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Category: Pediatrics

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Concise Critical Appraisal: Use of Telemedicine During Interhospital Transport of Children

Jackson et al (Ped Crit Care Med. 2018;19:1033-1038) set out to analyze the impact telemedicine had on time to surgery in children with intracranial hemorrhage (ICH).


Concise Critical Appraisal: Effect of Community-Acquired Pediatric Sepsis on Survivors

Killien et al (Pediatr Crit Care Med. 2019;Epub ahead of print) set out to evaluate the prevalence of health-related quality of life (HRQL) decline in pediatric survivors of community-acquired sepsis, severe sepsis, and septic shock and to determine which factors are associated with a failure to return to baseline HRQL.


Anti-Factor Xa-Based Monitoring of Unfractionated Heparin

Saini et al (J Pediatr. 2019;209:212-219.e1) sought to evaluate the clinical outcomes in pediatric patients receiving unfractionated heparin while being monitored using anti-factor Xa and to determine the correlation between anti-factor Xa, heparin, and activated partial thromboplastin time.


Assessment of Inflammation Phenotypes in Pediatric Sepsis-Induced Multiple Organ Failure

This Concise Critical Appraisal discusses how Carcillo et al (Pediatr Crit Care Med. 2019. Epub ahead of print) compared mortality in children with severe sepsis and MOF who present with one of four phenotypes: 1) immunoparalysis-associated MOF (IPMOF), 2) thrombocytopenia-associated MOF (TAMOF), 3) sequential liver failure-associated MOF (SMOF), and 4) MOF without any immunologic phenotype. The study investigated the association between these phenotypes and macrophage activation syndrome, a potential common pathway of uncontrolled inflammation (Carcillo et al. Pediatr Crit Care Med. 2017;18:S32-S45).
 


From the PICU to America’s Got Talent: Angelica Hale’s Story

Most people know Angelica Hale as the tenacious young lady who won hearts with her incredible performances on America’s Got Talent in 2017. But before she became the youngest runner-up in the show’s history, she was a severely ill four-year-old with sepsis and kidney failure. Read ICU Heroes Award winner Angelica Hale's story.
 


Discovery Grant Awarded to Researchers Seeking to Uncover Drivers of PARDS, Improve Therapy

Researchers seeking to evaluate the causes of PARDS and improve therapy options have been awarded the Discovery Research Grant, making it the first time the full grant has been awarded to a single project because of the strength of the grant.


Concise Critical Appraisal: Use of Early Versus Late Enteral Nutrition in Critically Ill Children

What is the benefit of early versus late nutrition in critically ill children? In this Concise Critical Appraisal, Daniel E. Sloniewsky, MD, FCCM, offers a deep dive on this Pediatric Critical Care Medicine article by Srinivasan et al, which sought to answer this question using data from the Heart and Lung Failure-Pediatric Insulin Titration (HALF-PINT) study.


Concise Critical Appraisal: PERSEVERE Biomarkers in Predicting AKI in Pediatric Septic Shock

Can the biomarkers identified in the Pediatric Sepsis Biomarker Risk Model (PERSEVERE II) be used to predict acute kidney injury and renal recovery in pediatric septic shock? This Concise Critical Appraisal explores a study in which Stanski et al (Am J Respir Crit Care Med. 2020;201:848-855) sought to answer this question.


SCCM Pod-425 Outcomes in Cystic Fibrosis PICU Admissions

Cystic fibrosis patient care has advanced greatly in recent years and the mortality rate has improved. Host Margaret M. Parker, MD, MCCM, talks with Michael A. Smith, MD, about PICU mortality and the factors associated with death among critically ill children with cystic fibrosis (Smith M, et al. Pediatr Crit Care Med. 2020 Oct;21:e879-887). Dr. Smith is in a pediatric critical care medicine fellow in the department of pediatric critical care medicine at the University of California, San Francisco in San Francisco, California, USA.


