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Cognitive, Functional, and Quality of Life Outcomes 6 Months After Mechanical Ventilation for Bronchiolitis: A Secondary Analysis of Data From the Randomized Evaluation of Sedation Titration for Respiratory Failure Trial (RESTORE). Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-12-01 Meredith Fischer,David K Ngendahimana,R Scott Watson,Adam J Schwarz,Steven L Shein
OBJECTIVES To describe rates and associated risk factors for functional decline 6 months after critical bronchiolitis in a large, multicenter dataset. DESIGN Nonprespecified secondary analysis of existing 6-month follow-up data of patients in the Randomized Evaluation of Sedation Titration for Respiratory Failure trial (RESTORE, NCT00814099). SETTING Patients recruited to RESTORE in any of 31 PICUs
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Noninvasive Neurally Adjusted Ventilatory Assist in Infants With Bronchiolitis: Respiratory Outcomes in a Single-Center, Retrospective Cohort, 2016-2018. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-21 Alex Lepage-Farrell,Laurence Tabone,Virginie Plante,Atsushi Kawaguchi,Joshua Feder,Sally Al Omar,Guillaume Emeriaud
OBJECTIVES To describe our experience of using noninvasive neurally adjusted ventilatory assist (NIV-NAVA) in infants with bronchiolitis, its association with the evolution of respiratory effort, and PICU outcomes. DESIGN Retrospective analysis of a prospectively curated, high-frequency electronic database. SETTING A PICU in a university-affiliated maternal-child health center in Canada. PATIENTS Patients
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Death by Neurologic Criteria in Children Undergoing Extracorporeal Cardiopulmonary Resuscitation: Retrospective Extracorporeal Life Support Organization Registry Study, 2017-2021. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-20 Raphael Joye,Vladimir L Cousin,Julie Wacker,Aparna Hoskote,Fabienne Gebistorf,Joseph E Tonna,Peter T Rycus,Ravi R Thiagarajan,Angelo Polito
OBJECTIVES To determine factors associated with brain death in children treated with extracorporeal cardiopulmonary resuscitation (E-cardiopulmonary resuscitation). DESIGN Retrospective database study. SETTINGS Data reported to the Extracorporeal Life Support Organization (ELSO), 2017-2021. PATIENTS Children supported with venoarterial extracorporeal membrane oxygenation (ECMO) for E-cardiopulmonary
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Mortality and Timing of Withdrawal of Life-Sustaining Therapies After Out-of-Hospital Cardiac Arrest: Two-Center Retrospective Pediatric Cohort Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-20 Rachel Vassar,Nehali Mehta,Lane Epps,Fei Jiang,Edilberto Amorim,Sharon Wietstock
OBJECTIVES Pediatric out-of-hospital cardiac arrest (OHCA) is associated with substantial morbidity and mortality. Limited data exist to guide timing and method of neurologic prognostication after pediatric OHCA, making counseling on withdrawal of life-sustaining therapies (WLSTs) challenging. This study investigates the timing and mode of death after pediatric OHCA and factors associated with mortality
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Scenario Decision-Making About Plasma and Platelet Transfusion for Intracranial Monitor Placement: Cross-Sectional Survey of Pediatric Intensivists and Neurosurgeons. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-15 Marianne E Nellis,Oliver Karam,Guillermo Aldave,Brandon G Rocque,David F Bauer,
OBJECTIVES To report pediatric intensivists' and pediatric neurosurgeons' responses to case-based scenarios about plasma and platelet transfusions before intracranial pressure (ICP) monitor placement in children with severe traumatic brain injury (TBI). DESIGN Cross-sectional, electronic survey to evaluate reported plasma and platelet transfusion decisions in eight scenarios of TBI in which ICP monitor
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Delay Between Actual Occurrence of Patient Vital Sign and the Nominal Appearance in the Electronic Health Record: Single-Center, Retrospective Study of PICU Data, 2014-2018. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-15 Katherine R Schlosser Metitiri,Adler Perotte
OBJECTIVES Patient vital sign data charted in the electronic health record (EHR) are used for time-sensitive decisions, yet little is known about when these data become nominally available compared with when the vital sign was actually measured. The objective of this study was to determine the magnitude of any delay between when a vital sign was actually measured in a patient and when it nominally
