The August 2023 issue features articles examining physician experience when families refuse determination of death by neurologic criteria and another examining the outcomes after implementation of an ICU Liberation Bundle (A-F). Clinical investigations compared outcomes associated with centrifugal versus roller pumps for neonatal venovenous extracorporeal membrane oxygenation (ECMO) with somewhat unexpected results, assessed the inspiratory efforts in sedated children, implemented an algorithm to work up new fever or instability, and explored the utility of repeat tracheal aspirate cultures in the pediatric intensive care unit (PICU). The PCCM trial assessed the use of bundled consent for PICU patients, and the remainder of articles covered a variety of topics, from the relationship of admission PaO2 and mortality, long-term functional outcomes for neonates with congenital diaphragmatic hernia, enteral nutrition on ECMO, the use of shock in in-hospital cardiac arrest, and the use of inhaled anesthetics versus ECMO for status asthmaticus.