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Halden F Scott, Richard J Brilli, Raina Paul, Charles G Macias, Matthew Niedner, Holly Depinet, Troy Richardson, Ruth Riggs, Heidi Gruhler, Gitte Y Larsen, W Charles Huskins, Fran Balamuth
OBJECTIVES: To describe the Children's Hospital Association's Improving Pediatric Sepsis Outcomes sepsis definitions and the identified patients; evaluate the definition using a published framework for evaluating sepsis definitions. DESIGN: Observational cohort. SETTING: Multicenter quality improvement collaborative of 46 hospitals from January 2017 to December 2018, excluding neonatal ICUs. PATIENTS: Improving Pediatric Sepsis Outcomes Sepsis was defined by electronic health record evidence of suspected infection and sepsis treatment or organ dysfunction...
October 2020: Critical Care Medicine
Lauren A Beslow, Alexandra B Linds, Christine K Fox, Manoëlle Kossorotoff, Yenny C Zuñiga Zambrano, Marta Hernández-Chávez, Sahar M A Hassanein, Susan Byrne, Ming Lim, Nkechi Maduaka, Dimitrios Zafeiriou, Michael M Dowling, Ryan J Felling, Mubeen F Rafay, Laura L Lehman, Michael J Noetzel, Timothy J Bernard, Nomazulu Dlamini
OBJECTIVE: Severe complications of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) include arterial ischemic stroke (AIS) in adults and multisystem inflammatory syndrome in children. Whether stroke is a frequent complication of pediatric SARS-CoV-2 is unknown. This study aimed to determine the proportion of pediatric SARS-CoV-2 cases with ischemic stroke and the proportion of incident pediatric strokes with SARS-CoV-2 in the first 3 months of the pandemic in an international cohort...
April 2021: Annals of Neurology
Aline B Maddux, Neethi Pinto, Ericka L Fink, Mary E Hartman, Sholeen Nett, Katherine Biagas, Elizabeth Y Killien, Leslie A Dervan, LeeAnn M Christie, Peter M Luckett, Laura Loftis, Mellanye Lackey, Melissa Ringwood, McKenna Smith, Lenora Olson, Sam Sorenson, Kathleen L Meert, Daniel A Notterman, Murray M Pollack, Peter M Mourani, R Scott Watson
OBJECTIVES: Assessing outcomes after pediatric critical illness is imperative to evaluate practice and improve recovery of patients and their families. We conducted a scoping review of the literature to identify domains and instruments previously used to evaluate these outcomes. DESIGN: Scoping review. SETTING: We queried PubMed, EMBASE, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and the Cochrane Central Register of Controlled Trials Registry for studies evaluating pediatric critical care survivors or their families published between 1970 and 2017...
December 2020: Critical Care Medicine
Ian K Maconochie, Richard Aickin, Mary Fran Hazinski, Dianne L Atkins, Robert Bingham, Thomaz Bittencourt Couto, Anne-Marie Guerguerian, Vinay M Nadkarni, Kee-Chong Ng, Gabrielle A Nuthall, Gene Y K Ong, Amelia G Reis, Stephen M Schexnayder, Barnaby R Scholefield, Janice A Tijssen, Jerry P Nolan, Peter T Morley, Patrick Van de Voorde, Arno L Zaritsky, Allan R de Caen
This 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (CoSTR) for pediatric life support is based on the most extensive evidence evaluation ever performed by the Pediatric Life Support Task Force. Three types of evidence evaluation were used in this review: systematic reviews, scoping reviews, and evidence updates. Per agreement with the evidence evaluation recommendations of the International Liaison Committee on Resuscitation, only systematic reviews could result in a new or revised treatment recommendation...
October 20, 2020: Circulation
Amanda Ricciuto, Martine Aardoom, Esther Orlanski-Meyer, Dan Navon, Nicholas Carman, Marina Aloi, Jiri Bronsky, Jan Däbritz, Marla Dubinsky, Séamus Hussey, Peter Lewindon, Javier Martín De Carpi, Víctor Manuel Navas-López, Marina Orsi, Frank M Ruemmele, Richard K Russell, Gabor Veres, Thomas D Walters, David C Wilson, Thomas Kaiser, Lissy de Ridder, Dan Turner, Anne M Griffiths
BACKGROUND & AIMS: A better understanding of prognostic factors within the heterogeneous spectrum of pediatric Crohn's disease (CD) should improve patient management and reduce complications. We aimed to identify evidence-based predictors of outcomes with the goal of optimizing individual patient management. METHODS: A survey of 202 experts in pediatric CD identified and prioritized adverse outcomes to be avoided. A systematic review of the literature with meta-analysis, when possible, was performed to identify clinical studies that investigated predictors of these outcomes...