SCCM Pod-412 COVID-19 in Critically Ill Children

Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020;21:662-666) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.

Preparedness activities that every pediatric ICU should perform are also explored. Dr. Ong is head of the paediatric ICU at National University Hospital in Singapore.


SCCM Pod-407 Life Following Pediatric Septic Shock

Margaret M. Parker, MD, MCCM, and Jerry J. Zimmerman, MD, PhD, FCCM, talk about the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock.

This discussion is based on two articles Dr. Zimmerman recently published in Critical Care MedicineCritical Illness Factors Associated With Long-Term Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):319-328) and Trajectory of Mortality and Health-Related Quality of Life Morbidity Following Community-Acquired Pediatric Septic Shock (Zimmerman J, et al. Crit Care Med. 2020;48(3):329-337).

Dr. Zimmerman is professor of pediatrics and anesthesiology and a faculty member and emeritus division chief of pediatric critical care medicine at Seattle Children's Hospital, Harborview Medical Center, and University of Washington School of Medicine in Seattle, Washington, USA. He has received research funding from National Institutes of Health, Immunexpress, and Seattle Children’s Research Institute, royalties from Elsevier Publishing as co-editor for Pediatric Critical Care, and travel reimbursement from SCCM.


SCCM Pod-399 Risk for Mortality in Critically Ill Children Needing Renal Replacement Therapy

Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy," published in the November 2019 issue of Pediatric Critical Care Medicine (Hames D, et al. Pediatr Crit Care Med. 2019;20;1069-1077).

Dr. Hames speaks about some of the challenges of monitoring patients with acute kidney injury, the implications of the study for pediatric intensivists, the importance of being mindful of renal function and fluid balance for ventilated patients, and areas that need further investigation.

Dr. Hames is an attending physician in the Division of Cardiovascular Critical Care in the Department of Cardiology at Boston Children’s Hospital and an instructor in the Department of Pediatrics at Harvard Medical School in Boston, Massachusetts, USA.


SCCM Pod-394 Polyneuropathy in Critically Ill Mechanically Ventilated Children

Margaret M. Parker, MD, MCCM, speaks with Rakesh Lodha, MD, on his article titled Polyneuropathy in Critically Ill Mechanically Ventilated Children: Experience from Tertiary Care Hospital in North India, published the September issue of Pediatric Critical Care Medicine (Shubham S, et al. Pediatr Crit Care Med. 2019;20:826-831).

The authors review the methodology, primary findings, and limitations of the study, as well as implications to the clinician at the bedside and pressing research issues.

Dr. Lodha is a professor at All India Institute of Medical Sciences in New Delhi, India. This podcast is sponsored by Sound Critical Care.


SCCM Pod-393 Updated Pediatric Admission, Discharge, and Triage and Levels of Care Guidance

Margaret M. Parker, MD, MCCM, and Lorry R. Frankel, MD, FCCM, discuss the updated pediatric critical care admission, discharge, and triage criteria and levels of care guidance published in the September issue of Pediatric Critical Care Medicine (Frankel L, et al. Pediatr Crit Care Med. 2019;20:847-887).

They review the methodology behind the development of this joint Society of Critical Care Medicine and American Academy of Pediatrics updated guidance, the areas of agreement, and what we may see in future updates.

Dr. Frankel is chair of the Department of Pediatrics at California Pacific Medical Center and emeritus professor of pediatrics at Stanford University School of Medicine in Stanford, California, USA.


SCCM Pod-391 Pediatric Nutritional Guidelines

Margaret M. Parker, MD, MCCM, and Elizabeth Emrath, MD, discuss Dr. Emrath’s talk on the new pediatric nutritional guidelines (Mehta N, et al. Pediatr. Crit Care Med. 2017;18:675-715) from the 48th Critical Care Congress precourse Current Concepts in Pediatric Critical Care.

They review the updated recommendations and what future research is needed. Dr. Emrath is an assistant professor at the Medical University of South Carolina in Charleston, South Carolina, USA.

