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Adult ICU Liberation Guidelines PANDEM Guidelines for Children and Infants
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This podcast discusses a novel machine learning model that identifies ICU transfers in hospitalized children more accurately than current tools. The discussion centers on the article “Development and External Validation of a Machine Learning Model for Prediction of Potential Transfer to the PICU,” published in the July 2022 issue of Pediatric Critical Care Medicine.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Neurology
This podcast will examine a retrospective, observational cohort study that found an association between excessive oxygen supplementation in the first day of mechanical ventilation with multiple organ dysfunction syndrome on day 7 of admission and in-hospital mortality in critically ill children. Host Elizabeth H. Mack, MD, MS, FCCM, is joined by L. Nelson Sanchez-Pinto, MD, MBI, to discuss the study’s findings.
The PANDEM guidelines evaluate current practices and provide recommendations for management of pain, agitation, iatrogenic withdrawal, neuromuscular blockade, delirium, ICU environment, and early mobility in critically ill infants and children. Host Margaret M. Parker, MD, MCCM, is joined by Heidi A. B. Smith, MD, MSCI, FAAP, to discuss the guidelines.
On December 3, 2021, the U.S. Food and Drug Administration revised the emergency use authorization (EUA) of bamlanivimab and etesevimab (previously authorized for pediatric patients 12 years of age and older weighing at least 40 kilograms, or about 88 pounds), to additionally authorize bamlanivimab and etesivimab administered together for the treatment of mild to moderate COVID-19 in all younger pediatric patients, including newborns, who have a positive COVID-19 test and are at high risk for progression to severe COVID-19, including hospitalization or death. This revision also authorizes bamlanivimab and etesevimab, to be administered together, for post-exposure prophylaxis for prevention of COVID-19 in all pediatric patients, including newborns, at high risk of progression to severe COVID-19, including hospitalization or death.
With the rise in cases among children across the country, more healthcare professionals who typically work with adult patients are being tasked with treating pediatric patients. SCCM’s latest blog post summarizes two webcasts SCCM hosted to help smooth this transition.
As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). Pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. This webinar was held on October 15, 2021.
The average annual incidence of pediatric in-hospital cardiac arrest (IHCA) has recently been estimated at more than 15,000 cases.1 Survival rates for pediatric patients who have had pulseless cardiac arrest have remained below 50% for the past decade.2,3 The American Heart Association currently recommends epinephrine, the cornerstone medication for cardiac arrest, dosed every 3 to 5 minutes in adult and pediatric cardiac arrest, although there is conflicting evidence about whether this is the best interval.4,5 Epinephrine is believed to acutely increase coronary perfusion pressure by increasing diastolic blood pressure (DBP).
As pediatric cases of COVID-19 increase, it is vital to prepare for surges that may overwhelm capacity in pediatric intensive care units (ICUs). During this FREE webcast, pediatric critical care experts will address questions related caring for critically ill pediatric patients and steps to prepare for the next pediatric surge. We know children are not little adults. Whether you are practicing in an adult ICU environment or are a non-ICU clinician who may benefit from critical care training, this webcast will prepare you to treat critically ill pediatric patients. Webcast Recorded on Wednesday, September 22, 2021
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Infectious Diseases Society of America (IDSA) COVID-19 Real-Time Learning Network. These resources are categorized as Pediatrics
From Critical Care Medicine. In this observational, multicenter registry of children with coronavirus disease 2019, the authors found that ICU admission was common. Older age, fever, multisystem inflammatory syndrome in children, and seizure disorder were independently associated with ICU admission, and mortality was lower among children than mortality reported in adults.
With children going back to school, continued outbreaks of respiratory syncytial virus (RSV), and the upcoming flu season, it is important to prepare for potential surges of pediatric patients with COVID-19.
Update on research and evidence in multisystem inflammatory syndrome in children. This is SCCM curated COVID-19 microlearning content. Curriculum Topic: Cardiovascular Complications: Venous Thromboembolism, Myocarditis, and Shock
This article was first published in the Spring 2021 issue of Critical Connections. Certified child life specialists are an invaluable investment in the success of ICU liberation programs. They engage, empower, and support children and their families to mitigate the psychosocial impacts of a critical illness or injury.
