Pediatric Critical Care Medicine最新文献

{"title":"Thank You, Mom.","authors":"Naoki Fujiwara","doi":"10.1097/PCC.0000000000004013","DOIUrl":"10.1097/PCC.0000000000004013","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1340-1341"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295771","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":"PedSep Steps a Tango.","authors":"Colleen M Badke, Jerry J Zimmerman","doi":"10.1097/PCC.0000000000004037","DOIUrl":"10.1097/PCC.0000000000004037","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1322-1324"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766473","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":"Ethical Dilemmas in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Qualitative Study of Interprofessional Perspectives.","authors":"Maneesha Limaye, Meagan E Peterson, Sabrina Derrington, Claudia Mueller, Peggy K Han","doi":"10.1097/PCC.0000000000004006","DOIUrl":"10.1097/PCC.0000000000004006","url":null,"abstract":"<p><strong>Objectives: </strong>Interprofessional perspectives on the ethical dilemmas associated with pediatric extracorporeal cardiopulmonary resuscitation (ECPR) are underexplored in the literature. In this study we aimed to explore interprofessional perspectives on pediatric ECPR and the ethical dilemmas encountered by healthcare teams.</p><p><strong>Design: </strong>Descriptive, exploratory, qualitative study using semi-structured interviews.</p><p><strong>Setting: </strong>Noncardiac PICU at a quaternary care academic center in the United States.</p><p><strong>Participants: </strong>Fifteen pediatric providers from general surgery, noncardiac intensive care, and perfusion.</p><p><strong>Intervention: </strong>None.</p><p><strong>Measurements and main results: </strong>Semi-structured interviews were conducted between December 2022 and April 2023. Interviews were audio recorded and professionally transcribed verbatim. Using a constructivist grounded theory approach, interviews were coded by an interprofessional team using qualitative software. Interviewing continued until thematic saturation was reached. Codes were organized into common themes using the constant comparative method and discussed in iterative multidisciplinary meetings. Themes were analyzed through a virtues-based ethical framework to better characterize the ethical motivations guiding professional perspectives. We identified five major themes, including 1) informed consent; 2) decision-making authority; 3) past experiences; 4) end-of-life care; and 5) resource allocation.</p><p><strong>Conclusions: </strong>In this single-center study carried out 2022-2023, we explored interprofessional perspectives on the ethical complexities in pediatric ECPR. Viewing these themes through a virtues-based ethical perspective may offer a structured approach to facilitate team dialogue. Further research is needed to determine whether this approach influences clinical decision-making and impacts team alignment.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1278-1286"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148331990","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":"Three Waxberries.","authors":"Caifang Xu","doi":"10.1097/PCC.0000000000004012","DOIUrl":"10.1097/PCC.0000000000004012","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1338-1339"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148308865","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 and Validation of Temperature Trajectory-Based Phenotypes in Pediatric Sepsis: A Multicenter Retrospective Cohort Study, 2012-2018.","authors":"Stephanie R Brown, L Nelson Sanchez-Pinto, Jocelyn R Grunwell, Xiao Hu, Craig M Coopersmith, Mihir R Atreya, Colin M Rogerson, Alon Geva, Tellen D Bennett, Grace Chong, Sareen S Shah, Mark W Hall, Sivasubramanium V Bhavani","doi":"10.1097/PCC.0000000000004031","DOIUrl":"10.1097/PCC.0000000000004031","url":null,"abstract":"<p><strong>Objectives: </strong>Sepsis is a heterogeneous syndrome resulting from a complex interaction between the infectious agent and the host response. In adults with sepsis, longitudinal temperature measurements have been used to identify phenotypes with distinct clinical characteristics, immune profiles, and outcomes. Our objective was to develop and validate temperature trajectory-based phenotypes in critically ill children with sepsis. We hypothesized that the temperature trajectory-based phenotypes would be independently associated with clinical outcomes.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Setting: </strong>A total of 13 PICUs in the United States from January 1, 2012, to January 1, 2018.</p><p><strong>Patients: </strong>Children (age 0-18 y) with community-acquired sepsis meeting Phoenix sepsis criteria admitted to a PICU directly or via an emergency department, who survived to 24 hours and had greater than or equal to 4 temperature measurements in the first 24 hours of admission were included.