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

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)]

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]

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 AAP Call for Abstracts for the Section on Critical Care is now available: http://aap.confex.com/aap/2009/cfp.cgi. These abstracts will be presented at the 2009 National Conference and Exhibition Saturday, October 17, 2009 - Tuesday, October 20, 2009 in Washington, DC. Deadline for submissions was Friday, April 17, 2009. The preliminary Section on Critical Care program schedule now available online via the SOCC website here.... This includes a special 25-Year SOCC Anniversary program and celebration If you have any questions, please contact Carolyn Mensching at 847-434-4079 or via email at cmensching@aap.org.

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


The International Children's Heart Foundation welcomes pediatric intensivists and nurses with significant cardiac experience for 2 week trips to provide direct care and local program development. Read more here...


NIH updates:

From Tammara Jenkins on January 13, 2009:
The Critical Pertussis study, sponsored by the NICHD Collaborative Pediatric Critical Care Research Network (CPCCRN), began enrolling subjects in June, 2008. There are currently 16 non–CPCCRN PALISI sites involved in the study; however, additional sites are still being accepted. Non-CPCCRN Site PIs are required to attend a 1-1/2 day training session in order to participate. For convenience, the final training session has been scheduled to coincide with the March PALISI meeting. The training meeting will be held in Salt Lake City on March 9 & 10, 2009. Please direct inquiries and send the completed interest form and requested CVs to Tammara Jenkins via email tjenkins@mail.nih.gov (Note: submission of a completed interest form does not imply commitment from either party at this time). More information about this study, including interest forms and the most current protocol version, is available on the PALISI website

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 May 2009 issue of Pediatric Critical Care Medicine:

Tibballs J, Kinney S. Reduction of hospital mortality and of preventable cardiac arrest and death with increased survival on introduction of a pediatric medical emergency team. Pediatr Crit Care Med. 2009; 10:306–312. [abstract; full-text (pdf; 220K)]


New PedsCCM Evidence-based Journal Club Reviews

Esteban A, Alia I, Tobin MJ, et al.
Effect of Spontaneous Breathing Trial Duration on Outcome of Attempts to Discontinue Mechanical Ventilation
[abstract]
[Review by M. Fares Albitar MD, Ikram Haque MD, Shands Hospital at the University of Florida, Gainesville, Florida]

Yung D, Widlitz AC, Rosenzweig EB, et al.
Outcomes in Children With Idiopathic Pulmonary Arterial Hypertension
[abstract]
[Review by Christoph Hornik MD, David Turner MD, Duke Children’s Hospital, Durham, North Carolina]

Knoester H, Bronner MB, Bos AP.
Surviving pediatric intensive care: physical outcome after 3 months.
[abstract]
[Review by Simon Li, MD and E. Vincent S. Faustino, MD, Yale University School of Medicine, New Haven, CT]

Gray A, Goodacre S, Newby DE, Masson M, Sampson F, Nicholl J; 3CPO Trialists.
Noninvasive ventilation in acute cardiogenic pulmonary edema.
[abstract]
[Review by Kimberly Baker DO and Michael Wilhelm MD, American Family Children’s Hospital at the University of Wisconsin Hospital and Clinics Madison, WI]

Papazian L, Gainnier M, Marin V, et al.
Comparison of prone positioning and high-frequency oscillatory ventilation in patients with acute respiratory distress syndrome.
[abstract]
[Review by Jonna Clark MD, Seattle Children's Hospital, Seattle WA]

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Important News...continued...

SCCM Pediatric Section News

The Pediatric Section meetings at the 2009 SCCM Congress in Nashville are here... (pdf; 28K)

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 past couple of months on PedsCCM...

