Journal of Pediatric Intensive Care最新文献

{"title":"Inborn Errors of Metabolism in Pediatric Intensive Care Unit: Much More to Understand.","authors":"Puspraj Awasthi, Suresh Kumar Angurana","doi":"10.1055/s-0041-1731022","DOIUrl":"https://doi.org/10.1055/s-0041-1731022","url":null,"abstract":"We read with interest the recently published article titled “ Inborn Errors of Metabolism in a Tertiary Pediatric Intensive Care Unit ” by Lipari et al 1 and want to make few important comments. Authors enrolled 65 cases of inborn errors of metabolism (IEMs) with 88 admission to a pediatric intensive care unit (PICU) in Portugal over a period 11 years (2009 – 2019) accounting for 2% of PICU admissions. The children with intoxication disorders, energy metabolism defects, complex molecules, and other disorders accounted for 35.4% ( n ¼ 23), 32.3% ( n ¼ 21), 26.2% ( n ¼ 17), and 6.1% ( n ¼ 4), respectively. The median age at admission to PICU was 3 years (range: 3 days – 21 years) and 70.4% ( n ¼ 62) admissions were for metabolic decompensation and 29.5% ( n ¼ 26) were elective/scheduled surgery/procedure admissions. The reasons for decompensation included infections (55.4%, n ¼ 36) and metabolic stress during neonatal period (18.7%, n ¼ 12). The common clinical presentations were respiratory failure (34.1%, 30/88) and neurological deterioration (29.5%, 26/88). The treatment included mechanical ventilation ( n ¼ 30), continuous venovenous hemodia fi ltration (CVVHDF) ( n ¼ 16), speci fi c nutritional management, and supportive care. The median duration of PICU stay was 3.6 days (range:","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9649296/pdf/10-1055-s-0041-1731022.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9965902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Slow and Steady: Optimizing Intensive Care Unit Treatment Weans for Children with Chronic Critical Illness","authors":"R. Troch, Alexandra Lazzara, Flora N. Yazigi, Carly E. Blatt, Avery W. Zierk, B. Chalk, L. Prichett, Sofia Perazzo, K. Rais-Bahrami, R. Boss","doi":"10.1055/s-0043-1763256","DOIUrl":"https://doi.org/10.1055/s-0043-1763256","url":null,"abstract":"Abstract Pediatric chronic critical illness (PCCI) is characterized by prolonged and recurrent hospitalizations, multiorgan conditions, and use of medical technology. Our prior work explored the mismatch between intensive care unit (ICU) acute care models and the chronic needs of patients with PCCI. The objective of this study was to examine whether the number and frequency of treatment weans in ICU care were associated with clinical setbacks and/or length of stay for patients with PCCI. A retrospective chart review of the electronic medical record for 300 pediatric patients with PCCI was performed at the neonatal intensive care unit, pediatric intensive care unit, and cardiac intensive care unit of two urban children's hospitals. Daily patient care data related to weans and setbacks were collected for each ICU day. Data were analyzed using multilevel mixed multiple logistic regression analysis and a multilevel mixed Poisson regression. The patient-week level adjusted regression analysis revealed a strong correlation between weans and setbacks: three or more weekly weans yielded an odds ratio of 3.35 (95% confidence interval [CI] = 2.06–5.44) of having one or more weekly setback. There was also a correlation between weans and length of stay, three or more weekly weans were associated with an incidence rate ratio of 1.09 (95% CI = 1.06–1.12). Long-stay pediatric ICU patients had more clinical setbacks and longer hospitalizations if they had more than two treatment weans per week. This suggests that patients with PCCI may benefit from a slower pace of care than is traditionally used in the ICU. Future research to explore the causative nature of the correlation is needed to improve the care of such challenging patients.