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Pediatric Profound Dengue Shock Syndrome and Use of Point-of-Care Ultrasound During Mechanical Ventilation to Guide Treatment: Single-Center Retrospective Study, 2013-2021. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-15 Luan Thanh Vo,Dat Tat Nguyen,Thinh Ngoc Tran,Hang Hoang-Thanh Tran,Trang Thi-Hoai Đoan,Tram Ngoc Pham,Thanh Thi-Hoai Mai,Quynh Xuan-Thuy Nguyen,Thuan Khac Nguyen,Thuong Thi-Kim Nguyen,Sakib Burza,Thanh Tat Nguyen
OBJECTIVES Profound dengue shock syndrome (DSS) complicated by severe respiratory failure necessitating mechanical ventilation (MV) accounts for high case fatality rates among PICU-admitted patients. A major challenge to management is the assessment of intravascular volume, which can be hampered by severe plasma leakage and the use of MV. DESIGN Retrospective cohort, from 2013 to 2021. PATIENTS Sixty-seven
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Organ Donation in Canadian PICUs: A Cross-Sectional Survey, 2021-2022. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-15 Laurie A Lee,Dori-Ann Martin,Meagan Mahoney,Lee James,Yaron Avitzur,Allison Carroll,Bailey Piggott,Christopher Tomlinson,Simon Urschel,Lorraine Hamiwka
OBJECTIVES To understand contemporary pediatric organ donation programs in Canadian PICUs, including: policies and practices, data collection and reporting, and system and process barriers. DESIGN A cross-sectional survey carried out 2021-2022. SETTING Canadian PICUs affiliated with a donor physician network. SUBJECTS Pediatric intensivists identified as the donation program lead, or most knowledgeable
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Development and Validation of a Model for Endotracheal Intubation and Mechanical Ventilation Prediction in PICU Patients. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-13 Daniela Chanci,Jocelyn R Grunwell,Alireza Rafiei,Ronald Moore,Natalie R Bishop,Prakadeshwari Rajapreyar,Lisa M Lima,Mark Mai,Rishikesan Kamaleswaran
OBJECTIVES To develop and externally validate an intubation prediction model for children admitted to a PICU using objective and routinely available data from the electronic medical records (EMRs). DESIGN Retrospective observational cohort study. SETTING Two PICUs within the same healthcare system: an academic, quaternary care center (36 beds) and a community, tertiary care center (56 beds). PATIENTS
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A Prognostic Model for Critically Ill Children in Locations With Emerging Critical Care Capacity. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-10 Arjun Chandna,Suy Keang,Meas Vorlark,Bran Sambou,Chhay Chhingsrean,Heav Sina,Pav Vichet,Kaajal Patel,Eang Habsreng,Arthur Riedel,Lazaro Mwandigha,Constantinos Koshiaris,Rafael Perera-Salazar,Paul Turner,Ngoun Chanpheaktra,Claudia Turner
OBJECTIVES To develop a clinical prediction model to risk stratify children admitted to PICUs in locations with limited resources, and compare performance of the model to nine existing pediatric severity scores. DESIGN Retrospective, single-center, cohort study. SETTING PICU of a pediatric hospital in Siem Reap, northern Cambodia. PATIENTS Children between 28 days and 16 years old admitted nonelectively
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Implementation Science Research in Pediatric Critical Care Medicine. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Charlotte Z Woods-Hill,Heather Wolfe,Sara Malone,Katherine M Steffen,Asya Agulnik,Brian F Flaherty,Ryan P Barbaro,Maya Dewan,Sapna R Kudchadkar,
OBJECTIVES Delay or failure to consistently adopt evidence-based or consensus-based best practices into routine clinical care is common, including for patients in the PICU. PICU patients can fail to receive potentially beneficial diagnostic or therapeutic interventions, worsening the burden of illness and injury during critical illness. Implementation science (IS) has emerged to systematically address
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The Path to Durable Access in Critically Ill Children; Not a Straight Line. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Erik Su,Vidit Bhargava,Danny V Gil,Aarti Bavare
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Cardiopulmonary Resuscitation, Epinephrine, and Extracorporeal Membrane Oxygenation: Finding the Right Balance. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Warwick Butt
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The Fontan Circulation Holds Water: The Impact of Arginine Vasopressin on the Fontan Circulation. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Mubbasheer Ahmed,Ronald A Bronicki
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If Not Now, When? Taking Action to Improve Mental Health Outcomes for Families of Children With Heart Disease. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Justin J Elhoff,Nadine A Kasparian