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>A total of 11,566 patients met all criteria for study inclusion. A total of 2327 patients (20%) developed the primary outcome of persistent multiple organ dysfunction syndrome (MODS) assessed at day 7 of admission. We used group-based trajectory modeling to identify temperature trajectory-based phenotypes. Three groups were identified: \"hyperthermic\" (35%), \"normothermic\" (59%), and \"hypothermic\" (6%), which were reproducible and had similar outcomes on a validation set. The \"hypothermic\" trajectory-based phenotype group had the highest odds of persistent MODS odds ratio (OR), 5 (95% CI, 4-6), and ICU mortality OR, 11 (95% CI, 9-15). In an exploratory analysis, hypothermia (< 35°C) at the time of PICU admission was also associated with persistent MODS and ICU mortality. The association between \"hypothermic\" trajectory-based phenotype and poor outcome remained after adjusting for hypothermia at admission, severity of illness, age, and technology dependence.</p><p><strong>Conclusions: </strong>We developed and validated temperature trajectory-based phenotypes of pediatric sepsis in a large multicenter cohort. The \"hypothermic\" trajectory-based phenotype was independently associated with worse clinical outcomes.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1215-1223"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808875","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":"Collaborative General Practitioner Shared Care Versus Self-Directed Care Following Critical Illness in Young Children: A Pilot Hybrid Effectiveness-Implementation Randomized Controlled Trial.","authors":"Debbie A Long, Zephanie Tyack, Lori Anthony, Belinda Dow, Leigh Dunn, Renate Le Marsney, Trang M T Pham, James Best, Kerri-Lyn Webb, Helen Liley, Christian Stocker, Debra Thoms, Luregn J Schlapbach, Charlotte Moore, Paula Lister, Samudragupta Bora, Kristen Gibbons","doi":"10.1097/PCC.0000000000004024","DOIUrl":"10.1097/PCC.0000000000004024","url":null,"abstract":"<p><strong>Objectives: </strong>Up to one in three PICU survivors experience persistent developmental or psychologic challenges, and parents often report significant psychologic distress. Current health systems lack standardized pathways to support children and families after PICU. We aimed to assess the feasibility of a randomized controlled trial (RCT) of a collaborative general practitioner (GP) shared-care follow-up model of care intervention and the feasibility, acceptability, and appropriateness of the intervention.</p><p><strong>Design: </strong>Multicenter, pilot, hybrid effectiveness-implementation study with parallel RCT. Trial registration: Australian and New Zealand Clinical Trials Registry, ACTRN12621000799853, June 24, 2021.</p><p><strong>Setting: </strong>Two PICUs in Queensland, Australia.</p><p><strong>Participants: </strong>Parents of children admitted to PICU from ages 2 months or older to younger than 4 years.</p><p><strong>Interventions: </strong>Participants were randomized (1:1, web-based block randomization schedule) to 6 months of GP shared care (intervention) or self-directed care (active control).</p><p><strong>Measurements and main results: </strong>The primary outcome was trial feasibility. Secondary effectiveness and implementation outcomes included child neurodevelopmental vulnerability and parent psychosocial outcomes at 6 months and parental perception of the feasibility, acceptability, and appropriateness of the intervention, respectively. Between October 2021 and March 2023, 154 of 363 eligible parents (one per family) provided consent (42%); 69 were randomized to the intervention, and 72 to active control. Most parents were mothers (95%), 31-40 years old (54%), from metropolitan areas (72%). Children were predominantly male (64%), younger than 12 months old (41%), admitted for respiratory illness (39%). Retention (81%), fidelity (96%), and intervention acceptability was high (71-86%), but recruitment was low (42%) and intervention feasibility varied (35-82%). At 6 months, neurodevelopmental vulnerability rates were similar (shared care [39%] vs. active control [44%]; adjusted odds ratio (aOR), 0.72 [95% CI, 0.32-1.60]). Parenting stress was lower in the intervention group (median, 20 [interquartile range (IQR), 12-47]) vs. active control (median, 42 [IQR, 19-66]; difference, -23 [95% CI, -40 to -6]).</p><p><strong>Conclusions: </strong>A trial of a collaborative GP-shared-care model of care post-PICU is feasible and may reduce parenting stress. Further intervention refinement and a larger trial are warranted to evaluate clinical effectiveness, implementation, and scalability.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1308-1321"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819291","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":"Peripheral IV Versus Extended Dwell Catheter Longevity in the PICU: Single-Center Retrospective Cohort, 2023-2024.","authors":"Olivier Cusson, Stephen A Kutcher, Anne Tsampalieros, Dayre McNally","doi":"10.1097/PCC.0000000000004044","DOIUrl":"10.1097/PCC.0000000000004044","url":null,"abstract":"<p><strong>Objectives: </strong>To review the longevity of extended dwell catheters (EDCs) vs. peripheral IV catheters (PIVs) in pediatric critical care and explore factors associated with catheter duration.</p><p><strong>Design: </strong>Retrospective cohort study between September 2023 and August 2024.