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77080282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prophet Isa's (Alayhi As-Salam) Miracle of \"Bringing the Dead into Life\": A Message to Intensivists.","authors":"Hüseyin Çaksen","doi":"10.1055/s-0042-1758746","DOIUrl":"10.1055/s-0042-1758746","url":null,"abstract":"One-hundred and twenty-four thousand prophets came from the first Prophet Adam (Alayhi As-Salam [AS]), the first man, to the last Prophet Muhammad (Salla Allahu Alayhi Wa Sallam [SAW]).1 The Prophet Isa (AS) is one of the five greatest (ulul-azm) prophets. The others are Nuh (AS), Ibrahim (AS), Musa (AS), and Muhammad (SAW).2 Jesus (Isa) is the prophet who is mentioned as Isa, Ibn Maryam, and Messiah in the Quran, who is given the Bible, who is reported to give the good news of Muhammad (SAW), who is described as “a spirit and word from Allah,” but who is emphasized as a servant. Isa (AS) performed many miracles, such as resurrecting the dead by Allah’s leave. He resurrects Lazarus, who was dead 4 days ago.3 The prophets’ miracles were mentioned in the Quran, so that people imitate these miracles and make similar ones. Herein, we discussed the Prophet Isa’s (AS) the miracle of “bringing the dead into life” from the Islamic perspective to emphasize that Isa (AS) addressed today’s intensivists with this miracle. The All-Wise Quran sends the prophets to man’s communities as leaders and vanguards of spiritual and moral progress. Similarly, it gives all of them several wonders and makes them the masters and foremen in regard to mankind’s material progress, and commands men to follow them absolutely. Thus, just as by speaking of the spiritual and moral perfections of the prophets, it is encouraging people to benefit from them, so too in discussing their miracles it is inferring encouragement to achieve similar things and to imitate them. It may even be said that like spiritual and moral attainments, material attainments and wonders were first given to mankind as a gift by the hand of miracles.1 The Quran says about Isa’s (AS) miracles as follows: “I (Isa) heal those born blind, and the lepers, and I (Isa) bring the dead into life, by Allah’s leave.”4,5Nursi1 interpreted this ayat as follows: Just as the Quran explicitly urges man to follow Isa’s (AS) high morals, so it allusively encourages him toward the elevated art and dominical medicine of which Isawas the master. The ayat indicates the following: “Remedies may be found for even themost chronic ills. Inwhich case, Oman!, O calamity-afflicted sons of Adem (AS)! Don’t despair! Whatever the ill, its cure is possible. Search for it and you will find it. It is even possible to give a temporary tinge of life to death.”And in meaning Almighty Allah is saying through the figurative tongue of this ayat: “Oman! I gave two gifts to one of My servants who abandoned the world for Me. One was the remedy for spiritual ills, and the other the cure for physical sicknesses. Moribund hearts were raised to life through the light of guidance, and sick people who were as though dead found health through his breath and cure. You too may find the cure for every ill in the pharmacy of My wisdom. Work to find it! If you seek, you will certainly find.” Thus, this ayat traces the limit that is far ahead of man’s present progr","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9894687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10644531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemodynamic and Oximetric Response to Sodium Bicarbonate Boluses in Children with Single Ventricle Parallel Circulation: A Retrospective, Single-Center Study","authors":"F. Savorgnan, S. Flores, Rohit S. Loomba, Sebastián Acosta","doi":"10.1055/s-0043-1762911","DOIUrl":"https://doi.org/10.1055/s-0043-1762911","url":null,"abstract":"Abstract The aim of the study was to evaluate the hemodynamic and oximetric changes in patients with parallel circulation (Norwood, hybrid, and BT-shunted) after sodium bicarbonate bolus administration. This study was a retrospective analysis of physiologic data. To eliminate confounders, sodium bicarbonate boluses concurrently administered with normal saline, 5% albumin, epinephrine boluses, blood transfusions, change in vasoactive inotropic score or mechanical circulatory support were excluded. Blood pressure, arterial oxygen saturation, heart rate (HR), and cerebral and renal near infrared spectroscopy were continuously recorded from 1-hour pre to 1-hour post each intervention. Out of 429 boluses, 293 boluses met the inclusion criteria. Measurements show an increase in blood pressure ( p  = 0.01) and HR ( p  < 0.01), and a decrease in pulmonary-to-systemic flow ratio ( p  = 0.02) and renal oxygen extraction ratio (rOER) ( p  = 0.04) at some point during the first hour postbolus. The arterial oxygen saturation increased, and the rOER decreased for those patients with pre-bolus pH < 7.20 and/or pre-bolus serum bicarbonate level < 18 mEq/L, according to linear regression models ( p  < 0.05). Sodium bicarbonate was associated with improvement of hemodynamic and oximetric parameters in this cohort, particularly for those patients with pH < 7.20 and/or serum bicarbonate level < 18 mEq/L. This finding is consistent with an increase in cardiac output due to the removal of the acidotic negative inotropic effect by the sodium bicarbonate.