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 14 years old... thanks to everyone for your great support!..
Timely issues facing Pediatric Critical Care Medicine

Boucek MM, Mashburn C, Dunn SM, et al. Pediatric Heart Transplantation after Declaration of Cardiocirculatory Death. New Engl J Med 2008; 359:709-714. [full-text]. This issue includes several relevant and thought-provoking commentaries, including: Truog RD, Miller FG. The Dead Donor Rule and Organ Transplantation. New Engl J Med 2008; 359:674-675. [full-text]

Marik PE, Pastores SM, Annane D, et al; American College of Critical Care Medicine. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: consensus statements from an international task force by the American College of Critical Care Medicine. Crit Care Med. 2008 Jun;36(6):1937-49. [abstract]

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]

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]

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]

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]

Important News...


AAP Section on Critical Care News:

The 2008 AAP National Conference and Exhibition was in Boston, October 11-14. The SOCC program is here... (pdf; 600K)

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 Summer 2008 newsletter is here... (pdf; 1.2MB)

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


NIH updates:

The Pediatric Critical Care Scientist Development Program (PCCSDP) has been successfully reissued by the NICHD. Read the RFA here... This program is 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

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

The Collaborative Pediatric Critical Care Research Network (CPCCRN): A renewal RFA has been issued (U10) for site application here... And the Data Coordinating Center RFA is here...

more NIH updates... including announcements regarding changes to the peer review process...


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)


The third newsletter of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICSS) is here... (pdf; 380K)


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 November 2008 issue of Pediatric Critical Care Medicine:

Montañana PA, I Alapont VM, Ocón AP, López PO, Prats JL, Parreño JD. The use of isotonic fluid as maintenance therapy prevents iatrogenic hyponatremia in pediatrics: A randomized, controlled open study. Pediatr Crit Care Med. 2008; 9(6):589-597. [abstract; full-text (pdf 788K)


New PedsCCM Evidence-based Journal Club Reviews

Kumar A, Roberts D, Wood KE, et al.
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock.
[abstract]
[Review by Thomas Conlon MD, University of Pittsburgh Medical Center/Children’s Hospital of Pittsburgh of UPMC]

Knirsch W, Kretschmar O, Tomaske M, Stutz K, Nagdyman N, Balmer C, Schmitz A, Béttex D, Berger F, Bauersfeld U, Weiss M.
Cardiac output measurement in children: comparison of the Ultrasound Cardiac Output Monitor with thermodilution cardiac output measurement.
[abstract]
[Review by Jagdish Ambwani MD, Newark Beth Israel Medical Center, New Jersey]

Mercat A, Richard J-C M, Vielle B, et al. for the Expiratory Pressure (Express) Study Group
Positive End-Expiratory Pressure Setting in Adults With Acute Lung Injury and Acute Respiratory Distress Syndrome: A Randomized Controlled Trial.
[abstract]
[Review by Aveek Jayant, Aveek Jayant, Postdoctoral student, Dept of Anaesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Medical College PO, Thiruvananthapuram, India]

Kollef MH, Afessa B, Anzueto A, et al. for the NASCENT Investigation Group
Silver-Coated Endotracheal Tubes and Incidence of Ventilator-Associated Pneumonia: The NASCENT Randomized Trial
[abstract]
[Review by Guruprasad T. Mahadevaiah MD and Sameer Gupta MD, University of Minnesota Children’s Hospital, Fairview MN]

Honeycutt TC, El Khashab M, Wardrop RM 3rd, McNeal-Trice K, Honeycutt AL, Christy CG, Mistry K, Harris BD, Meliones JN, Kocis KC.
Probiotic administration and the incidence of nosocomial infection in pediatric intensive care: a randomized placebo-controlled trial.
[abstract]
[Review by Samantha Gee MD, University of Florida College of Medicine, Shand's Children's Hospital, Gainesville FL]

[ View All ]


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)

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.

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 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.

The Laura P. and Leland K. Whittier Virtual Pediatric Intensive Care Unit announces the creation of a VPICU Fellowship Program. Read details and application instructions here... (pdf 150K)

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 past couple of months on PedsCCM...

