{"title":"A Conversation in the Delivery Room.","authors":"Carlo Bellini","doi":"10.1097/PCC.0000000000003774","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003774","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174419","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}
Madeline J Wozniak, Sarah L Mayer, Jerry J Zimmerman
{"title":"To Give or Not to Give? Corticosteroid Therapy in the Pediatric Cardiac ICU Is the Question.","authors":"Madeline J Wozniak, Sarah L Mayer, Jerry J Zimmerman","doi":"10.1097/PCC.0000000000003767","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003767","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209108","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}
Ashley M Bach, Nicole K McKinnon, Hongming Zhuang, Elizabeth Kaufman, Matthew P Kirschen
{"title":"The authors reply.","authors":"Ashley M Bach, Nicole K McKinnon, Hongming Zhuang, Elizabeth Kaufman, Matthew P Kirschen","doi":"10.1097/PCC.0000000000003766","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003766","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128306","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}
Christopher M Horvat, Johanna R Rosen, Joseph Carcillo
{"title":"The Phoenix Criteria for Pediatric Sepsis.","authors":"Christopher M Horvat, Johanna R Rosen, Joseph Carcillo","doi":"10.1097/PCC.0000000000003762","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003762","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079212","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}
L Nelson Sanchez-Pinto, Colleen M Badke, Linda Pololi
{"title":"Group Peer Mentoring: A Strategy to Promote Career Development and Improve Well-Being Among Early-Career Faculty in Pediatric Critical Care Medicine.","authors":"L Nelson Sanchez-Pinto, Colleen M Badke, Linda Pololi","doi":"10.1097/PCC.0000000000003763","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003763","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079210","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":"\"Just Take the Two Minutes\".","authors":"May Shum","doi":"10.1097/PCC.0000000000003768","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003768","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019556","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":"Point-of-Care Ultrasound in Pediatric Resuscitation? What's All the Rapid Ultrasound for Shock and Hypotension About?","authors":"Sebastian C Tume, Erik Su","doi":"10.1097/PCC.0000000000003761","DOIUrl":"https://doi.org/10.1097/PCC.0000000000003761","url":null,"abstract":"","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047540","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}
Christina R Rufener, Zaineb Boulil, Denise M Suttner, David K Werho, Helen A Harvey, Erica I Bak, Nicole O'Brien, Sapna R Kudchadkar, Nicole G Coufal
{"title":"Extubation Practices and Outcomes During Pediatric Respiratory Extracorporeal Membrane Oxygenation: Analysis of the Extracorporeal Life Support Organization Registry, 2018-2022.","authors":"Christina R Rufener, Zaineb Boulil, Denise M Suttner, David K Werho, Helen A Harvey, Erica I Bak, Nicole O'Brien, Sapna R Kudchadkar, Nicole G Coufal","doi":"10.1097/PCC.0000000000003711","DOIUrl":"10.1097/PCC.0000000000003711","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the outcomes associated with extubation during extracorporeal membrane oxygenation (ECMO) in pediatric patients.</p><p><strong>Design: </strong>Retrospective cohort study using the Extracorporeal Life Support Organization (ELSO) registry, 2018-2022.</p><p><strong>Setting: </strong>Multicenter and international database of all ECMO centers in the ELSO registry.</p><p><strong>Patients: </strong>Patients between 30 days and 18 years old receiving pulmonary ECMO support.