Cerebral Oxygen Saturation and Autoregulation During Hypotension in Extremely Preterm Infants

Cerebral Oxygen Saturation and Autoregulation During Hypotension in Extremely Preterm Infants

Dopamine had no effect on rScO2 compared to placebo in hypotensive infants. Hypotension and cerebral hypoxia are associated with early intraventricular hemorrhage or death. Prospective cohort study of blinded rScO2 measurements... read more

Comparison of the Efficacy and Safety of Cuffed vs. Uncuffed Endotracheal Tubes for Infants in the Intensive Care

Comparison of the Efficacy and Safety of Cuffed vs. Uncuffed Endotracheal Tubes for Infants in the Intensive Care

There was no difference in the primary outcome, though percentage time spent in optimal leak range was significantly higher in cuffed uncuffed endotracheal tube (ETT) group. Cuffed ETTs reduced reintubations to optimise ETT... read more

Simulated Identification of Silent COVID-19 Infections Among Children

Simulated Identification of Silent COVID-19 Infections Among Children

In this simulation modeling study of a synthetic US population, in the absence of vaccine availability for children, a targeted approach to rapidly identify silent COVID-19 infections in this age group was estimated to significantly... read more

Sedation with Midazolam After Cardiac Surgery in Children with and without Down Syndrome

Sedation with Midazolam After Cardiac Surgery in Children with and without Down Syndrome

The majority of children with and without Down syndrome required additional sedation after cardiac surgery. This pharmacokinetic and pharmacodynamic analysis does not provide evidence for different dosing of midazolam in... read more

24-Hour Esophageal pH Measurement in Mechanically Ventilated Children

24-Hour Esophageal pH Measurement in Mechanically Ventilated Children

The current study shows high incidence of gastroesophageal reflux on 24-hour esophageal pH-metry in mechanically ventilated children with medical diagnoses. The significance of this finding and its impact on ventilator-associated... read more

Non-resuscitation fluid in excess of hydration requirements is associated with higher mortality in critically ill children

Non-resuscitation fluid in excess of hydration requirements is associated with higher mortality in critically ill children

Non-resuscitation fluid in excess of hydration requirements is associated with increased mortality in critically ill children. Excess maintenance fluid is a modifiable contributor to this fluid volume. Strategies to reduce... read more

Decreased Intestinal Microbiome Diversity in Pediatric Sepsis

Decreased Intestinal Microbiome Diversity in Pediatric Sepsis

Intestinal dysbiosis was associated with altered short-chain fatty acid metabolites in children with sepsis, but these findings were not linked directly to mitochondrial or immunologic changes. More detailed mechanistic studies... read more

Conversion From Continuous Infusion Fentanyl to Continuous Infusion Hydromorphone in the Pediatric ICU

Conversion From Continuous Infusion Fentanyl to Continuous Infusion Hydromorphone in the Pediatric ICU

A median 14% fentanyl dose reduction was noted when transitioning to hydromorphone. Further exploration is needed to determine if opioid rotations with hydromorphone can reduce opioid/sedative exposure. A total of 36 children... read more

Haloperidol and Quetiapine for the Treatment of ICU-Associated Delirium in a Tertiary Pediatric ICU

Haloperidol and Quetiapine for the Treatment of ICU-Associated Delirium in a Tertiary Pediatric ICU

In our small, single-center study, patients treated with haloperidol or quetiapine showed no short-term improvement in delirium screening scores after starting treatment when compared with untreated, propensity score-matched... read more

Improving Outcomes for Children Requiring ECMO Therapy Following Hematopoietic Stem Cell Transplantation

Improving Outcomes for Children Requiring ECMO Therapy Following Hematopoietic Stem Cell Transplantation

Pediatric patients posthematopoietic stem cell transplantation supported with extracorporeal membrane oxygenation have improving survival rates over time. With 26% of patients (16/62) surviving to hospital discharge in the... read more

Bridging the Gap Between Intensivists and Primary Care Clinicians in ECMO for Respiratory Failure in Children

Bridging the Gap Between Intensivists and Primary Care Clinicians in ECMO for Respiratory Failure in Children

All pediatric clinicians should be aware not only of the potential benefits and complications of ECMO but also that survivors need effective screening, support, and follow-up. The 2009 influenza A(H1N1) pandemic, along... read more

Management of Neonates With Tetralogy of Fallot

Management of Neonates With Tetralogy of Fallot

What are the differences in outcomes between a strategy of staged repair (SR) (initial palliation [IP] and subsequent complete repair [CR]) as compared with primary repair (PR) for infants with symptomatic tetralogy of Fallot... read more

Physiological dead space and alveolar ventilation in ventilated infants

Physiological dead space and alveolar ventilation in ventilated infants

Prematurely born infants with pulmonary disease have a higher dead space than term controls, which may influence the optimum level during volume-targeted ventilation. A prospective study of mechanically ventilated infants... read more

Analysis of Fentanyl Pharmacokinetics and Tolerance in Critically-Ill Children

Analysis of Fentanyl Pharmacokinetics and Tolerance in Critically-Ill Children

Different weight-based fentanyl dosing rates may be required for infants and children of different ages to achieve similar plasma concentrations. Using SBS scores may guide the dosing titration of fentanyl that resulted in... read more

Serum Amylase and Lipase for the Prediction of Pancreatic Injury in Critically Ill Children Admitted to the PICU

Serum Amylase and Lipase for the Prediction of Pancreatic Injury in Critically Ill Children Admitted to the PICU

Serum amylase and lipase could serve as independent biomarkers to predict pancreatic injury in critically ill children. A group of 79 children who died of different causes were investigated by autopsy. They were divided... read more

Childhood sepsis deadlier for Black patients

Childhood sepsis deadlier for Black patients

In this large, representative analysis of paediatric severe sepsis in the USA, we found evidence of outcome disparities by race or ethnicity and insurance status. Our findings suggest that there might be differential... read more

PEM Playbook – Pediatric Pain

PEM Playbook – Pediatric Pain

Pain is multifactorial: it is comprised of physical, psychological, emotional, cultural, and contextual features. In children often the predominant feature may not be initially apparent.  Although clinicians may focus on... read more