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Pediatric Critical Care Medicine and Cardiac Critical Care Research. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-02 Paul A Checchia
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Adverse Tracheal Intubation Events in Critically Ill Underweight and Obese Children: Retrospective Study of the National Emergency Airway for Children Registry (2013-2020). Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-11-01 Kelsey M Gladen,David Tellez,Natalie Napolitano,Lauren R Edwards,Ronald C Sanders,Taiki Kojima,Matthew P Malone,Justine Shults,Conrad Krawiec,Shashikanth Ambati,Riley McCarthy,Aline Branca,Lee A Polikoff,Philipp Jung,Simon J Parsons,Palen Mallory,Kavipriya Komeswaran,Christopher Page-Goertz,Megan C Toal,G Kris Bysani,Keith Meyer,Fabrizio Chiusolo,Lily B Glater-Welt,Awni Al-Subu,Katherine Biagas,Jan
OBJECTIVES Extremes of patient body mass index are associated with difficult intubation and increased morbidity in adults. We aimed to determine the association between being underweight or obese with adverse airway outcomes, including adverse tracheal intubation (TI)-associated events (TIAEs) and/or severe peri-intubation hypoxemia (pulse oximetry oxygen saturation < 80%) in critically ill children
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Brazilian Portuguese Translation and Cross-Cultural Adaptation of the Sophia Observation Withdrawal Symptoms Pediatric Delirium Tool for the Diagnosis of Withdrawal Syndrome and Delirium in Children. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-27 Roberta Esteves Vieira de Castro,Juliana Patrícia Chaves de Almeida,Daniela Nasu Monteiro Medeiros,Elie Cheniaux,José Colleti Júnior,Maria Clara de Magalhães-Barbosa,Arnaldo Prata-Barbosa,Erwin Ista
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Challenges of Families of Patients Hospitalized in the PICU: A Preplanned Secondary Analysis From the Navigate Dataset. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-27 Julia B Tager,Jessica T Hinojosa,Brynn M LiaBraaten,Kathryn A Balistreri,Danica Aniciete,Elizabeth Charleston,Joel E Frader,Douglas B White,Marla L Clayman,Lauren R Sorce,W Hobart Davies,Charles B Rothschild,Kelly N Michelson,
OBJECTIVES To describe challenges experienced by parents of children hospitalized in the PICU during PICU admission as reported by family navigators. DESIGN A preplanned secondary analysis of open-response data coded via inductive qualitative approach from the Navigate randomized controlled trial (RCT) dataset (ID NCT02333396). SETTING Two university-affiliated PICUs in the Midwestern United States
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Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children's Hospital Acquired Thrombosis Consortium. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-26 Anthony A Sochet,Julie Jaffray,Brian R Branchford,Elizabeth E Havlicek,Maua Mosha,Ernest K Amankwah,Vera Ignjatovic,E Vincent S Faustino,Neil A Goldenberg
OBJECTIVES To determine if the duration of invasive mechanical ventilation (IMV) was associated with hospital-acquired venous thromboembolism (HA-VTE) among critically ill children. DESIGN A multicenter, matched case-control study as a secondary analysis of Children's Hospital Acquired Thrombosis (CHAT) Consortium registry. SETTING PICUs within U.S. CHAT Consortium participating centers. PATIENTS Children
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Adaptation and Validation of the Cornell Assessment of Pediatric Delirium Tool in the Greek Language. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-26 Aikaterini Volanaki,George Briassoulis,George Gerostergios,George Samiotakis,Evgenia Soumaki,Chani Traube,Stavroula Ilia
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Tracheal Intubation by Advanced Practice Registered Nurses in Pediatric Critical Care: Retrospective Study From the National Emergency Airway for Children Registry (2015-2019). Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-26 Danielle M Van Damme,Emily M McRae,Sharon Y Irving,Serena P Kelly,Keiko M Tarquinio,John S Giuliano,Michael D Ruppe,Krista L Kierys,Ryan K Breuer,Simon J Parsons,Palen P Mallory,Asha N Shenoi,Kelly A Swain,Lee A Polikoff,Anthony Lee,Michelle A Adu-Darko,Natalie Napolitano,Justine Shults,Akira Nishisaki,John W Berkenbosch,
OBJECTIVES To describe tracheal intubation (TI) practice by Advanced Practice Registered Nurses (APRNs) in North American PICUs, including rates of TI-associated events (TIAEs) from 2015 to 2019. DESIGN/SETTING Retrospective study using the National Emergency Airway Registry for Children with all TIs performed in PICU and pediatric cardiac ICU between January 2015 and December 2019. The primary outcome
