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PCCM Audio Summary - June 2026

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The June 2026 issue of Pediatric Critical Care Medicine (PCCM) features four original research articles focused on topics of extracorporeal membrane oxygenation (ECMO) and dying, including: (1) layperson knowledge and understanding of determination of brain death/death by neurologic criteria in the pediatric intensive care unit (PICU) and recommendations for a toolkit, (2) comparison of patients with adenoviral respiratory infections versus those with other viral respiratory infections on ECMO, (3) a retrospective cost analysis of bivalirudin monitoring using dilute thrombin time in pediatric ECMO, and (4) development of an instrument to measure the quality of dying and death in PICUs in Japan. The three clinical investigation articles explored the pathogenesis contributing to arterial catheter–associated proximal ischemic injury, the development of the Critical Illness Recovery for ChiLdrEn (CIRCLE) personalized program to improve child and family outcomes, and evaluation of pre-ECMO markers of impaired oxygen delivery and neurologic outcomes in infants on ECMO. A PCCM technical note describes the use of an “in-series” approach to apply both continuous renal replacement therapy and therapeutic plasma exchange in patients who need it. The PCCM trials are in the beginning phases: the Paediatric Intensive Care Adaptive Platform Trial (PIVOTAL) aims to embed clinical research within routine pediatric critical care practice, and the Protocolized Evaluation of Permissive Blood Pressure Targets vs. Usual Care (PRESSURE) trial aims to compare a permissive mean arterial pressure target with usual care in critically ill children. The PCCM narrative this month is entitled “Extubate Patient.”