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88469738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted Article: The Spiritual Dimension of Death: A Mini Review.","authors":"Hüseyin Çaksen","doi":"10.1055/s-0042-1758739","DOIUrl":"10.1055/s-0042-1758739","url":null,"abstract":"","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11196129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76562292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Presepsin as a Biomarker of Sepsis in Children: A Systemic Review and Meta-Analysis","authors":"D. Khera, Nisha Toteja, Simranjeet Singh, Siyaram Didel, Kuldeep Singh, A. Chugh, Surjit Singh","doi":"10.1055/s-0042-1758479","DOIUrl":"https://doi.org/10.1055/s-0042-1758479","url":null,"abstract":"\u0000 Objectives Biomarkers in sepsis are an arena of avid research as they can facilitate timely diagnosis and help reduce mortality. Presepsin is a promising candidate with good diagnostic performance reported in adult and neonatal studies. However, there is no clear consensus about its utility in the pediatric age group. This study aimed to synthesize scientific evidence regarding the diagnostic and prognostic performance of presepsin in pediatric sepsis.\u0000 Data Sources A systematic literature search was conducted in MEDLINE/PubMed, Cochrane Central Register of Clinical Trials, Google Scholar, and Scopus to identify relevant studies reporting the diagnostic and prognostic accuracy of presepsin.\u0000 Study Selection Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we retrieved all controlled trials and observational studies on presepsin as a biomarker in children aged <19 years with sepsis.\u0000 Data Extraction Two authors independently performed study screening, data extraction, and quality assessment of the included studies.\u0000 Data Synthesis Among the 267 citations identified, a total of nine relevant studies were included in the final analysis. The pooled diagnostic sensitivity and specificity of presepsin were 0.99 (95% confidence interval [CI]; 0.97–1.00) and 0.88 (95% CI; 0.83–0.92), respectively, with a diagnostic odds ratio (DOR) of 28.15 (95% CI; 0.74–1065.67) and area under the curve (AUC) in summary receiver operating curve of 0.89. Prognostic accuracy for presepsin had a sensitivity of 0.64 (95% CI; 0.35–1.0), specificity of 0.62 (95% CI; 0.44–0.87), and DOR of 3.3 (95% CI; 0.20–53.43). For procalcitonin, the pooled sensitivity for diagnostic accuracy was 0.97 (95% CI; 0.94–1.00), specificity was 0.76 (95% CI; 0.69–0.82), DOR was 10.53 (95% CI; 5.31–20.88), and AUC was 0.81.\u0000 Conclusion Presepsin has good diagnostic accuracy with high sensitivity and specificity. Its prognostic accuracy in predicting mortality is low.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73231636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive and Clinical Characteristics of Nonsurvivors in a Tertiary Pediatric Intensive Care Unit in Turkey: 6 Years of Experience","authors":"Z. Karakaya, Merve Boyraz, Seyma Koksal Atis, Servet Yuce, M. Duyu","doi":"10.1055/s-0043-1764330","DOIUrl":"https://doi.org/10.1055/s-0043-1764330","url":null,"abstract":"Abstract The objective of this study was to identify the characteristics of nonsurvivors in a pediatric intensive care unit (PICU) in Turkey. This is a retrospective analysis of patients who died in a tertiary PICU over a 6-year period from 2016 to 2021. Data were drawn from electronic medical records and resuscitation notes. Mode of death was categorized as failed cardiopulmonary resuscitation (F-CPR) or brain death. Among the 161 deaths, 136 nonsurvivors were included and 30.1% were younger than 1 year. Severe pneumonia, respiratory failure, and acute respiratory distress syndrome (ARDS) (31.6%) were the most common primary diagnoses. The most common mode of death was F-CPR (86.8%). More than half of the subjects had been admitted from pediatric emergency departments (58.1%), and more than half (53.7%) had died within 7 days in the PICU. Patients admitted from pediatric emergency departments had the lowest frequency of comorbidities ( p  < 0.001). Severe pneumonia, respiratory failure, and ARDS diagnoses were significantly more frequent in those who died after 7 days ( p  < 0.001), whereas septicemia, shock, and multiple organ dysfunction were more common among those who died within the first day of PICU admission ( p  < 0.001). It may be important to note that patients referred from wards are highly likely to have comorbidities, while those referred from pediatric emergency departments may be relatively younger. Additionally, patients with septicemia, shock, or multiple organ dysfunction were more likely to die earlier (within 7 days), especially compared with those with severe pneumonia, respiratory failure, or ARDS.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74070403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid Removal in Children on Continuous Renal Replacement Therapy Improves Organ Dysfunction Score","authors":"S. Tadphale, P. Luckett, R. Quigley, Archana V Dhar, Diane Gollhofer, V. Modem","doi":"10.1055/s-0043-1764499","DOIUrl":"https://doi.org/10.1055/s-0043-1764499","url":null,"abstract":"Abstract The objective is to assess impact of fluid removal on improvement in organ function in children who received continuous renal replacement therapy (CRRT) for management of acute kidney injury and/or fluid overload (FO). A retrospective review of eligible patients admitted to a tertiary level intensive care unit over a 3-year period was performed. Improvement in nonrenal organ function, the primary outcome, was defined as decrease in nonrenal component of Pediatric Logistic Organ Dysfunction (PELOD) score on day 3 of CRRT. The cohort was categorized into Group 1 (improvement) and Group 2 (no improvement or worsening) in nonrenal PELOD score. Multivariable logistic regression analysis was performed to identify independent predictors. A higher PELOD score at CRRT initiation (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.05, 1.18, p  < 0.001), belonging to infant-age group (OR: 4.53, 95% CI: 4.40, 5.13, p  = 0.02) and greater fluid removal during initial 3 days of CRRT (OR: 1.05, 95% CI: 1.01, 1.10, p  = 0.01) were associated with an improvement in nonrenal PELOD score at day 3 of CRRT. FO at CRRT initiation (OR: 0.66, 95% CI: 0.46, 0.93, p  = 0.02) and having an underlying oncologic diagnosis (OR: 0.28, 95% CI: 0.09, 0.85, p  = 0.03) were associated with worsening of nonrenal PELOD score at day 3 of CRRT. Careful consideration of certain modifiable patient and/or fluid removal kinetic factors may have an impact on outcomes.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79795981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Orbital Ultrasound in the Monitoring of Children with Raised Intracranial Pressure—Prospective Observational Study Conducted in Tertiary Care Centre","authors":"Nithiya Selvam, N. Parameswaran, R. Ananthakrishnan","doi":"10.1055/s-0042-1760395","DOIUrl":"https://doi.org/10.1055/s-0042-1760395","url":null,"abstract":"Abstract Our objective was to evaluate the role of optic nerve sheath diameter measurement by orbital ultrasound in monitoring children with nontraumatic coma and increased intracranial pressure (ICP). A single-center prospective observational study was conducted in the pediatric intensive care unit (PICU) of a tertiary care teaching hospital in Puducherry, India. Children admitted to the PICU with features of raised ICP were enrolled. Baseline characteristics and raised ICP characteristics were recorded. Optic nerve sheath diameter (ONSD) measurements were taken in all children in the supine position using bedside ultrasound with a 12 MHz linear probe. The probe was initially placed in the axial plane, and measurements were taken at a distance of 3 mm posterior to the site at which the optic nerve enters the globe. Measurements were recorded sequentially 8th hourly till ICP features got resolved or the patient died. Along with each measurement, clinical parameters were recorded. The ONSD measurements were compared with clinical features. We also recruited children admitted to the PICU for other conditions without