This month’s issue features articles on a variety of sepsis and shock topics as well as challenges with mechanical ventilation in pediatric patients. The neurocritical intensive care articles evaluate phenotypes in acute brainstem dysfunction and the use of a pediatric neurocritical care team for patients with status epilepticus. Several online clinical investigations and brief reports explore mitigation of nephrotoxic pain medications, application of new acute kidney injury criteria, use of esmolol after tetralogy of Fallot repair, risk of infection development with proton pump inhibitor use, outcomes of acute lymphoblastic leukemia and cytokine release syndrome after chimeric antigen receptor T cell therapy, and an article discussing bereaved caregiver perspectives on end-of-life care in pediatric patients with ventricular assist devices.