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Organ Dysfunction in Children With Blood Culture-Proven Sepsis: Comparative Performance of Four Scores in a National Cohort Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-25 Luregn J Schlapbach,Sabrina Goertz,Niels Hagenbuch,Blandine Aubert,Sebastien Papis,Eric Giannoni,Klara M Posfay-Barbe,Martin Stocker,Ulrich Heininger,Sara Bernhard-Stirnemann,Anita Niederer-Loher,Christian R Kahlert,Giancarlo Natalucci,Christa Relly,Thomas Riedel,Christoph Aebi,Christoph Berger,Philipp K A Agyeman,
OBJECTIVES Previous studies applying Sepsis-3 criteria to children were based on retrospective analyses of PICU cohorts. We aimed to compare organ dysfunction criteria in children with blood culture-proven sepsis, including emergency department, PICU, and ward patients, and to assess relevance of organ dysfunctions for mortality prediction. DESIGN We have carried out a nonprespecified, secondary analysis
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Dexmedetomidine Withdrawal Syndrome in Children in the PICU: Systematic Review and Meta-Analysis. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-19 Thomas Knapp,Olivia DiLeonardo,Tim Maul,Alexander Hochwald,Zhuo Li,Jobayer Hossain,Adam Lowry,Jason Parker,Kimberly Baker,Peter Wearden,Jennifer Nelson
OBJECTIVES To systematically review literature describing the clinical presentation, risk factors, and treatment for dexmedetomidine withdrawal in the PICU (PROSPERO: CRD42022307178). DATA SOURCES MEDLINE/PubMed, Cochrane, Web of Science, and Scopus databases were searched. STUDY SELECTION Eligible studies were published from January 2000 to January 2022 and reported clinical data for patients younger
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Pre-Extubation Ultrasound Measurement of In Situ Cuffed Endotracheal Tube Laryngeal Air Column Width Difference: Single-Center Pilot Study of Relationship With Post-Extubation Stridor in Under 5 Years Old. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-10 Luke Burton,Jeremy Loberger,Mark Baker,Priya Prabhakaran,Vidit Bhargava
OBJECTIVES Post-extubation stridor (PES) is difficult to predict before extubation. We therefore evaluated the potential diagnostic performance of pre-extubation laryngeal air column width difference (LACWD) measurement, as assessed by intensivist-performed point-of-care laryngeal ultrasound, in relation to clinically important PES. DESIGN Prospective observational cohort study. SETTING Single quaternary
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Suicide and Self-Harm in Adolescents During the COVID-19 Pandemic: A U.S. Virtual Pediatric Systems, LLC, Database Study of PICU Admissions, 2016-2021. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-09 Casey K McCluskey,Tyler R Black,Janine Zee-Cheng,Margaret J Klein,Anna Lin,Colin M Rogerson,Christopher L Carroll,Kenneth E Remy,Matthew C Scanlon,Steven L Shein,Melvin Wright,Alexandre T Rotta
OBJECTIVES To characterize the epidemiology of suicide and self-harm among adolescents admitted to PICUs during the first 2 years of the COVID-19 pandemic in the United States. DESIGN Descriptive analysis of a large, multicenter, quality-controlled database (Virtual Pediatric Systems [VPS]), and of a national public health dataset (U.S. Centers for Disease Control and Prevention web-based Wide-ranging
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A Survey of PICU Clinician Practices and Perceptions regarding Respiratory Cultures in the Evaluation of Ventilator-Associated Infections in the BrighT STAR Collaborative. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-09 Anna C Sick-Samuels,Danielle W Koontz,Anping Xie,Daniel Kelly,Charlotte Z Woods-Hill,Anushree Aneja,Shaoming Xiao,Elizabeth A Colantuoni,Jill Marsteller,Aaron M Milstone,
OBJECTIVES To characterize respiratory culture practices for mechanically ventilated patients, and to identify drivers of culture use and potential barriers to changing practices across PICUs. DESIGN Cross-sectional survey conducted May 2021-January 2022. SETTING Sixteen academic pediatric hospitals across the United States participating in the BrighT STAR Collaborative. SUBJECTS Pediatric critical
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Critical Care Utilization in Children With Cancer: U.S. Pediatric Health Information System Database Cohort 2012-2021. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-09 Colin M Rogerson,Courtney M Rowan
OBJECTIVES To determine changes in pediatric oncology hospitalizations requiring intensive care over the period 2012-2021. DESIGN Retrospective study of hospital admission. SETTING Registry data from 36 children's hospitals in the U.S. Pediatric Health Information Systems database. PATIENTS Children 18 years or younger admitted to any of 36 hospitals with an oncology diagnosis. INTERVENTIONS None.