</p><p><strong>Setting: </strong>A single mixed cardiac and general PICU in an academic health care center in Ottawa, Canada.</p><p><strong>Patients: </strong>A total of 400 vascular access catheters were included, comprising 329 PIVs and 71 EDCs in 238 unique patients.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Median (interquartile range [IQR]) unadjusted catheter dwell times were 4.6 days (IQR, 2.8-7.9 d) for EDCs and 2.3 days (IQR, 1.2-4.1 d) for PIVs. In an adjusted mixed-effects multivariable regression model, EDCs as opposed to PIVs were associated with 62% greater longevity (1.62 [95% CI, 1.10-2.37]). Factors associated with increased longevity included use of upper limb location (1.49 [95% CI, 1.07-2.07]) and sedation combined with acute invasive mechanical ventilation (2.12 [95% CI, 1.47-3.05]). A sensitivity analysis of only failed devices failed to identify an associated increase or decrease in longevity for EDCs (1.38 [95% CI, 0.80-2.37]), but close inspection of the estimate and upper limit of the 95% CI shows that we are unable to exclude the possibility of more than doubling of longevity. We also failed to demonstrate an association between the proportion of catheters still functional at the time of removal and catheter type: PIV, 26% (95% CI, 21-31%) vs. EDC, 30% (95% CI, 20-42%).</p><p><strong>Conclusions: </strong>In our center, 2023-2024, use of EDCs as opposed to PIVs in PICU cases was associated with longer duration of use, suggesting preferred use of EDCs in patients requiring medium-term IV access, but not meeting criteria for central access. Further prospective studies are necessary to evaluate broader use of EDCs and optimum insertion practices.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1299-1307"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891465","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":"Validation of SeptiCyte RAPID to Discriminate Sepsis From Noninfectious Systemic Inflammation in Critically Ill Children.","authors":"Jerry J Zimmerman, Sainath Raman, Warwick W Butt, Silvia Cermelli, Roy F Davis, Elizabeth Y Killien, Shane George, Kristen S Gibbons, Adam D Irwin, Krupa A Navalkar, Thomas D Yager, Florian H Zapf, Lachlan J M Coin, Luregn J Schlapbach, Richard B Brandon","doi":"10.1097/PCC.0000000000004027","DOIUrl":"10.1097/PCC.0000000000004027","url":null,"abstract":"<p><strong>Objectives: </strong>Biomarkers with adequate precision to rule-in/rule-out sepsis in children represent an unmet need. SeptiCyte RAPID is a point-of-care, U.S. Food and Drug Administration-cleared, host gene expression biomarker test for the determination of sepsis probability (reported in 1 hr as a SeptiScore) using a small-volume peripheral blood sample. We have previously reported on SeptiCyte RAPID performance in adults. Here we report a retrospective, noninterventional clinical validation study of SeptiCyte RAPID, as a sepsis diagnostic adjunct in children.</p><p><strong>Design, setting, and patients: </strong>Critically ill children ( n = 284), 1 month to 18 years old, admitted to PICUs, with or without suspected or documented infection, but all of whom met criteria for systemic inflammatory response syndrome (SIRS) and were enrolled at multiple clinical sites in the United States and Australia in four separate studies.</p><p><strong>Interventions: </strong>None; SeptiCyte RAPID results were not used to guide patient treatment.</p><p><strong>Measurements and main results: </strong>A combination of clinical adjudication and an independent panel of three physicians (Retrospective Physician Diagnosis [RPD]), blinded to SeptiCyte RAPID results, were used to retrospectively categorize patients into sepsis vs. noninfectious SIRS categories. Diagnostic performance of SeptiCyte RAPID for differentiating sepsis and noninfectious SIRS compared with RPD was measured using area under the curve (AUC), likelihood ratio, and a monotonic increase in probability of sepsis and increasing SeptiScores. Binomial logistic regression analysis was used to integrate clinical parameters in a model based on SeptiCyte RAPID. Higher SeptiScores correlated with higher probability of sepsis. SeptiCyte RAPID AUC for identifying sepsis in children ranged from 0.80 to 0.83. A model additionally integrating lactate, platelet number, mean arterial pressure, Pa co2 , mechanical ventilation, weight, age, and leukocyte count increased SeptiCyte RAPID performance (AUC, 0.86; 95% CI, 0.85-0.87).</p><p><strong>Conclusions: </strong>SeptiCyte RAPID demonstrated similar performance characteristics in children to that previously reported for adults. Additional real world effectiveness studies are warranted to determine real-time clinical utility, patient benefits, and health economic impact.