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Overall, 2178 patients were included, of which 105 were extubated during ECMO support (4.8%). Analysis of pre-ECMO data failed to identify an association between extubation strategy and severity using the Pediatric Pulmonary Rescue with ECMO Prediction (P-PREP) score. Use of extubation, vs. not, was associated with older age (median, 6.1 vs. 2.5 yr; p = 0.006), and longer ECMO duration (median 12.9 vs. 7.1 d; p < 0.0001). We failed to identify an association between the use of extubation, vs. not, and ECMO complications. In a propensity matching analysis with 3:1 matching of nonextubated to extubated cases, mortality was 34.3% and 43.8%, respectively ( p = 0.08). In the matched subset, extubation, vs. not, was associated with shorter median PICU length of stay (LOS) after decannulation (6.6 vs. 12.2 d; p = 0.001) and higher use of mobilization (28.6% vs. 9.8%; p < 0.0001). In a multivariable analysis, we failed to identify an association between using the extubation strategy, vs. not, and greater odds of mortality (odds ratio, 1.74; 95% CI, 0.94-3.27; p = 0.08). However, we cannot exclude the possibility that the use of an extubation strategy is associated with greater odds of mortality.</p><p><strong>Conclusions: </strong>In the 2018-2022 ELSO registry data, extubating pediatric patients on ECMO for pulmonary cause was an uncommon practice, associated with improved mobility and decreased ICU LOS after ECMO decannulation. However, given the concerns about mortality, careful consideration of patient candidacy and further studies are needed.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e680-e688"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143458811","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}
Benjamin R White, Lee Polikoff, Robin Alexander, Benjamin R Baer, Alexandre T Rotta, Sebastián González-Dambrauskas, Ledys M Izquierdo, Pablo Castellani, Christopher M Watson, Ryan A Nofziger, Steven Pon, Todd Karsies, Steven L Shein
{"title":"Acute Respiratory Distress Syndrome in Children With Lower Respiratory Tract Infection Requiring Invasive Mechanical Ventilation: Post Hoc Analysis of the 2019-2020 Bronchiolitis and Codetection Cohort.","authors":"Benjamin R White, Lee Polikoff, Robin Alexander, Benjamin R Baer, Alexandre T Rotta, Sebastián González-Dambrauskas, Ledys M Izquierdo, Pablo Castellani, Christopher M Watson, Ryan A Nofziger, Steven Pon, Todd Karsies, Steven L Shein","doi":"10.1097/PCC.0000000000003712","DOIUrl":"10.1097/PCC.0000000000003712","url":null,"abstract":"<p><strong>Objectives: </strong>Bronchiolitis and other lower respiratory tract infections (LRTIs) are the most common causes of pediatric respiratory failure. There is insufficient evidence characterizing pediatric acute respiratory distress syndrome (PARDS) in young children with LRTI to inform clinical management. We aimed to describe the prevalence and clinical characteristics of children intubated for LRTI and meeting PARDS criteria.</p><p><strong>Design: </strong>We performed a post hoc analysis of data from the Bronchiolitis And COdetectioN (BACON) study, an international prospective observational study of critical bronchiolitis. We compared PARDS subjects (meeting criteria the first full calendar day following intubation) to non-PARDS subjects.</p><p><strong>Setting: </strong>Forty-eight international PICUs recruiting to the BACON study, from December 2019 to November 2020.</p><p><strong>Patients: </strong>Children younger than 2 years old, requiring mechanical ventilation for acute LRTI.</p><p><strong>Interventions: </strong>None.</p><p><strong>Measurements and main results: </strong>Complete data were available for 571 children. Day 1 PARDS was diagnosed in 240 subjects(42%) and associated with increased mortality (7.9% vs. 2.7%; p = 0.023), greater duration of invasive ventilation (165 hr [interquartile range, 112-251 hr] vs. 135 hr [76-204 hr]; p < 0.001), and PICU length of stay (11 d [7-16 d] vs. 8 d [5-13 d]; p < 0.001). In our multivariable competing risk model, the presence of PARDS on day 1 was causally related to a prolonged duration of mechanical ventilation with the probability of extubation at 7 days for those with PARDS equal to 49% (44-54%) compared with 64% (59-69%) for those without PARDS.</p><p><strong>Conclusions: </strong>PARDS development was common in this critical bronchiolitis cohort, resulted in a longer duration of mechanical ventilation, and was associated with increased mortality and PICU length of stay. Prospective studies are needed to elucidate the optimal management of critical bronchiolitis.</p>","PeriodicalId":19760,"journal":{"name":"Pediatric Critical Care Medicine","volume":" ","pages":"e600-e610"},"PeriodicalIF":4.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143567782","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}