  • McCaffrey J, Farrell C, Whiting P, Dan A, Bagshaw SM, Delaney AP. Corticosteroids to prevent extubation failure: a systematic review and meta-analysis. Intensive Care Med. 2009 Jun;35(6):977-86 [abstract] (File Cabinet, EB Journal Club)
  • Maloney-Wilensky E, Gracias V, Itkin A, Hoffman K, Bloom S, Yang W, Christian S, LeRoux PD. Brain tissue oxygen and outcome after severe traumatic brain injury: a systematic review. Crit Care Med. 2009 Jun;37(6):2057-63. [abstract] (File Cabinet)
  • Annane D, Bellissant E, Bollaert PE, Briegel J, Confalonieri M, De Gaudio R, Keh D, Kupfer Y, Oppert M, Merduri GU. Corticosteroids in the Treatment of Severe Sepsis and Septic Shock in Adults: A Systematic Review. JAMA. 2009; 301:2362-2375. [abstract] (File Cabinet, EB Journal Club)
  • Bronicki RA, Anas NG. Cardiopulmonary interaction. Pediatr Crit Care Med. 2009 May;10(3):313-22. [abstract] (File Cabinet)
  • Marchick MR, Kline JA, Jones AE. The significance of non-sustained hypotension in emergency department patients with sepsis. Intensive Care Med. 2009 Jul;35(7):1261-4. [abstract] (File Cabinet, EB Journal Club)
  • Dünser MW, Takala J, Ulmer H, Mayr VD, Luckner G, Jochberger S, Daudel F, Lepper P, Hasibeder WR, Jakob SM. Arterial blood pressure during early sepsis and outcome. Intensive Care Med. 2009 Jul;35(7):1225-33. [abstract] (File Cabinet, EB Journal Club)
  • Poomthavorn P, Lertbunrian R, Preutthipan A, Sriphrapradang A, Khlairit P, Mahachoklertwattana P. Serum free cortisol index, free cortisol, and total cortisol in critically ill children. Intensive Care Med. 2009 Jul;35(7):1281-5. [abstract] (File Cabinet)
  • Moler FW, Meert K, Donaldson AE, Nadkarni V, Brilli RJ, Dalton HJ, Clark RS, Shaffner DH, Schleien CL, Statler K, Tieves KS, Hackbarth R, Pretzlaff R, van der Jagt EW, Levy F, Hernan L, Silverstein FS, Dean JM; Pediatric Emergency Care Applied Research Network. In-hospital versus out-of-hospital pediatric cardiac arrest: a multicenter cohort study. Crit Care Med. 2009 Jul;37(7):2259-67. [abstract] (File Cabinet)
  • Siempos II, Kopterides P, Tsangaris I, Dimopoulou I, Armaganidis AE. Impact of catheter-related bloodstream infections on the mortality of critically ill patients: a meta-analysis. Crit Care Med. 2009 Jul;37(7):2283-9. [abstract] (File Cabinet, EB Journal Club)

Last Updated: 2009-06-23 19:29:03

  • Pollack MM, Holubkov R, Glass P, Dean JM, Meert KL, Zimmerman J, Anand KJ, Carcillo J, Newth CJ, Harrison R, Willson DF, Nicholson C; Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network. Functional status scale: new pediatric outcome measure. Pediatrics. 2009 Jul;124(1):e18-28. [abstract] (File Cabinet)
  • Braga MS, Dominguez TE, Pollock AN, Niles D, Meyer A, Myklebust H, Nysaether J, Nadkarni V. Estimation of optimal CPR chest compression depth in children by using computer tomography. Pediatrics. 2009 Jul;124(1):e69-74. [abstract] (File Cabinet)
  • Zimmerman JJ, Akhtar SR, Caldwell E, Rubenfeld GD. Incidence and outcomes of pediatric acute lung injury. Pediatrics. 2009 Jul;124(1):87-95. [abstract] (File Cabinet)
  • Orr RA, Felmet KA, Han Y, McCloskey KA, Dragotta MA, Bills DM, Kuch BA, Watson RS. Pediatric specialized transport teams are associated with improved outcomes. Pediatrics. 2009 Jul;124(1):40-8. [abstract] (File Cabinet)
  • Zebrack M, Dandoy C, Hansen K, Scaife E, Mann NC, Bratton SL. Early resuscitation of children with moderate-to-severe traumatic brain injury. Pediatrics. 2009 Jul;124(1):56-64. [abstract] (File Cabinet)

Last Updated: 2009-07-01 08:51:03

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courses & conferences to note...

10th Congress of the World Federation of Societies of Intensive and Critical Care Medicine, August 28 - September 01 2009 Florence, Italy Website... Brochure... 

10th World Congress of WFSICCM & WFPICCS Meeting, August 28 - September 01 2009 Florence, Italy Website...

1st Asian Congress Pediatric Intensive Care (APICC2009) & 11th National Conference of Pediatric Critical Care Chapter of Indian Academy of Pediatrics (IAP), September 24 - September 27 2009 Chandigarh, India Website...

AAP 2009 National Conference and Exhibition, October 17 - October 20 2009 Washington, DC Website...

SCCM's 39th Critical Care Congress, January 09 - January 13 2010 Miami Beach, FL 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

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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