PedsCCM: The Pediatric Critical Care Website:
The multidisciplinary and practical resource for Pediatric Critical Care on the Internet Peer reviewed original content integrated with links to selected web resources ... now 13 years old... thanks to everyone for your great support!..

Timely issues facing Pediatric Critical Care Medicine

de Oliveira CF, de Oliveira DS, Gottschald AF, Moura JD, Costa GA, Ventura AC, Fernandes JC, Vaz FA, Carcillo JA, Rivers EP, Troster EJ. ACCM/PALS haemodynamic support guidelines for paediatric septic shock: an outcomes comparison with and without monitoring central venous oxygen saturation. Intensive Care Med. 2008 Mar 28; DOI 10.1007/s00134-008-1085-9. [abstract]

Dellinger RP, Levy MM, Carlet JM, et al; for the International Surviving Sepsis Campaign Guidelines Committee. Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2008. Crit Care Med. 2008 Jan;36(1):296-327 [abstract]

Sharek PJ, Parast LM, Long K, Coombs J, Earnest K, Sullivan J, Frankel LR, Roth SJ. Effect of a Rapid Response Team on Hospital-wide Mortality and Code Rates Outside the ICU in a Children's Hospital. JAMA 2007;298 2267-2274 [abstract]

Lacroix J, Hebert PC, Hutchison, et al. Transfusion Strategies for Patients in Pediatric Intensive Care Units. New Engl J Med 2007; 356:1609-1619. [abstract]

Brilli RJ, Gibson R, Luria JW, Wheeler TA, Shaw J, Linam M, Kheir J, McLain P, Lingsch T, Hall-Haering A, McBride M. Implementation of a medical emergency team in a large pediatric teaching hospital prevents respiratory and cardiopulmonary arrests outside the intensive care unit* Pediatr Crit Care Med. 2007; 8(3):236-246 [abstract][full-text (pdf;1.7M)]

Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents. Pediatric Critical Care Medicine 2003; 4(3):S1-S75. [full-text]

Slonim AD, Pollack MM. Integrating the Institute of Medicine's six quality aims into pediatric critical care: Relevance and applications. Pediatr Crit Care Med. 2005 May;6(3):264-269. [abstract; full-text (pdf: 280K)]

Carnevale FA, Alexander E, Davis M, Rennick J, Troini R. Daily living with distress and enrichment: the moral experience of families with ventilator-assisted children at home. Pediatrics. 2006 Jan;117(1):e48-60. [abstract]

2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, includes new recommendations for Pediatric Basic Life Support and Pediatric Advanced Life Support

The Robert Wood Johnson Foundation has issued a Special Report on Pediatric Palliative Care. This in response to the Institute of Medicine's 2002 report: When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families

Curtis JR, Cook DJ, Wall RJ, et al. Intensive care unit quality improvement: a "how-to" guide for the interdisciplinary team. Crit Care Med. 2006 Jan;34(1):211-8 [abstract]

1st International Sepsis Forum on Sepsis in Infants and Children. Pediatr Crit Care Med 2005; S1-S164. [table of contents]

Rosenberg DI, Moss MM, AAP Section on Critical Care and Committee on Hospital Care. Guidelines and Levels of Care for Pediatric Intensive Care Units. Pediatrics 2004;114 1114-1125. [abstract]

Perondi MBM, Reis AG, Paiva EF, Nadkarni VM, Berg RA. A Comparison of High-Dose and Standard-Dose Epinephrine in Children with Cardiac Arrest. New Engl J Med 2004; 350:1722-1730. [abstract]

Han YY, Carcillo JA, Dragotta MA, et al. Early Reversal of Pediatric-Neonatal Septic Shock by Community Physicians Is Associated With Improved Outcome. Pediatrics 2003;112 793-799. [abstract]. With an accompanying editorial: Kirby A, Goldstein B. Improved Outcomes Associated With Early Resuscitation in Septic Shock: Do We Need to Resuscitate the Patient or the Physician? Pediatrics 2003;112 976-977 [full-text]