  • Borasino S, Morrison W, Silberman J, Nelson RM, Feudtner C. Physicians' Contact With Families After the Death of Pediatric Patients: A Survey of Pediatric Critical Care Practitioners' Beliefs and Self-Reported Practices. Pediatrics. 2008; 122:e1174-e1178 [abstract] (File Cabinet)
  • Domi T, Edgell DS, McCrindle BW, et al. Frequency, Predictors, and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children Pediatrics 2008;122: 1292-1298 [abstract] (File Cabinet, EB Journal Club)
  • Knoester H, Sol JJ, Ramsodit P, et al. Cardiac Function in Pediatric Septic Shock Survivors. Arch Pediatr Adolesc Med. 2008; 162:1164-1168 [abstract] (File Cabinet, EB Journal Club)
  • Changes at the NIH regarding the peer review process:
  • Yañez LJ, Yunge M, Emilfork M, Lapadula M, Alcántara A, Fernández C, Lozano J, Contreras M, Conto L, Arevalo C, Gayan A, Hernández F, Pedraza M, Feddersen M, Bejares M, Morales M, Mallea F, Glasinovic M, Cavada G. A prospective, randomized, controlled trial of noninvasive ventilation in pediatric acute respiratory failure. Pediatr Crit Care Med. 2008 Sep;9(5):484-9. [abstract] (File Cabinet, EB Journal Club)
  • The third newsletter of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICSS) is here... (pdf; 380K) (Organizations)
  • Mathews SC, Pronovost PJ. Physician Autonomy and Informed Decision Making: Finding the Balance for Patient Safety and Quality JAMA. 2008;300(24):2913-2915. [extract]
  • Zappitelli M, Goldstein SL, Symons JM, Somers MJ, Baum MA, Brophy PD, Blowey D, Fortenberry JD, Chua AN, Flores FX, Benfield MR, Alexander SR, Askenazi D, Hackbarth R, Bunchman TE; Prospective Pediatric Continuous Renal Replacement Therapy Registry Group. Protein and calorie prescription for children and young adults receiving continuous renal replacement therapy: a report from the Prospective Pediatric Continuous Renal Replacement Therapy Registry Group. Crit Care Med. 2008 Dec;36(12):3239-45. [abstract] (File Cabinet)
  • Weisberg LS. Management of severe hyperkalemia. Crit Care Med. 2008 Dec;36(12):3246-51 [abstract] (File Cabinet)

Last Updated: 2009-01-02 11:07:11

  • Cinel I, Opal SM. Molecular biology of inflammation and sepsis: A primer. Crit Care Med. 2009 Jan;37(1):291-304. [abstract] (File Cabinet)
  • de Smet AM, Kluytmans JA, Cooper BS, et al. Decontamination of the Digestive Tract and Oropharynx in ICU Patients. N Engl J Med. 2009 Jan 1;360(1):20-31. [abstract] (File Cabinet, EB Journal Club)
  • Neufeld RE, Clark BG, Robertson CM, Moddemann DM, Dinu IA, Joffe AR, Sauve RS, Creighton DE, Zwaigenbaum L, Ross DB, Rebeyka IM; Western Canadian Complex Pediatric Therapies Follow-up Group. Five-year neurocognitive and health outcomes after the neonatal arterial switch operation. J Thorac Cardiovasc Surg. 2008 Dec;136(6):1413-1421.e2. [abstract] (File Cabinet, EB Journal Club)

Last Updated: 2009-01-02 11:20:12

View More

courses & conferences to note...

Cardiology 2009, February 04 - February 08 2009 Atlantis Paradise Island, Bahamas Website...

Bedside Ultrasound in the PICU Course, February 23 - February 24 2009 McGill Medical Simulation Centre, Montreal Canada Brochure... 

Canadian Critical Care Conference, February 25 - February 27 2009 Whistler, British Columbia, Canada Website...

9th European Postgraduate Course in Neonatal and Pediatric Intensive Care, March 19 - March 21 2009 Berne, Switzerland Website...

Second International Pediatric Simulation Symposium and Workshops, April 22 - April 23 2009 Florence, Italy Website... Brochure... 

[ view all ]

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

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...

Children & Clinical Studies: an NIH-developed website to explain clinical research to children and families - why it is needed, what to expect, how to identify additional reliable resources.

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

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]

Mathews SC, Pronovost PJ. Physician Autonomy and Informed Decision Making: Finding the Balance for Patient Safety and Quality JAMA. 2008;300(24):2913-2915. [extract]

PedsCCM.org founded 1995

Questions or comments?

Fill out our Feedback Form | Editorial Notes | About Us