This podcast is sponsored by Nestle Health Science.


SCCM Pod-389 Infections on Extracorporeal Life Support

Margaret M. Parker, MD, MCCM, and Luregn Schlapbach, MD, FCICM, review a survey of international practice on prevention, diagnosis, and treatment of infections on extracorporeal life support in adults and children published in Pediatric Critical Care Medicine (Farrell, Deborah, et al. Pediatr Crit Care Med. 2019;20:667-671).

Dr. Schlapbach is a pediatric intensivist at Queensland Children's Hospital in South Brisbane, Australia.


SCCM Pod-384 Updated Pediatric Severe Traumatic Brain Injury Guidelines

Margaret M. Parker, MD, MCCM, and Patrick M. Kochanek, MD, MCCM, discuss the updated pediatric severe traumatic brain injury guidelines (Kochanek P, et al. Pediatr Crit Care Med. 2019;20:S1-S82).

They review what is new in the third edition of the guidelines and what further research can be done.

Dr. Kochanek is director of the Safar Center for Resuscitation Research at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania, USA.

This podcast is sponsored by Philips and Masimo.


SCCM Pod-372 Nutrition Support Therapy in the Pediatric Critically Ill Patient

Margaret Parker, MD, MCCM, speaks with Nilesh M. Mehta, MD, about the article, “Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Pediatric Critically Ill Patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition,” published in the July 2017 issue of Pediatric Critical Care Medicine. Dr. Mehta discusses best practices in nutrition therapy in critically ill children.

Dr. Mehta is the Director of Critical Care Nutrition in the division of critical care medicine in the department of anesthesiology, critical care, and pain medicine at Boston Children’s Hospital and an associate professor of anesthesia (critical care) at Harvard Medical School in Boston, Massachusetts.

Mehta, Nilesh M. MD; Skillman, Heather E. MS, RD, CSP, CNSC; Irving, Sharon Y. PhD, CRNP, FCCM, FAAN; Coss-Bu, Jorge A. MD; Vermilyea, Sarah MS, RD, CSP, LD, CNSC; Farrington, Elizabeth Anne PharmD, FCCP, FCCM, FPPAG, BCPS; McKeever, Liam MS, RDN; Hall, Amber M. MS; Goday, Praveen S. MBBS, CNSC; Braunschweig, Carol PhD, RD. Ped Crit Care Med. 2017; 18(7):675-715.

This podcast is supported by an educational grant provided from Abbott Nutrition.


SCCM Pod-369 Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality

Margaret Parker, MD, MCCM, speaks with Stefanie G. Ames, MD, about the article “Hospital Variation in Risk-Adjusted Pediatric Sepsis Mortality,” published in the May 2018 issue of Pediatric Critical Care Medicine.

Dr. Ames discusses study findings regarding the development of a method to evaluate hospital pediatric sepsis performance and how to assess hospital variation in risk-adjusted sepsis mortality in a large state-wide sample.

Dr. Ames is a pediatric critical care fellow at the University of Pittsburg School of Medicine in Pittsburg, Pennsylvania.

She is working with the Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center in the department of critical care medicine. Ped Crit Care Med. 2018; 19(5):390-396.


SCCM Pod-367 Variability in Antibiotic Use Across PICUs

Margaret Parker, MD, MCCM, speaks with Thomas V. Brogan, MD, about the article “Variability in Antibiotic Use Across PICUs,” published in the June 2018 issue of Pediatric Critical Care Medicine. Dr. Brogan discusses study findings regarding the variation in antibiotic use in pediatric intensive care units (PICUs) across institutions. He considers how overuse or inappropriate use can be addressed in PICUs in the future. Dr. Brogan is a Professor of Pediatrics in the Division of Pediatric Critical Care Medicine at the Seattle Children’s Hospital and the University Washington School of Medicine in Seattle, Washington. Ped Crit Care Med. 2018; 19(6):519-527. Released: 7/26/18