Carcillo JA, Fields AI et al. Clinical practice parameters for hemodynamic support of pediatric and neonatal patients in septic shock. Crit Care Med. 2002;30(6):1365-78. [abstract; full-text pdf from the SCCM]

Tenner PA, Dibrell H, Taylor RP. Improved survival with hospitalists in a pediatric intensive care unit Crit Care Med 2003; 31(3):847-852 [abstract]

O'Grady NP, Alexander M, Dellinger EP et al. Guidelines for the Prevention of Intravascular Catheter-Related Infections. Pediatrics 2002;110:e51 [abstract]

Nolan JP, Morley PT, Vanden Hoek TL, et al. ; International Liaison Committee on Resuscitation. Therapeutic hypothermia after cardiac arrest: an advisory statement by the advanced life support task force of the International Liaison Committee on Resuscitation. Circulation. 2003 Jul 8;108(1):118-21 [full-text]

American College of Cardiology Foundation/American Heart Association/American College of Physicians, Task Force on Clinical Competence. ACC/AHA/AAP recommendations for training in pediatric cardiology. Pediatrics. 2005; 116:1574-1596. [full-text] Correspondence in response: Baden HP, Zimmerman JJ, Brilli RJ et al. Intensivist-Led Team Approach to Critical Care of Children With Heart Disease. Pediatrics 2006;117 1854-1856 [link]

Drabek T, Stezoski J, Garman RH, Wu X, Tisherman SA, Stezoski SW, Fisk JA, Jenkins L, Kochanek PM. Emergency preservation and delayed resuscitation allows normal recovery after exsanguination cardiac arrest in rats: a feasibility trial. Crit Care Med. 2007 Feb;35(2):532-7. [abstract]

Important News...

Intensivists needed for multiple International Children's Heart Foundation congenital heart surgery trips this year. Read more....

CA-BSI Collaborative - Phase II Announcement

The National Association of Children’s Hospitals and Related Institutions (NACHRI) and a team of PICU clinicians and Improvement Science faculty launched a three-year quality improvement project (Phase I) in October of 2006 that focused on prevention of catheter-associated blood stream infections (CA-BSI) in the 29 pediatric intensive care units (PICU) of 27 children’s institutions. The results of this Phase I collaborative have been remarkable. This Phase I collaborative is now being expanded to additional PICUs that seek to improve the healthcare of children by preventing CA-BSI events. Our initial collaborative progress to date shows:

The number of infections has decreased from a pre-collaborative CA-BSI rate of 5.39 per 1,000 catheter days to a sustained rate of 3.19 per 1,000 catheter days. This reduction represents a statistically significant 41 percent decrease in CA-BSI events. The reduced CA-BSI rate can be extrapolated to:

  • Prevention of 177 infections in the 27 institutions
  • Cost savings of approximately $6 million
  • Estimated 20 deaths prevented

As the Co-Chairs for this project we want to make you aware that we are now enrolling participating sites into the second phase of the project. We hope to enroll an additional 40 - 50 PICUs. In addition, we are happy to answer questions you may have. We are attaching additional information and an enrollment sheet for you.

Richard J. Brilli (rich.brilli@cchmc.org ) and Marlene M. Miller (mmiller@nachri.org)


AAP Section on Critical Care News:

The 2008 AAP National Conference and Exhibition is in Boston, October 11-14. Abstract submission deadline is April 11, 2008. The SOCC preliminary program is here...

New from PREP®!: Critical Care Self-Assessment Program

Review for exams and maintain your knowledge of pediatric critical care with the new self-study program from a source you can trust. Brought to you by the American Academy of Pediatrics' Pediatrics Review and Education Program®, PREP® ICU is an online subspecialty self-assessment program designed to help pediatric intensivists succeed in the PICU. Click here for a FREE trial.

The SOCC Spring 2007 newsletter is here... (pdf; 500K)

A joint resource from the AAP and the AHRQ is available: Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians

Registration for the ABP's 2008 Pediatric Critical Care Medicine Certifying Examination has closed; the deadline was March 31, 2008. Register on the ABP website...