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Vascular Reconstruction After Cannulation for Support With Extracorporeal Membrane Oxygenation: Literature Review of Data in the Pediatric Population. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-10-05 Tiffany Zens,R Scott Eldredge,Manrit Gill,Steven Mathew,Mark Molitor
OBJECTIVES Extracorporeal membrane oxygenation (ECMO) is an invaluable life-support resource in the treatment of critically ill children. Traditionally, neck vascular cannulation requires ligation of the carotid artery and jugular vein. In this literature review, we identify rates of postoperative vessel patency, complications, and neurologic outcomes after vascular reconstruction following decannulation
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Nonresuscitation Fluid Accumulation and Outcomes After Pediatric Cardiac Surgery: Single-Center Retrospective Cohort Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-25 Matthew R Hudkins,Laura Miller-Smith,Patrick D Evers,Ashok Muralidaran,Benjamin E Orwoll
OBJECTIVES Postoperative patients after congenital cardiac surgery are at high risk of fluid overload (FO), which is known to be associated with poor outcomes. "Fluid creep," or nonresuscitation IV fluid in excess of maintenance requirement, is recognized as a modifiable factor associated with FO in the general PICU population, but has not been studied in congenital cardiac surgery patients. Our objective
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Viral Detection by Reverse Transcriptase Polymerase Chain Reaction in Upper Respiratory Tract and Metagenomic RNA Sequencing in Lower Respiratory Tract in Critically Ill Children With Suspected Lower Respiratory Tract Infection. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-21 Christina M Osborne,Charles Langelier,Jack Kamm,Kayla Williamson,Lilliam Ambroggio,Ron W Reeder,Christopher Locandro,J Kirk Harris,Brandie D Wagner,Aline B Maddux,Saharai Caldera,Amy Lyden,Victoria Soesanto,Eric A F Simões,Matthew K Leroue,Todd C Carpenter,Mark W Hall,Athena F Zuppa,Joseph A Carcillo,Kathleen L Meert,Murray M Pollack,Patrick S McQuillen,Daniel A Notterman,Joseph DeRisi,Peter M Mourani
OBJECTIVES Viral lower respiratory tract infection (vLRTI) contributes to substantial morbidity and mortality in children. Diagnosis is typically confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) of nasopharyngeal specimens in hospitalized patients; however, it is unknown whether nasopharyngeal detection accurately reflects presence of virus in the lower respiratory tract (LRT)
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Utility of Hospital Failure to Rescue for Analyzing Variation in Pediatric Postoperative Mortality. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-11 Steven C Mehl,Jorge I Portuondo,Yao Tian,Mehul V Raval,Sohail R Shah,Adam M Vogel,David Wesson,Nader N Massarweh
OBJECTIVES To evaluate the association between pediatric hospital performances in terms of failure to rescue (FTR), defined as postoperative mortality after a surgical complication, and mortality among patients without a surgical complication. DESIGN Retrospective cohort study. SETTING Forty-eight academic, pediatric hospitals; data obtained from Pediatric Health Information System database (Child
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Bleeding in Critically Ill Children With Malignancy or Hematopoietic Cell Transplant: A Single-Center Prospective Cohort Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-07 Julie Levasseur,Lauren Fikse,Audrey Mauguen,James S Killinger,Oliver Karam,Marianne E Nellis
OBJECTIVES To determine the incidence of bleeding in critically ill children with malignancy and to describe associated patient characteristics, interventions, and clinical outcomes. DESIGN Prospective cohort study. SETTING PICU in a specialized cancer hospital. PATIENTS Children with malignancy or hematopoietic cell transplant 0-18 years of age were admitted to the PICU from November 2020 to November
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Pediatric Death After Withdrawal of Life-Sustaining Therapies: A Scoping Review. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-07 Conall Francoeur,Amina Silva,Laura Hornby,Krista Wollny,Laurie A Lee,Alexandra Pomeroy,Florence Cayouette,Nathan Scales,Matthew J Weiss,Sonny Dhanani
OBJECTIVES Evaluate literature on the dying process in children after withdrawal of life sustaining measures (WLSM) in the PICU. We focused on the physiology of dying, prediction of time to death, impact of time to death, and uncertainty of the dying process on families, healthcare workers, and organ donation. DATA SOURCES MEDLINE, Embase, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL
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Survival With Favorable Neurologic Outcome and Quality of Cardiopulmonary Resuscitation Following In-Hospital Cardiac Arrest in Children With Cardiac Disease Compared With Noncardiac Disease. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-07 Myke Federman,Robert M Sutton,Ron W Reeder,Tageldin Ahmed,Michael J Bell,Robert A Berg,Robert Bishop,Matthew Bochkoris,Candice Burns,Joseph A Carcillo,Todd C Carpenter,J Michael Dean,J Wesley Diddle,Richard Fernandez,Ericka L Fink,Deborah Franzon,Aisha H Frazier,Stuart H Friess,Kathryn Graham,Mark Hall,David A Hehir,Christopher M Horvat,Leanna L Huard,Theresa Kirkpatrick,Tensing Maa,Laura A Maitoza
OBJECTIVES To assess associations between outcome and cardiopulmonary resuscitation (CPR) quality for in-hospital cardiac arrest (IHCA) in children with medical cardiac, surgical cardiac, or noncardiac disease. DESIGN Secondary analysis of a multicenter cluster randomized trial, the ICU-RESUScitation Project (NCT02837497, 2016-2021). SETTING Eighteen PICUs. PATIENTS Children less than or equal to 18
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Dying and Death in a Pediatric Cardiac ICU: Mixed Methods Evaluation of Multidisciplinary Staff Responses. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-06 Elizabeth G Broden,Valerie K Bailey,Dorothy M Beke,Jennifer M Snaman,Katie M Moynihan