From Critical Care Medicine. In this article, the authors found that endothelial dysfunction is associated with severe acute respiratory syndrome coronavirus 2–related multisystem inflammatory syndrome in children with shock and may constitute one of the underlying mechanisms.
How can clinical information gleaned from focused cardiac ultrasound (FCU) be used to augment clinical assessments in children with suspected septic shock? This month’s Concise Critical Appraisal analyzes a study published in Pediatric Critical Care Medicine that sought to show how often a clinician’s hemodynamic characterization of a child with septic shock was altered by FCU and to further validate an expert-developed algorithm for these assessments.
From Pediatric Critical Care Medicine. This study delineates significant clinically relevant differences in presentation, explanatory factors, and outcomes among children admitted to PICU with severe acute respiratory syndrome coronavirus 2–related illness stratified by multisystem inflammatory syndrome in children.
This resource details an update on MIS-C during the COVID-19 pandemic. This is SCCM curated COVID-19 microlearning content.
This resource details vaccinations for pediatric patients during the COVID-19 pandemic. This is SCCM curated COVID-19 microlearning content.
From Critical Care Explorations. The authors describe the nationwide U.K. PICU experience of severe acute respiratory syndrome coronavirus-2 infection during the first wave of the pandemic and compare this with the critical care course of the 2019 influenza cohort.
From Pediatric Critical Care Medicine. The authors analyzed the short-term biochemical improvements and clinical outcomes following treatment of children with postsevere acute respiratory syndrome coronavirus-2 inflammatory syndrome (multisystem inflammatory syndrome in children/pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2) admitted to U.K. PICUs and collated current treatment guidance from U.K. PICUs.
The Society of Critical Care Medicine's Critical Care Congress features internationally renowned faculty and content sessions highlighting the most up-to-date, evidence-based developments in critical care medicine. This is a presentation from the Society of Critical Care Medicine's 47th Critical Care Congress.
From Pediatric Critical Care Medicine. In this article, the authors found that hybrid rounds employed during pandemic facilitated social distancing while retaining patient-centered multidisciplinary ICU rounds but compromised teaching during rounds.
From Pediatric Critical Care Medicine. The authors of this Editorial sought to assess the evolving discussion surrounding the naming of a novel pediatric hyperinflammatory syndrome – a condition that showed overlapping features of Kawasaki disease and toxic shock syndrome -- through the analysis of its evolution around the Twitter hashtag #PedsICU.
SCCM’s COVID-19 Rapid Resource Center now links to pertinent content from the Centers for Disease Control and Prevention (CDC). These resources are categorized as Pediatrics
From Pediatric Critical Care Medicine Early preparation for the training and education of healthcare providers, as well as the continuation or modification of routine medical education programs, is of great importance in times of the coronavirus disease 2019 pandemic or other public health emergencies; this study aimed to characterize these self-reported efforts by the pediatric simulation community.
This Concise Critical Appraisal delves into a study published in Pediatric Critical Care Medicine that sought to determine whether early hemostatic intervention can prevent the development of DIC and improve outcomes.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on November 4, 2020.
From Pediatric Critical Care Medicine. In this report, the authors describe the hybrid model implemented at institutions in New York and London and discuss shared experiences, pitfalls, challenges, and adjustments required in caring for both young and older patients.
Dive into a study that evaluates a standardized process of using rapid exome sequencing to help diagnose critically ill children with suspected genetic diseases in this Concise Critical Appraisal.
From Pediatric Critical Care Medicine. In this article, the authors review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack completed controlled trials in children at the time of the paper.
From Pediatric Critical Care Medicine. In this article, the authors report their experience developing a clinical inpatient protocol for the evaluation, management, and follow-up of patients with multisystem inflammatory syndrome.