Pediatric Critical Care Medicine 2008: 5th Biannual Review for Board Preparation, Recertification, and Comprehensive Update. April 12-15, 2008. Ritz-Carlton, McLean VA. [brochure; website]

NIH updates:

The Pediatric Critical Care Scientist Development Program (PCCSDP) has been funded to foster the development of highly promising young faculty in pediatric critical care into physician scientists. Details of the program can be found at www.pccsdp.org

PA-04-059: Technologies for Monitoring and Performing Resuscitation (SBIR [R43/R44]): This funding opportunity will foster development of better systems and methods for out-of-hospital and basic resuscitation research that:

  • enables monitoring of genetic, molecular, biochemical, physical or metabolic derangements associated with circulatory, hypoxemic, or traumatic arrest; and
  • elucidates the unique pathophysiology of irreversible injury following multiple organ or whole-body ischemia and reperfusion.

NIH Program Announcement for EMSC research: "This multi-agency program announcement is designed to improve the quality and quantity of research related to emergency medical services for children (EMSC), with the goal of reducing morbidity and mortality in children through improved care delivery." Read the full text here...

Multidisciplinary Translational Research in Critical Care (RO1). Read more...

New CDC funding opportunities for brain injury and acute injury research.... Read more here...

Be sure to scan the list of fellowships available for those with NIH Training Grant funding for pediatric scientist training...

more NIH updates...


PEDIATRIC CRITICAL CARE MEDICINE
our specialty's first journal is now online - bimonthly - with full-text
Support this acclaimed resource by subscribing today!

Featured full-text article from the March 2008 issue of Pediatric Critical Care Medicine:

Yung M, Wilkins B, Norton L, Slater A, for the Paediatric Study Group; Australian and New Zealand Intensive Care Society. Glucose control, organ failure, and mortality in pediatric intensive care*. Pediatr Crit Care Med 2008; 9(2):147-152 [abstract; full-text (188K)]


New PedsCCM Evidence-based Journal Club Reviews

Thomas NJ, Hollenbeak CS, Lucking SE, Willson DF.
Cost-effectiveness of exogenous surfactant therapy in pediatric patients with acute hypoxemic respiratory failure.
[abstract]
[Review by Mahesh Sharman MD, Paula Silva MD, Hurley Medical Center and Michigan State University, Flint, MI]

Nadel S, Goldstein B, Williams MD, Dalton H, Peters M, Macias WL, Abd-Allah SA, Levy H, Angle R, Wang D, Sundin DP, Giroir B
REsearching severe Sepsis and Organ dysfunction in children: a gLobal perspective (RESOLVE) study group. Drotrecogin alfa (activated) in children with severe sepsis: a multicentre phase III randomised controlled trial.
[abstract]
[Review by Kimberly Baker MD, American Family Children's Hospital, University of Wisconsin, Madison, WI]

Cheng KC, Hou CC, Huang HC, Lin SC, Zhang H.
Intravenous injection of methylprednisolone reduces the incidence of postextubation stridor in intensive care unit patients.
[abstract]
[Review by Julianne Harrison DO, Myke Federman MD, Mattel Children’s Hospital at UCLA, Los Angeles CA]

Garrel D, Patenaude J, Nedelec B, et al.
Decreased mortality and infectious morbidity in adult burn patients given enteral glutamine supplements: A prospective, controlled, randomized clinical trial.
[abstract]
[Review by Jama Sy MD, Texas Children's Hospital and Baylor College of Medicine, Houston TX]

Casartelli CH, Garcia PC, Branco RG, Piva JP, Einloft PR, Tasker RC.
Adrenal response in children with septic shock.
[abstract]
[Review by Penelope Sandiford MD, Children’s Hospital of Michigan, Detroit MI]

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Important News...continued...

SCCM Pediatric Section News

Papers discussed at the Pediatrics Year in Review session at the SCCM Congress in Hawaii are here... (pdf; 100K)
Minutes from the Business Meeting are here... (pdf;40K)
Minutes from the Fellowship Directors meeting are here... (pdf; 208K)



The new PICU List is operational. Details are here... Or to join the new forum and email list, click on http://www.vpicu.org/piculist_signup.php

Nursing/Advanced Practice Nursing Section News: The PedsCCM EB Journal Club now has a Nursing Research section. The new section will highlight the research of Advanced Practice Nurses. APN's are encouraged to submit reviews to this new section.

