithvi Sendi, Balagangadhar R Totapally","doi":"10.1097/PCC.0000000000003812","DOIUrl":"10.1097/PCC.0000000000003812","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1307-e1309"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822194","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":"Development of a Novel Cardiac Arrest Ventilation Rate Metronome: A Human Factors and Implementation Science Mixed-Methods Approach.","authors":"Amanda O'Halloran, James Sannino, Cheryl Dominick, Christine Bailey, Lori Boyle, Lindsay N Shepard, Vinay Nadkarni, Heather Wolfe, Ryan W Morgan, Akira Nishisaki, Meghan Lane-Fall, Robert Sutton","doi":"10.1097/PCC.0000000000003811","DOIUrl":"10.1097/PCC.0000000000003811","url":null,"abstract":"<p><strong>Objectives: </strong>Excessive ventilation adversely affects cardiopulmonary resuscitation (CPR) hemodynamics and outcomes. Pediatric providers rarely achieve guideline-recommended CPR ventilation rates. We aimed to use human factors engineering to design a metronome to improve compliance with recommended CPR ventilation rates. We hypothesized that in usability testing, our novel metronome would achieve: 1) a System Usability Scale (SUS) score greater than 68 and 2) greater than 70% of CPR epochs with ventilation rates within target range, which would be sufficient to support a pilot trial in our PICU.</p><p><strong>Design: </strong>Prospective single-center mixed-methods study.</p><p><strong>Setting: </strong>Seventy-five-bed academic PICU.</p><p><strong>Participants: </strong>Multidisciplinary clinicians.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>We elicited clinician feedback on the proposed ventilation rate metronome with a survey. Participatory design sessions determined optimal metronome components. During high-fidelity simulation usability testing, we collected qualitative and quantitative measures reflecting participant feedback and performance. Average ventilation rates were calculated during 30-second epochs of CPR, with average rates ± 2 breaths/min (bpm) from the target considered to be within goal range. Among 107 survey respondents, perceptions of appropriateness, acceptability, and feasibility of the ventilation rate metronome were favorable. The final prototype used a bell sound for high saliency in noisy environments and a scrolling timed vertical bar, with pre-set options for three guideline-recommended CPR ventilation rates (infants: 30 bpm, children 1-17 yr old: 20 bpm, adults: 10 bpm). In usability testing (three groups, 34 clinicians), median SUS was 92.5 of 100 (interquartile range, 89.4-93.1), with 0 attributable errors. Overall, 34 of 36 (94% [95% CI, 81-99%]) epochs of simulated CPR with metronome use had ventilation rates ± 2 bpm from the target rate.</p><p><strong>Conclusions: </strong>Utilizing human factors engineering and implementation science, we successfully designed a novel ventilation rate metronome. When deployed during high-fidelity cardiac arrest simulations, metronome use had high usability scores and resulted in excellent compliance with recommended ventilation rates.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1264-e1274"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855962","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":"Nutritional Status and Mechanical Ventilation Practices in Pediatric Acute Respiratory Distress Syndrome: A Secondary Analysis of the 2017-2023 PARDSAsia Study.","authors":"Chen Yun Goh, Karen Ka Yan Leung, Jia Yueh Chong, Xuemei Zhu, Nattachai Anantasit, Lijia Fan, Chunfeng Liu, Louise Ngu, Kam Lun Ellis Hon, Jan Hau Lee, Wei Xu, Hiroshi Kurosawa, Dyah Kanya Wati, Rujipat Samransamruajkit, Li Huang, Muralidharan Jayashree, Yek Kee Chor, Hongxing Dang, Chin Seng Gan, Kah Min Pon, Chian Wern Tai, Phuc Huu Phan, Kazunori Aoki, Felix Liauw, Soo Lin Chuah, Suparyatha Ida Bagus Gede, Pei Chuen Lee, Jacqueline Soo May Ong, Siew Wah Lee, Chengsi Ong, Rehena Sultana, Judith Ju-Ming Wong","doi":"10.1097/PCC.0000000000003807","DOIUrl":"10.1097/PCC.0000000000003807","url":null,"abstract":"<p><strong>Objectives: </strong>In this non-prespecified secondary analysis of the PARDSAsia (NCT04068038) 2017-2023 dataset, we describe baseline nutrition status of children with pediatric acute respiratory distress syndrome (PARDS) and determine its association with positive end expiratory pressure (PEEP) during ventilation and mortality. We hypothesized that abnormal nutritional status was associated with adverse outcomes.</p><p><strong>Design: </strong>The dataset included anthropometric and nutritional data, and body mass index (BMI) z scores were obtained using the World Health Organization standards. Underweight is BMI z score less than -1 and overweight is BMI z score greater than +1. PEEP and F io2 combinations, by the standard grid, in underweight, overweight and normal nutrition groups were compared. Cox proportional hazard regression tested the association between nutrition status and 60-day mortality.</p><p><strong>Setting: </strong>Twenty-one PICUs across Asia, 2017-2023.</p><p><strong>Patients: </strong>PARDSAsia patients met the 2015 International Guidelines for the Diagnosis and Management of PARDS (PALICC) criteria.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Overall, of 693 PARDSAsia patients, we included 625 cases comprising 261 of 625 (41.8%) underweight, 235 of 625 (37.6%) normal, and 129 of 625 (20.6%) overweight patients. Being underweight compared with normal or overweight status, was associated with younger median (interquartile range) age: respectively, 1.0 (0.3, 3.7) vs. 1.4 (0.5, 4.6) vs. 1.9 (0.7, 8.5) years ( p < 0.001). The prescription of PEEP was more conservative in patients who were underweight compared with patients of normal or overweight nutritional status: PEEP/F io2 combinations were, respectively, -1.7 (-3.3, 0.0) vs. -0.9 (-2.7, 0.0) vs. -0.6 (-1.8, 0.4) cm H 2 O below recommended grid value ( p < 0.001). Underweight nutritional status was associated with greater risk of 60-day mortality (adjusted hazard ratio 1.85 [95% CI, 1.14-3.01]).</p><p><strong>Conclusions: </strong>Underweight nutritional status was prevalent among children within the PARDSAsia 2017-2023 dataset and was associated with poor clinical outcomes. The prescription of PEEP was more conservative in underweight patients compared with those with normal or overweight status.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1242-e1252"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789637","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":"Isolated Moderate Pediatric Traumatic Brain Injury in Japan, 2019-2024.","authors":"Shu Utsumi, Nobuaki Shime","doi":"10.1097/PCC.0000000000003817","DOIUrl":"10.1097/PCC.0000000000003817","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e1310-e1311"},"PeriodicalIF":4.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001204","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}