features of raised ICP as controls. We compared ONSD measurements of cases with controls. In total, 185 children were recruited, of which 81 had features of raised ICP and 104 were without increased ICP. The ONSD measurements in children with raised ICP were significantly higher as compared with those without ICP. Among children with raised ICP, there was a negative correlation between ONSD and Glasgow Coma Scale scores ( r  = −0.739, p ≤ 0.0001). In children with raised ICP, there was a significant difference in ONSD at different intervals, demonstrating a falling trend from admission to 32nd-hour readings. ONSD measurements were higher in children with clinical signs of increased ICP compared with controls, thereby suggesting that this noninvasive measure may be helpful in the neuromonitoring of children with neurologic insults.","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72933172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Quran Recitation on Sedation and Pain in Children","authors":"H. Çaksen","doi":"10.1055/s-0042-1760632","DOIUrl":"https://doi.org/10.1055/s-0042-1760632","url":null,"abstract":"Optimizing the comfort of pediatric patients during a critical illness is an essential facet of day-to-day care in the pediatric intensive care unit (PICU). Optimum delivery of comfort in the complex ecosystem of the PICU remains elusive. A great deal has been published on (1) standardizing measures of comfort; (2) the best non-pharmacologic and pharmacologic therapies to use; (3) the best way to deliver these therapies; and (4) how to ensure quick and appropriate responses to changes in a patient’s comfort level.1 Analgesia-based, multimodal sedative approaches are the foundation for comfort, whereby pain is addressed first and then sedation titrated to a predefined target based on the goals of care.1 Non-pharmacological interventions can reduce the total requirement and associated side effects of sedation and analgesia medications and have been recommended by international sedation guidelines in PICU.2 For example, use of musical intervention has beneficial effects on the level of sedation in children admitted to PICU.3,4 The majority of parents thought that music therapy helped their child to communicate (89%), feel less isolated (100%) copewith stress during hospitalization (100%), contributed to physical recovery (90%), and alleviated feelings of anxiety (90%).5 A metaanalysis showed that music intervention significantly decreased the pain levels, both in the newborn group and in the infant/children group. Music intervention significantly reduced heart rate and respiratory rate and increased peripheral capillary oxygen saturation. In subgroup analyses of types of pain, music intervention had significant effects on prick pain, chronic and procedural pain, and postoperative pain.6 Herein we discussed the effects of Quran recitation, a non-pharmacological intervention, on sedation and pain in children followed in intensive care unit to attract attention to the fact that the Quran is not only a book containing religious teachings, but also a Shifa (healing) book. Parents exhibit different attitudes toward their children’s pain. Mariyana et al7 defined eight themes in managing the pain of childrenwith cancer during palliative care as follows: the dimensions of pain experienced by children undergoing palliative care; mothers’ physical and psychological responses; mothers’ emotional responses; barriers encountered by mothers when taking care of their child at home; mothers’ interventions to reduce their child’s pain; mothers’ efforts to distract their child from pain; giving encouragement when the child is in pain; and mothers’ efforts and prayers to make their child comfortable.7 In another study, six themes related to parents’ attitudes toward their children’s pain were reported as follows: pain can and should be managed; Allah’s will; parent’s worst pain was emotional pain due to child’s diagnosis; belief that their presence could ameliorate their child’s pain; desire for shared decision making; and the child’s responsibility to express pain. In","PeriodicalId":44426,"journal":{"name":"Journal of Pediatric Intensive Care","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2022-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84481997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}