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

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...


Response options to donate or volunteer to assist with relief for the earthquake disaster in Haiti:
  • Project Hope
  • Center for International Disaster Information
  • Partners in Health (PIH) has been providing rural health care in Haiti for years. From Tracy Kidder (Mountains Beyond Mountains) in NY Times 1/14/10: "As a result of this calamity, Partners in Health probably just became the largest health care provider still standing in all Haiti."
  • An extensive list of various relief organizations compiled by NBC News is here...
  • Reports of various airlines offering free flights to Haiti for doctors and nurses is a hoax...


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.

A full description of needs and the programme is here.... (pdf; 85K), and an updated schedule of trips is here...


Save the date: the next Pediatric Critical Care Colloquium, sponsored by Children's Hospital of Pittsburgh of UPMC, will be May 15-17, 2010, at the Fairmont Pittsburgh.


AAP Section on Critical Care News:

The AAP 2010 National Conference and Exhibition is October 2-5 in San Francisco. Abstract submission deadline is April 16, 2010. Submit abstracts here.... The preliminary Section on Critical Care program schedule is available online via the SOCC website here... (pdf; 78K).

See the SOCC 25th Anniversary Commemorative Booklet here... (pdf; 4.8 MB)

The SOCC Summer 2009 newsletter is here... (pdf; 848K)

PREP® ICU: Critical Care Self-Assessment Program

Challenge your knowledge of pediatric critical care, review for examination, and earn Maintenance of Certification (MOC) points with the online self-study program based on subspecialty content specifications from the American Board of Pediatrics. PREP® ICU is an intensely peer-reviewed self-assessment program designed to help pediatric intensivists succeed in the PICU. Click here ( http://www.prepicu.org/ ) for a FREE trial.

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): 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...


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 fourth newsletter of the World Federation of Pediatric Intensive and Critical Care Societies (WFPICSS) is here... (pdf; 136K)


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 January 2010 issue of Pediatric Critical Care Medicine:

Breatnach C, Conlon NP, Stack M, Healy M, O'Hare BP. A prospective crossover comparison of neurally adjusted ventilatory assist and pressure-support ventilation in a pediatric and neonatal intensive care unit population* Pediatr Crit Care Med 2010; 11(1):7-11 [abstract; full-text (pdf; 262K)]


New PedsCCM Evidence-based Journal Club Reviews

King VJ, Viswanathan M, Bordley WC, et al.
Pharmacologic Treatment of Bronchiolitis in Infants and Children: A Systematic Review
[abstract]
[Review by Chloe Johnston MD, Imperial College Healthcare NHS Trust, London, UK]

Marelich GP, Murin S, Battistella F, Inciardi J, Vierra T, Roby M.
Protocol Weaning of Mechanical Ventilation in Medical and Surgical Patients by Respiratory Care Practitioners and Nurses : Effect on Weaning Time and Incidence of Ventilator-Associated Pneumonia.
[abstract]
[Review by Julia Mercer Niebauer MD, University of Alabama at Birmingham, AL]

Choong K, Bohn D, Fraser DD, Gaboury I, Hutchison JS, Joffe AR, Litalien C, Menon K, McNamara P, Ward RE
Vasopressin in Pediatric Vasodilatory Shock - A Multi-center Randomized Controlled Trial
[abstract]
[Review by Elora Hussain MD and Conrad Epting MD, Children’s Memorial Hospital, Northwestern University, Chicago, IL]

McCaffrey J, Farrell C, Whiting P, Dan A, Bagshaw SM, Delaney AP.
Corticosteroids to prevent extubation failure: a systematic review and meta-analysis.
[abstract]
[Review by Enrico Opocher MD, University Hospital of Padua, Italy]

Simon L, Saint-Louis P, Amre DK, Lacroix J, Gauvin F.
Procalcitonin and C-reactive protein as markers of bacterial infection in critically ill children at onset of systemic inflammatory response syndrome
[abstract]
[Review by Konstantine Xoinis MD, University of California, San Francisco]

[ View All ]


Important News...continued...

SCCM Pediatric Section News

From the 2009 SCCM Congress in Nashville:

Business section minutes are here... (pdf; 560K)
A report on our journal, Pediatric Critical Care Medicine, given by editor Pat Kochanek is here... (pdf; 600K)
Newsletter and Minutes from the Fellowship Directors meeting are here... (pdf; 93K)
APN Committee minutes are here... (pdf; 76K)
Resident Education Committee minutes are here... (pdf; 73K)

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.

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 month of February on PedsCCM...

  • Santamaria J, Tobin A, Holmes J. Changing cardiac arrest and hospital mortality rates through a medical emergency team takes time and constant review. Crit Care Med. 2010 Feb;38(2):445-50. [abstract] (File Cabinet)
  • Willems A, Harrington K, Lacroix J, Biarent D, Joffe AR, Wensley D, Ducruet T, HĂ©bert PC, Tucci M; TRIPICU investigators; Canadian Critical Care Trials Group; Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Comparison of two red-cell transfusion strategies after pediatric cardiac surgery: a subgroup analysis. Crit Care Med. 2010 Feb;38(2):649-56. [abstract] (File Cabinet, EB Journal Club)
  • WFPICCS Newsletter, February 1, 2010, volume 3 no. 1. [pdf; 238K] (Organizations)
  • COIITSS Study Investigators, Annane D, Cariou A, Maxime V, Azoulay E, D'honneur G, Timsit JF, Cohen Y, Wolf M, Fartoukh M, Adrie C, SantrĂ© C, Bollaert PE, Mathonet A, Amathieu R, Tabah A, Clec'h C, Mayaud J, Lejeune J, Chevret S. Corticosteroid treatment and intensive insulin therapy for septic shock in adults: a randomized controlled trial. JAMA. 2010 Jan 27;303(4):341-8. [abstract] (File Cabinet, EB Journal Club)
  • Angus DC, Mira JP, Vincent JL. Improving clinical trials in the critically ill. Crit Care Med. 2010 Feb;38(2):527-32. [abstract] (File Cabinet)
  • Miller MR, Griswold M, Harris JM 2nd, Yenokyan G, Huskins WC, Moss M, Rice TB, Ridling D, Campbell D, Margolis P, Muething S, Brilli RJ. Decreasing PICU Catheter-Associated Bloodstream Infections: NACHRI's Quality Transformation Efforts. Pediatrics. 2010; 125 206-213 [abstract] (File Cabinet, EB Journal Club)

Last Updated: 2010-02-02 20:02:06

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courses & conferences to note...

Cardiology 2010, February 10 - February 14 2010 Contemporary Resort and Convention Center Walt Disney World, Lake Buena Vista, Florida, USA Website...

The 26th Annual Children's National Medical Center Symposium on ECMO & Advanced Therapies for Respiratory Failure, February 21 - February 25 2010 Keystone, CO Website...

7th Annual Critical Care Conference, March 17 - March 20 2010 Whistler, BC, Canada Website...

The 6th International Pediatric Continuous Renal Replacement Therapy (PCRRT), April 08 - April 10 2010 Rome, Italy Website... Brochure... 

Pediatric Ethics 2010: Advancing the Interests of Children, April 22 - April 24 2010 Cleveland, OH Website...

[ 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]

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