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1195-1206"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685622","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":"Prevalence of Acute Kidney Injury and Its Association With Outcomes in Children With Severe Traumatic Brain Injury: A Secondary Exploratory Analysis of the 2014-2017 \"Approaches and Decisions for Acute Pediatric Traumatic Brain Injury\" Study.","authors":"Ryan L DeSanti, Mohamed Almuqamam, Mona Faramawy, Anna M Janas, Tara M Neumayr, Dana Y Fuhrman, Ayse Akcan-Arikan, Michael J Bell","doi":"10.1097/PCC.0000000000004004","DOIUrl":"10.1097/PCC.0000000000004004","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with severe traumatic brain injury (TBI) are at risk of developing nonneurologic organ dysfunction. Acute kidney injury (AKI) has been associated with morbidity and mortality in adults with TBI, but the prevalence in children is poorly described. The objective of this study was to determine the prevalence of AKI among a multiinstitutional, international cohort of children with severe TBI and to explore the association of AKI with outcomes.</p><p><strong>Design: </strong>An unplanned, secondary exploratory analysis of the Approaches and Decisions for Acute Pediatric TBI (ADAPT) study.</p><p><strong>Setting: </strong>Fifty-one institutions participating in ADAPT.</p><p><strong>Patients: </strong>Children with severe TBI who underwent intracranial pressure monitoring and were admitted to a participating institution from 2014 to 2017.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>AKI was considered to have occurred when a patient met either the ADAPT definition of AKI or the Kidney Disease: Improving Global Outcomes (KDIGO) AKI criteria. The daily urine output and worst creatinine within the first 12 hours of admission were reviewed to determine who met KDIGO criteria. One thousand children were included and 160 children (16%) had AKI. Of these, stage 1 AKI occurred in 78 of 160 patients (48%), stage 2 in 65 of 160 patients (41%), and stage 3 AKI in 17 of 160 patients (11%). After adjusting for covariates in regression analyses, AKI was associated with an increase in hospital length of stay (LOS) and a worse Glasgow Outcome Scale Extended-Pediatrics score, but we failed to identify an association with longer PICU LOS or prevalence of mortality.</p><p><strong>Conclusions: </strong>In the ADAPT cohort, AKI was present in 16% of cases. Although we found an association between AKI and two clinically important secondary outcomes, more contemporary studies are needed to better characterize AKI in children with severe TBI and to determine whether strategies aimed at preventing AKI can improve patient-centered outcomes.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1254-1265"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362024","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":"Lung Superimposed Pressure in Pediatric Acute Respiratory Distress Syndrome: Single-Center Study, 2014-2024.","authors":"Lorenzo Ball, Matilde Maxenti, Alberto Giardina, Simon Corrado Serafini, Maria Beatrice Damasio, Rocco Grillo, Nicolò Patroniti, Maurizio Cereda, Nadir Yehya, Andrea Moscatelli","doi":"10.1097/PCC.0000000000004003","DOIUrl":"10.1097/PCC.0000000000004003","url":null,"abstract":"<p><strong>Objectives: </strong>Superimposed pressure (SP) is the hydrostatic pressure compressing dependent lung regions and is a major determinant of dorsal collapse in adult patients with acute respiratory distress syndrome (ARDS). CT studies clarify its role in determining the need for positive end-expiratory pressure (PEEP) in ARDS. We therefore aimed to describe SP in pediatric ARDS (pARDS) and assess its associations with anthropometric, clinical, and quantitative CT parameters.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Urban academic tertiary care children's hospital in Italy.</p><p><strong>Patients: </strong>All children with pARDS undergoing noncontrast chest CT between 2014 and 2024 compared with age-matched control patients with normal lung findings undergoing chest CT.</p><p><strong>Measurements and main results: </strong>We included 12 pARDS patients and 24 controls. Quantitative CT analysis was used to measure lung aeration and the SP in 10 ventral-to-dorsal regions. The median (interquartile range [IQR]) SP increased from ventral to dorsal in both groups but was higher in pARDS patients: (dorsal SP, 5.9 cm H 2 O [IQR, 4.4-7.5 cm H 2 O] vs. 3.0 cm H 2 O [IQR, 2.4-4.0 cm H 2 O]; p < 0.001). Compared with controls, we found that pARDS patients had higher lung weight, lower gas/tissue ratio, and less normally aerated tissue. In pARDS patients, SP correlated with chest circumference (ρ = 0.60; p = 0.043), lung weight (ρ = 0.76; p = 0.006) and inversely with normally aerated tissue (ρ = -0.72; p = 0.011). We failed to identify a relationship between SP and oxygenation indices.</p><p><strong>Interventions: </strong>None.</p><p><strong>Conclusions: </strong>SP in pARDS is lower and more variable compared with descriptions in adult patients with ARDS and is both affected by disease severity and chest size. We failed to identify an association between oxygenation indices and SP, which raises concerns about titrating PEEP based on oxygenation targets alone. Further studies are needed to confirm and integrate these in pARDS.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"1244-1253"},"PeriodicalIF":4.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362100","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}