From Critical Care Explorations. In this case report, the authors describe a pediatric patient with coronavirus disease-19-associated multisystem inflammatory syndrome without robust hyperinflammation and a delayed finding of coronary artery dilatation, which they believe highlights the need for further mechanistic understanding of coronavirus disease-19 disease and subsequent multisystem inflammatory syndrome in children or Kawasaki disease development.
From Critical Care Explorations. In this case report, the authors report a series of four critically ill pediatric patients with acute respiratory failure who received coronavirus disease 2019 convalescent plasma as a treatment strategy for severe disease.
Cystic fibrosis patient care has advanced greatly in recent years and the mortality rate has improved. Explore PICU mortality and the factors associated with death among critically ill children with cystic fibrosis in this iCritical Care podcast.
This is a presentation from the 47th Critical Care Congress on Pediatric Critical Care Collaborative Study Groups.
From Pediatric Critical Care Medicine. The authors evaluated the impact of the coronavirus disease 2019 pandemic, considering the physical distancing and schools closing, on the characteristics of admission and epidemiology on Brazilian PICUs.
From Pediatric Critical Care Medicine. In this editorial, the author reviews ""Perspectives on Pediatric Sepsis in Patients with COVID-19"" from the Surviving Sepsis Campaign Pediatric Guidelines Taskforce authors.
From Critical Care Explorations. In this Letter to the Editor, the authors describe the process converting half of their 40-bed PICU into a negative-pressure biocontainment ICU dedicated to adult coronavirus disease 2019 patients within a 1,003-bed academic quaternary hospital.
From Pediatric Critical Care Medicine. In this editorial, the author discusses issues emerging from the study by Bhumbra et al. (Clinical features of critical coronavirus disease 2019 in children) that are worthy of discussion and further exploration, including the predilection for racial minorities, similarities and differences to sepsis, wide expression of clinical disease, and the conundrum of providing family centered care.
From Pediatric Critical Care Medicine. In this article, the authors discuss the Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-associated Organ Dysfunction in Children as they relate to COVID-19.
From Critical Care Medicine. The authors describe the unique perspective of pediatric intensivists caring for critically ill adults during the coronavirus disease 2019 pandemic.
From Pediatric Critical Care Medicine. In this letter to the editor, the authors state that the understanding of the immunopathogenesis of SARS-CoV-2 infection is important not only to understand the epidemiologic and age-related differences in COVID-19, but it is critical for the identification of appropriate treatment, as well as for the development of a highly immunogenic vaccine with low risk of antibody dependent enhancement.
From Pediatric Critical Care Medicine. The authors conducted a survey and found that most U.S. pediatric institutions rapidly adapted their resuscitation systems and practices in response to the coronavirus disease 2019 pandemic.
From Pediatric Critical Care Medicine. In this study, the authors observed a greater proportion of hospitalized children requiring mechanical ventilation than has been reported to date; they state that older children, African-American or Hispanic children, and males may be at greater risk for severe illness requiring hospitalization.
From Pediatric Critical Care Medicine. This study found that patients with coronavirus disease 2019 have a high frequency of comorbidities, require longer stays, more ventilatory support than usual PICU admissions, suggesting several avenues for further exploration.
Margaret M. Parker, MD, MCCM, speaks with Rashid Alobaidi, MD, on his article titled "Population-Based Epidemiology and Outcomes of Acute Kidney Injury in Critically Ill Children,"
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on July 8th, 2020.
Montefiore Medical Center in the Bronx, New York, USA, quickly converted a children's hospital to an adult COVID-19 hospital. Hear Margaret M. Parker, MD, MCCM, talk with H. Michael Ushay, MD, PhD, FAAP, FCCM, about the process, challenges with staffing and personal protective equipment, and more.
Margaret M. Parker, MD, MCCM, speaks with Danny Hames, MD, on his article titled "Risk Factors for Mortality in Critically Ill Children Requiring Renal Replacement Therapy ," published in the November 2019 issue of Pediatric Critical Care Medicine (Hames D, et al. Pediatr Crit Care Med. 2019;20;1069-1077).
From Pediatric Critical Care Medicine. A foreword from the editors of PCCM about COVID-19 and the journal.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on June 10th, 2020.
