The September 2023 issue features articles on pediatric acute respiratory failure, including support modalities and analysis of cytokine measures in children. Other respiratory articles included in this month’s issue examine the role of plateau and driving pressures in pediatric acute respiratory distress syndrome, pre-extubation cuffed tube leaks and association with post-extubation laryngeal edema, and hyperoxia exposure and mortality. Other clinical investigations include examining the lactate/albumin ratio in critically ill children, hyperferritinemia in severe dengue infection, rewarming children after drowning-associated out-of-hospital cardiac arrest, and using clinical instability as a sign of severity of illness, among others.