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Timely issues facing Pediatric Critical Care Medicine
Two interesting point-counterpoint editorials regarding 24/7 in-house intensivist staffing:Burnham El, Mass M, Geraci MW. The Case for 24/7 In-House Intensivist Coverage Am. J. Respir. Crit. Care Med. 2010;181 1159-1160 [full-text], and Kahn JM, Hall JB. More Doctors to the Rescue in the Intensive Care Unit: A Cautionary Note. Am. J. Respir. Crit. Care Med. 2010;181 1160-1161 [full-text]
Brierley J, Carcillo J, Choong K, et al. 2007 American College of Critical Care Medicine clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock* Crit Care Med. 2009; 37(2):666-688 [abstract]
Newth CJ, Venkataraman S, Willson DF, Meert KL, Harrison R, Dean JM, Pollack M, Zimmerman J, Anand KJ, Carcillo JA, Nicholson CE; Eunice Shriver Kennedy National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Weaning and extubation readiness in pediatric patients. Pediatr Crit Care Med. 2009 Jan;10(1):1-11. [abstract; full-text (pdf; 730K)]
Angus DC, Mira JP, Vincent JL. Improving clinical trials in the critically ill. Crit Care Med. 2010 Feb;38(2):527-32. [abstract]
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] Levy MM, Dellinger RP, Townsend SR, Linde-Zwirble WT, Marshall JC, Bion J, Schorr C, Artigas A, Ramsay G, Beale R, Parker MM, Gerlach H, Reinhart K, Silva E, Harvey M, Regan S, Angus DC. The Surviving Sepsis Campaign: results of an international guideline-based performance improvement program targeting severe sepsis. Crit Care Med. 2010; 38:367-374. [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] 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...
From the World Federation of Pediatric Intensive and Critical Care Societies: "6th World Congress on Pediatric Critical Care, Syndney, Australia, March 13-17, 2011. Abstract Submissions close Friday 10 September 2010. Register now to secure your attendance at this important and exciting Congress. Be sure to register by 10 December 2010 to take full advantage of the Early Bird special rate. Click here to register." Response options to donate or volunteer to assist with relief for the earthquake disaster in Haiti:
Standing opportunities from the The International Children's Heart Foundation (ICHF), which welcomes pediatric intensivists and nurses with significant cardiac experience for 2 week trips to provide direct care and local program development. Pressing need: Beijing, China, September 4-15. This is a 10 day mission, to Beijing Children's Hospital. The unit has been working with ICHF since 2006, and is a new facility with Drager equipment throughout equipped in 2009. The unit does over 600 cardiac surgeries on children independently - and during our missions focusses on complex cases, infants and re-operations A full description of needs and the programme is here.... (pdf; 100K), and an updated schedule of trips is here...
NIH updates: The Pediatric Critical Care Scientist Development Program (PCCSDP) has been successfully reissued by the NICHD. Read more 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 The deadline for receipt of applications is October 1, 2010
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): Willson DF, Dean JM, Meert KL, Newth CJ, Anand KJ, Berger J, Harrison R, Zimmerman J, Carcillo J, Pollack M, Holubkov R, Jenkins TL, Nicholson C; for the Eunice Kennedy Shriver National Institute of Child Health, and Human Development Collaborative Pediatric Critical Care Research Network. Collaborative Pediatric Critical Care Research Network: Looking back and moving forward. Pediatr Crit Care Med 2010; 11(1):1-6. [abstract] more NIH updates... including announcements regarding changes to the peer review process... AAP Section on Critical Care News:
A joint resource from the AAP and the AHRQ is available: Pediatric Terrorism and Disaster Preparedness: A Resource for Pediatricians Last Updated: 2010-08-31 07:45:52 New PedsCCM Evidence-based Journal Club Reviews Fong JJ, Sylvia L, Ruthazer R, Schumaker G, Kcomt M, Devlin JW. Rajagopal SK, Almond CS, Laussen PC, Rycus PT, Wypij D, Thiagarajan RR. Afessa B, Shorr AF, Anzueto AR, Craven DE, Schinner R, Kollef MH. Franck LS, Harris SK, Soetenga DJ, Amling JK, Curley MA. Shorr AF, Jackson WL, Kelly KM, Fu M, Kollef MH. [ View All ]
Important News...continued... From the 2009 SCCM Congress in Nashville:
Business section minutes are here... (pdf; 560K)
"The EMSC National Resource Center has developed an online interactive map designed to provide health care professionals interested in volunteering a resource to identify disaster volunteer agencies in their state." The map is here....
The June 2010 newsletter of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICSS) is here... (pdf; 312K)
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: 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) 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. 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)... Last Updated: 2010-07-13 15:06:46 and also worth noting... Pediatric Fundamental Critical Care Support Approved U.S. Course ScheduleA 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] Last Updated: 2010-02-18 09:09:44 |
courses & conferences to note... American Academy of Pediatrics National Congress and Exhibition (NCE): Section on Critical Care, October 03 - October 04 2010 San Francisco, CA Brochure... 9th Optimizing Mechanical Ventilation for Infants and Children Conference, October 19 - October 21 2010 Washington-Duke Inn, Duke University Campus, Durham NC Website... Brochure... The Pediatric Cardiac Critical Care Society 8th International Conference, December 08 - December 11 2010 Miami Beach, Florida Website... SCCM 40th Annual Congress, January 15 - January 19 2011 San Diego, CA Website... 6th World Congress on Pediatric Critical Care, March 13 - March 17 2011 Sydney, Australia Website... Brochure... [ view all ] What's new for the past couple of months on PedsCCM...
Last Updated: 2010-08-24 16:36:05 |
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