OBJECTIVES Understanding factors influencing quality of pediatric end-of-life (EOL) care is necessary to identify interventions to improve family and staff experiences. We characterized pediatric cardiac ICU (PCICU) staff free-text survey responses to contextualize patterns in quality of dying and death (QODD) scoring. DESIGN This mixed methods study reports on a cross-sectional survey of PCICU staff
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The Lactate-Albumin Ratio Predicts Multiple Organ Dysfunction Syndrome and Death, But Is It Ready to Use? Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-05 Warwick Butt
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Noninvasive Ventilation in Pediatric Acute Respiratory Distress Syndrome: "Another Dogma Bites the Dust". Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-05 Christophe Milesi,Julien Baleine,Guillaume Mortamet,Juliette Apert,Arthur Gavotto,Gilles Cambonie
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Anticipating Pediatric Post-Extubation Risk: Calling All (North) Stars. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-09-05 Thomas Rappold,Akira Nishisaki
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Mental Health Provision in PICU: An Analysis of Referrals to an Embedded Psychologist Over 20 Years at a Single Center. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-28 Gillian A Colville
OBJECTIVES The main aim of this study was to illustrate the type of mental health provision possible on PICU by describing the nature of referrals of child patients and their parents to an embedded psychologist over a 20-year period, adding to the literature on intervention and service development. DESIGN Retrospective evaluation of anonymized departmental database. SETTING Twelve-bed PICU at a teaching
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Wide Institutional Variability in the Treatment of Pediatric Critical Asthma: A Multicenter Retrospective Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-24 Colin M Rogerson,Alexander H Hogan,Briana Waldo,Benjamin R White,Christopher L Carroll,Steven L Shein
OBJECTIVES Children with status asthmaticus refractory to first-line therapies of systemic corticosteroids and inhaled beta-agonists often receive additional treatments. Because there are no national guidelines on the use of asthma therapies in the PICU, we sought to evaluate institutional variability in the use of adjunctive asthma treatments and associations with length of stay (LOS) and PICU use
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Tracheostomy Timing During Pediatric Cardiac Intensive Care: Single Referral Center Retrospective Cohort. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-21 Miriam T Fox,Colin Meyer-Macaulay,Hanna Roberts,Stuart Lipsitz,Bryan D Siegel,Chris Mastropietro,Robert J Graham,Katie M Moynihan
OBJECTIVES To describe associations between the timing of tracheostomy and patient characteristics or outcomes in the cardiac ICU (CICU). DESIGN Single-institution retrospective cohort study. SETTING Freestanding academic children's hospital. PATIENTS CICU patients with tracheostomy placed between July 1, 2011, and July 1, 2020. INTERVENTIONS We compared patient characteristics and outcomes between
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Improving Outcomes for Infants After Cardiopulmonary Bypass Surgery for Congenital Heart Disease: A Commentary on Recent Randomized Controlled Trials. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-21 Luregn J Schlapbach,Kristen S Gibbons,Warwick Butt,Prince J Kannankeril,Jennifer S Li,Kevin D Hill,
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Parental Adverse Childhood Experiences and Post-PICU Stress in Children and Parents. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-18 Patrice Pryce,Maalobeeka Gangopadhyay,Jeffrey D Edwards
OBJECTIVES Hospitalization in a PICU is a stressful experience for children and their parents, with many experiencing posttraumatic stress disorder (PTSD) after discharge. Risk factors may include preillness traumatic events, such as adverse childhood experiences (ACEs). We sought to assess the feasibility of screening ACEs in parents of children admitted to a PICU, their prevalence, and their association
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Amplitude Integrated Electroencephalography: Simulated Assessment of Neonatal Seizure Detection in PICU Patients. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-07 Laura J MacDarby,Lauren K Byrne,Emily T O'Brien,Gerard F Curley,Martina Healy,John C McHugh
OBJECTIVES Amplitude integrated electroencephalography (aEEG) is a mainstay of care in neonatal ICUs; however, knowledge gaps exist in relation to its accuracy for identifying seizures in older children. We aimed to review the diagnostic accuracy of existing neonatal seizure detection criteria for seizure detection in older children in hospital. DESIGN Retrospective study. SETTING PICU/Neurophysiology
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Perfusion Index Variations in Children With Septic Shock: Single-Center Observational Cohort Study in India. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-07 Lalitha Av,Siji Kuzhikkombil Mani,Santu Ghosh
OBJECTIVES To study in children with septic shock: 1) variation in peripheral perfusion index (PI), which is a derived variable from pulse oximetry; 2) correlation between PI and lactate concentration; and 3) exploratory diagnostic evaluation between mortality and PI. DESIGN Prospective observational study (from October 2018 to March 2020). SETTING Pediatric emergency department and PICU of a tertiary
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Parental Perception and Measured Functional Status Following Pediatric Critical Illness: A Secondary Analysis of the Survivor Outcomes Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-07 Suzanne R Gouda,Neethi P Pinto
OBJECTIVES We evaluated the concordance between parent/guardian perception of child long-term function and objectively scored long-term functional status using the Functional Status Scale (FSS) among PICU survivors. DESIGN Secondary analysis of prospective cohort study. SETTING Urban, tertiary, academic PICU. PATIENTS PICU patients less than 18 years old were admitted between June and August 2012.