The Fifth World Congress on Pediatric Critical Care, June 24-28, 2007, in Geneva, Switzerland, was a great success. Presentations are now available for download from this meeting here....

From the FDA and CDC: Call for cases of Guillain Barre Syndrome (GBS) following administration of Meningococcal Conjugate Vaccine A, C, Y, and W135 (trade name Menactra)... More details...

NACHRI and CHCA PICU Catheter-associated Bloodstream infection initiatives make mainstream press: Landro L. Pediatric ICUs Make Headway Against Infection. Wall Street Journal Online. April 18, 2007. [full-text]


The first instructional video on the New England Journal of Medicine website comes from our colleagues: Tegtmeyer K, Brady G, Lai S, Hodo R, Braner D. Placement of an Arterial Line. New Engl J Med 2006; 354:e13. [free video]

Also see: Graham AS, Ozment C, Tegtmeyer K, Lai S, Braner DAV. Central Venous Catheterization. New Engl J Med 2007; 356:e21 [video]

The Pediatric Cardiac Intensive Care Society, PCICS, was formed to provide an optimum forum to promote excellence in pediatric cardiac critical care medicine. We have joined together from diverse backgrounds, organized a professional society, and now launch our inaugural membership campaign. The Society seeks international participation by healthcare professionals dedicated to acquiring knowledge and improving practice for our critically ill patients with congenital and acquired heart disease. (2005 Symposium information here...)

The Virtual PICU, in association with the National Association of Children's Hospitals and Related Institutions, and The National Outcomes Center announce the creation of VPS, LLC, the distributor and coordinating center for VPS (Virtual PICU Performance System), PICU database software. Go to myvps.org to learn more and sign up to participate.

Dr. Greg Hammer at Stanford University is seeking sites interested in participating in a NICHD funded study of the effects of sodium nitroprusside. Read more...

Updated request for participation from Drs. Wong and Shanley at Cincinnati Children's: "... we have a large scale clinical study to conduct microarray analyses in children with septic shock. Specifically, we are proposing to develop a national-level genomic data base (RNA) of children with SIRS and septic shock. The data base will be mined to conduct high throughput microarray analyses to define the genome-level expression profiles in this patient population." More details and contact information is here (pdf file, 52K)...



What's new for the month of May on PedsCCM...

  • Iscimen R, Cartin-Ceba R, Yilmaz M, Khan H, Hubmayr RD, Afessa B, Gajic O. Risk factors for the development of acute lung injury in patients with septic shock: an observational cohort study. Crit Care Med. 2008 May;36(5):1518-22. [abstract] (File Cabinet, EB Journal Club)
  • Huang SC, Wu ET, Chen YS, Chang CI, Chiu IS, Wang SS, Lin FY, Ko WJ. Extracorporeal membrane oxygenation rescue for cardiopulmonary resuscitation in pediatric patients. Crit Care Med. 2008 May;36(5):1607-13. [abstract] (File Cabinet, EB Journal Club)
  • Critical Care Nursing of Infants and Children. 2nd Edition. Curley MAQ, Moloney-Harmon PA, eds. 2001. (this edition is out of print and now freely available) (Nursing)

Last Updated: 2008-05-06 18:14:42

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courses & conferences to note...

5th Annual Conference on Pediatric CRRT, June 19 - June 21 2008 Disney's Contemporary Resort, Orlando, FL Website...

AAP 2008 National Conference and Exhibition, October 11 - October 14 2008 Boston, MA Website... Brochure... 

19th ESPNIC Medical & Nursing Annual Congress at the European Academy of Paediatrics, October 24 - October 28 2008 Nice, France Website...

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and also worth noting...

