This month’s issue features articles on utilization of neurocritical resources in critically ill children, examination of early administration of corticosteroids in septic shock and association with clinically meaningful outcomes, and evaluation of increased monocyte distribution width in children with systemic inflammatory response syndrome and sepsis. There are also interesting articles on transport medicine, tracheostomy placement in children with pulmonary hypertension, prevention of clots in patients with modified Blalock-Taussig shunts, parental experience in the pediatric ICU, and semiautomated regional citrate anticoagulation in chronic kidney replacement therapy. Finally, there is a compelling narrative on the complex decision of extracorporeal membrane oxygen candidacy in critically ill children and the need for a systematic approach.