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The Modified Clinical Progression Scale for Pediatric Patients: Evaluation as a Severity Metric and Outcome Measure in Severe Acute Viral Respiratory Illness. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-04 Shannon B Leland,Steven J Staffa,Margaret M Newhams,Robinder G Khemani,John C Marshall,Cameron C Young,Aline B Maddux,Mark W Hall,Scott L Weiss,Adam J Schwarz,Bria M Coates,Ronald C Sanders,Michele Kong,Neal J Thomas,Ryan A Nofziger,Melissa L Cullimore,Natasha B Halasa,Laura L Loftis,Natalie Z Cvijanovich,Jennifer E Schuster,Heidi Flori,Shira J Gertz,Janet R Hume,Samantha M Olson,Manish M Patel,David
OBJECTIVES To develop, evaluate, and explore the use of a pediatric ordinal score as a potential clinical trial outcome metric in children hospitalized with acute hypoxic respiratory failure caused by viral respiratory infections. DESIGN We modified the World Health Organization Clinical Progression Scale for pediatric patients (CPS-Ped) and assigned CPS-Ped at admission, days 2-4, 7, and 14. We identified
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Malnutrition and Nutrition Support in Latin American PICUs: The Nutrition in PICU (NutriPIC) Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-04 Santiago Campos-Miño,Artur Figueiredo-Delgado,Patricia Zárate,Patricia Zamberlan,Eliana Muñoz-Benavides,Jorge A Coss-Bu,
OBJECTIVES To characterize the nutritional status of children admitted to Latin American (LA) PICUs and to describe the adequacy of nutrition support in reference to contemporary international recommendations. DESIGN The Nutrition in PICU (NutriPIC) study was a combined point-prevalence study of malnutrition carried out on 1 day in 2021 (Monday 8 November) and a retrospective cohort study of adequacy
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Pulmonary Hemorrhage in Pediatric Hematopoietic Stem Cell Transplant Recipients: A Single-Center Retrospective Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-04 Yogi Chopra,Amal Alsabahi,Tal Schechter,Haifa Mtaweh,Neil Sweezey,Corinne Balit,Muhammad Ali,Kuang-Yueh Chiang,Adam Gassas,Joerg Krueger
OBJECTIVES Pulmonary hemorrhage (PH) is a serious complication posthematopoietic stem cell transplant (HSCT). In view of limited available pediatric data, we performed a retrospective study to describe epidemiology, management, and outcomes of PH post-HSCT in children in our national center. DESIGN Retrospective study. SETTING Academic children's hospital (2000-2015). SUBJECTS Children (< 18 yr) with
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Can We Change the Culture Around Fever in the PICU? Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-03 Takaharu Karube,Todd J Karsies
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Repeat Tracheal Aspirate Cultures: A Port in the Storm or a Sinking Ship? Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-03 Andrea M Prinzi,Kathleen Chiotos
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ICU Liberation Bundles and The Legend of Three Arrows. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-03 Nobuaki Shime,Graeme MacLaren
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Why Do Families Reject the Diagnosis of Brain Death, and How Should We Respond? Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-08-03 Robert D Truog
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Pediatric Acute Respiratory Distress Syndrome in South African PICUs: A Multisite Point-Prevalence Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-28 Brenda M Morrow,Eleonora Lozano Ray,Mignon McCulloch,Shamiel Salie,Asma Salloo,Ilse N Appel,Elri Du Plooy,Shannon Cawood,Porai Moshesh,Kathryn H Keeling,Lincoln J Solomon,Sbekezelo Hlophe,Despina Demopoulos,Noor Parker,Ayesha Bibi Khan,Kuban D Naidoo,Andrew C Argent
OBJECTIVES To describe the prevalence of pediatric acute respiratory distress syndrome (pARDS) and the characteristics of children with pARDS in South African PICUs. DESIGN Observational multicenter, cross-sectional point-prevalence study. SETTING Eight PICUs in four South African provinces. PATIENTS All children beyond the neonatal period and under 18 years of age admitted to participating PICUs.