A letter from the heart to physicians, from a mom with a child with special needs. A special message worth reading. [pdf; 56K]

Critical Care Nursing of Infants and Children. 2nd Edition. Curley MAQ, Moloney-Harmon PA, eds. 2001. (this edition is out of print and now freely available)

Program for Maintenance of Certification in Pediatrics update: The Pediatric Critical Care Medicine self-assessment is now available on the ABP Web site

The online pediatric mechanical ventilation simulator is back, from Ken Tegtmeyer, Oregon Health & Science University, and the Media Lab at Doernbecher Children's Hospital, Portland, OR

Pediatric Critical Care Medicine Board Review questions, from the Board Review Course by Tony Slonim and Heidi Dalton, D.C. Children's, now available for purchase. From Medtext.

World Federation of Pediatric and Intensive Care Societies (WFPICCS) Pediatric Sepsis Initiative Database is operational. Read more...

The TRIP database (Turning Research Into Practice) now has a special search page for critical care.

From Dr. Goldstein at Oregon Health & Sciences University: Traumatic Brain Injury Research Project: additional sites interested in participating in our physiologic waveform analysis and dynamic ICP modeling research project. Read more here...

How well do intensivists follow the evidence-based guidelines for prevention of catheter-related bloodstream infection when placing central venous lines? Not too well in the adult world, by their own admission: Rubinson L, Haponik EF, Wu AW, Diette GB. Internists' Adherence to Guidelines for Prevention of Intravascular Catheter Infections. JAMA 2003;290 2802 [abstract]

Pediatric Emergency Meds Drip Sheet Generator, D Hanauer

Pediatrics on Hand; the website for pediatric applications and files for your Palm OS PDA. Stockwell D, Bell P. Children's National Medical Center.

PICU Tools - a Palm OS application for pediatric intensive care practitioners. Calculate infusion rates, osmolarity, drug dosages, and complete hemodynamic profiles from pulmonary artery catheter data. Provides arterial blood gas interpretation, lab values and more. Now updated to version 4.0! Freeware, by M. Verive. Details here...

A comprehensive website all about pediatric continuous renal replacement therapy: pcrrt.com. Tim Bunchman, DeVos Children's Hospital, Grand Rapids, MI

Scoring Systems for ICU and Surgical Patients, with PRISM, PIM, PELOD, Pediatric Coma Scale, the Rotterdam score for meningococcal septic shock in children, Neonatal TISS, and now updated with PIM 2 and CRIB 2. By Jean-Yves Marandon, Société Française d'Anesthésie et de Réanimation.

Isabel Clinical Decision Support System: a online pediatric differential diagnosis tool, with contextual links to reference sources. (now requires paid subscription)

Request for Information from the CDC: Acute Encephalopathy Cases in U.S. Children Associated with Influenza Virus Infection. Read more here ...

The AAP announces a new area on their website for Children, Terrorism, and Disaster. Also of note: A joint resource from the AAP and the AHRQ is available: Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians

AHRQ Web M & M; peer-reviewed, online medical journal highlighting patient safety lessons drawn from real cases of medical errors

The NIH proposes all NIH-sponsored studies' publications be made publicly available, essentially adopting the call of The Public Library of Science. Read more here.... And add your voice to the public comment page. Read about Open Access here...

WWWeb Epidemiology & Evidence-based Medicine Sources for Veterinarians; an incredibly comprehensive list of clinical epidemiology and EBM links for health care practitioners treating all species!

A new, interactive website full of EBM tips: Evidence Based Practice Tips: Learning Tools for Evidence-based Practice

Want to publish your clinical trial in JAMA, The New England Journal, or other member journals of the International Committee of Medical Journal Editors? Since July 2005, your trial needs be registered in advance. Read DeAngelis CD, Drazen JM, Frizelle FA et al. Clinical Trial Registration: A Statement From the International Committee of Medical Journal Editors. JAMA 8 September 2004 (10.1001/jama.292.11.1363) [full-text]. Go to www.clinicaltrials.gov to register a trial. An update: Laine C, et al. Clinical Trial Registration: Looking Back and Moving Ahead. New Engl J Med 2007; 10.1056/NEJMe078110 [full-text]

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