This article was originally published in the Spring 2020 Issue of Critical Conectionns. The Surviving Sepsis Campaign (SCC) in February released its first guidelines for pediatric patients with sepsis, marking a new milestone in the initiative’s mission to improve sepsis care and save lives.
This resource details a pediatric ICU dashboard sample for tracking COVID-19. This is a community developed COVID-19 microlearning resource.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13th, 2020.
From Pediatric Critical Care Medicine. An editorial in response to an article by Killien et al. on resource "Prediction of Pediatric Critical Care Resource Utilization for Disaster Triage," noting that, although uniform use of the version of PELOD-2 proposed by Killien et al. won’t eliminate all variation from resource allocation strategies, finding any common ground in resource triage schemes is an important first step.
From Pediatric Intensive Care Medicine. In this letter to the editor, the authors explore the role of pediatric intensivists, as highly-skilled professionals, in the care of critically ill adults. With adequate guidance by professional societies and adult intensivists, pediatric critical care physicians can provide valuable assistance in the current pandemic and in potential COVID-19 epidemic waves to come.
From Pediatric Critical Care Medicine. In this letter to the editor, the authors respond to an article by Ong et al. and recommend lung ultrasound in children with COVID-19 as a means of improving outcomes.
This presentation covers treating COVID-19 in pediatric patients. This is SCCM curated COVID-19 microlearning content.
This presentation cover dermatological conditions seen in COVID-19 patients. This is SCCM curated COVID-19 microlearning content.
Questions from social media, blogs and the various discussion forums, including the new SCCM COVID-19 Discussion Group, were answered. This microlearning content was taken from the COVID-19 Critical Care for Non-ICU Clinicians: Expert Panel Series held on May 13, 2020.
From Pediatric Critical Care Medicine. The authors outline an approach to practically initiating supportive strategies within the PICU using a well-being approach to improving baseline resilience alongside an acute rescue strategy utilising a peer-support network.
From Pediatric Critical Care Medicine. The authors sought to determine whether currently available pediatric illness severity scores can predict duration of critical care resource use.
From Pediatric Critical Care Medicine. Editorial in response to Ong et al. article ("A comprehensive narrative review on the impact and implications of COVID-19 in children"), focusing on the management of those most severely affected, as well as providing some practical suggestions for pediatric intensive care clinicians to prepare should COVID-19 become more virulent in children.
Gain valuable insight on the clinical management of COVID-19 and its relevance to the pediatric critical care provider (Ong J, et al. Pediatr Crit Care Med. 2020 Apr 7; Epub ahead of print) with host Elizabeth H. Mack, MD, MS, FCCM, and Jacqueline Ong, MB BChir, MMed (Paeds), MRCPCH.
Ped Crit Care Med. 2020 Feb;21(2)e52-e106
Colleagues share the tools they have developed in their own institutions as they implement the Surviving Sepsis Campaign. The Sepsis Alert Checklist is from Wesley Healthcare.
The goal of PICUparent is to help parents understand their child's healthcare.
AfterPICU.com offers resources for children and families following a critical illness.
The PICU Passport from The University of Chicago Medicine's Comer Children's hospital helps patients and families document a stay in the pediatric ICU.
As children leave the pediatric intensive care unit, parents may notice changes. Some children may have additional needs after a stay in the PICU. This video aims to share stories and examples that exemplify challenges after a PICU stay.
Children may experience post-intensive care syndrome (PICS) after a stay in the intensive care unit. Symptoms include learning and attention difficulties, post-traumatic stress disorder, sadness and depression, difficulty sleeping, behavior changes, motor dysfunction, breathing problems, feeding problems and difficulty hearing and seeing. Families may also be impacted by PICS. Help prepare your whole family to identify and treat PICS.
Children may experience post-intensive care syndrome (PICS) after a stay in the intensive care unit.
Pediatr Crit Care Med. 2017;18(7):675–715
iCritical Care Pediatric Critical Care Medicine is a customized podcast feed that offers a portion of the iCritical Care podcasts, delivering only those related to the Society of Critical Care Medicine's leading pediatric journal.