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The Design of Nested Adaptive Clinical Trials of Multiple Organ Dysfunction Syndrome Children in a Single Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-27 John M VanBuren,Mark Hall,Athena F Zuppa,Peter M Mourani,Joseph Carcillo,J Michael Dean,Kevin Watt,Richard Holubkov
OBJECTIVES Describe the statistical design of the Personalized Immunomodulation in Sepsis-induced Multiple Organ Dysfunction Syndrome (MODS) (PRECISE) study. DESIGN Children with sepsis-induced MODS undergo real-time immune testing followed by assignment to an immunophenotype-specific study cohort. Interventional cohorts include the granulocyte macrophage-colony stimulating factor (GM-CSF) for the
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Variation in Early Pediatric Intensive Care Management Strategies and Duration of Invasive Mechanical Ventilation for Acute Viral Bronchiolitis in the United Kingdom: A Retrospective Multicenter Cohort Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-26 Mariana Miranda,Samiran Ray,Elizabeth Boot,David Inwald,Daleep Meena,Ramesh Kumar,Patrick Davies,Maria Rivero-Bosch,Philippa Sturgess,Charlotte Weeks,Kathryn Holliday,Sofia Cuevas-Asturias,Peter Donnelly,Ahmed Elsaoudi,Jon Lillie,Simon Nadel,Shane Tibby,Rebecca Mitting
OBJECTIVES Management of mechanically ventilated patients with bronchiolitis is not standardized and duration of mechanical ventilation has been shown to vary widely between centers. The aim of this study was to examine practice in a large number of U.K. PICUs with a view to identify if early management choices relating to fluid prescription, sedative agent use, and endotracheal tube (ETT) placement
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Outcome of Extracorporeal Cardiopulmonary Resuscitation in Pediatric Patients Without Congenital Cardiac Disease: Extracorporeal Life Support Organization Registry Study. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-21 Catherine E Beni,Samuel E Rice-Townsend,Ivie D Esangbedo,Tim Jancelewicz,Adam M Vogel,Christopher Newton,Laura Boomer,David H Rothstein
OBJECTIVES To describe the use of extracorporeal cardiopulmonary resuscitation (ECPR) in pediatric patients without congenital heart disease (CHD) and identify associations with in-hospital mortality, with a specific focus on initial arrest rhythm. DESIGN Retrospective cohort study using data from pediatric patients enrolled in Extracorporeal Life Support Organization (ELSO) registry between January
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Performance of Tools and Measures to Predict Fluid Responsiveness in Pediatric Shock and Critical Illness: A Systematic Review and Meta-Analysis. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-18 Sarah B Walker,Jessica M Winters,Jacob M Schauer,Peggy Murphy,Andrea Fawcett,L Nelson Sanchez-Pinto
OBJECTIVES In this systematic review and meta-analysis we asked: Do predictors of fluid responsiveness in children perform comparably: 1) in the PICU as in non-PICU settings? 2) in shock states compared with nonshock states? Additionally, 3) is there an association between preload responsiveness and clinical response? DATA SOURCES Ovid Medline, PubMed, and Embase databases were searched from inception
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Acute Hemodynamics in the Fontan Circulation: Open-Label Study of Vasopressin. Pediatr. Crit. Care Med. (IF 4.1) Pub Date : 2023-07-18 Gregory T Adamson,Jane Yu,Chandra Ramamoorthy,Lynn F Peng,Anne Taylor,Michael Lennig,Alexander R Schmidt,Jeffrey A Feinstein,Manchula Navaratnam
OBJECTIVE To describe the acute hemodynamic effect of vasopressin on the Fontan circulation, including systemic and pulmonary pressures and resistances, left atrial pressure, and cardiac index. DESIGN Prospective, open-label, nonrandomized study (NCT04463394). SETTING Cardiac catheterization laboratory at Lucile Packard Children's Hospital, Stanford. PATIENTS Patients 3-50 years old with a Fontan circulation