January 2021: Gastroenterology
Kusum Menon, Luregn J Schlapbach, Samuel Akech, Andrew Argent, Paolo Biban, Enitan D Carrol, Kathleen Chiotos, Mohammod Jobayer Chisti, Idris V R Evans, David P Inwald, Paul Ishimine, Niranjan Kissoon, Rakesh Lodha, Simon Nadel, Cláudio Flauzino Oliveira, Mark Peters, Benham Sadeghirad, Halden F Scott, Daniela C de Souza, Pierre Tissieres, R Scott Watson, Matthew O Wiens, James L Wynn, Jerry J Zimmerman, Lauren R Sorce
OBJECTIVE: To determine the associations of demographic, clinical, laboratory, organ dysfunction, and illness severity variable values with: 1) sepsis, severe sepsis, or septic shock in children with infection and 2) multiple organ dysfunction or death in children with sepsis, severe sepsis, or septic shock. DATA SOURCES: MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2004, and November 16, 2020. STUDY SELECTION: Case-control studies, cohort studies, and randomized controlled trials in children greater than or equal to 37-week-old postconception to 18 years with suspected or confirmed infection, which included the terms "sepsis," "septicemia," or "septic shock" in the title or abstract...
January 1, 2022: Critical Care Medicine
Nadir Yehya, Michael O Harhay, Margaret J Klein, Steven L Shein, Byron E Piñeres-Olave, Ledys Izquierdo, Anil Sapru, Guillaume Emeriaud, Philip C Spinella, Heidi R Flori, Mary K Dahmer, Aline B Maddux, Yolanda M Lopez-Fernandez, Bereketeab Haileselassie, Deyin Doreen Hsing, Ranjit S Chima, Amanda B Hassinger, Stacey L Valentine, Courtney M Rowan, Martin C J Kneyber, Lincoln S Smith, Robinder G Khemani, Neal J Thomas
OBJECTIVES: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist with trial design. We aimed to develop and validate mortality prediction models for patients with pediatric acute respiratory distress syndrome. DESIGN: Leveraging additional data collection from a preplanned ancillary study (Version 1) of the multinational Pediatric Acute Respiratory Distress syndrome Incidence and Epidemiology study, we identified predictors of mortality...
June 2020: Critical Care Medicine
D Williams Parsons, Katherine A Janeway, David R Patton, Cynthia L Winter, Brent Coffey, P Mickey Williams, Sinchita Roy-Chowdhuri, Gregory J Tsongalis, Mark Routbort, Nilsa C Ramirez, Lauren Saguilig, Jin Piao, Todd A Alonzo, Stacey L Berg, Elizabeth Fox, Douglas S Hawkins, Jeffrey S Abrams, Margaret Mooney, Naoko Takebe, James V Tricoli, Nita L Seibel
PURPOSE: The National Cancer Institute-Children's Oncology Group Pediatric MATCH trial aimed to facilitate evaluation of molecular-targeted therapies in biomarker-selected cohorts of childhood and young adult patients with cancer by screening tumors for actionable alterations. PATIENTS AND METHODS: Tumors from patients age 1-21 years with refractory solid tumors, lymphomas, or histiocytic disorders were subjected to cancer gene panel sequencing and limited immunohistochemistry to identify actionable alterations for assignment to phase II treatment arms...
July 10, 2022: Journal of Clinical Oncology
Ericka L Fink, Aline B Maddux, Neethi Pinto, Samuel Sorenson, Daniel Notterman, J Michael Dean, Joseph A Carcillo, Robert A Berg, Athena Zuppa, Murray M Pollack, Kathleen L Meert, Mark W Hall, Anil Sapru, Patrick S McQuillen, Peter M Mourani, David Wessel, Deborah Amey, Andrew Argent, Werther Brunow de Carvalho, Warwick Butt, Karen Choong, Martha A Q Curley, Maria Del Pilar Arias Lopez, Demet Demirkol, Ruth Grosskreuz, Amy J Houtrow, Hennie Knoester, Jan Hau Lee, Debbie Long, Joseph C Manning, Brenda Morrow, Jhuma Sankar, Beth S Slomine, McKenna Smith, Lenora M Olson, R Scott Watson
OBJECTIVES: More children are surviving critical illness but are at risk of residual or new health conditions. An evidence-informed and stakeholder-recommended core outcome set is lacking for pediatric critical care outcomes. Our objective was to create a multinational, multistakeholder-recommended pediatric critical care core outcome set for inclusion in clinical and research programs. DESIGN: A two-round modified Delphi electronic survey was conducted with 333 invited research, clinical, and family/advocate stakeholders...
December 2020: Critical Care Medicine
M Ellen Kuenzig, Stephen G Fung, Luba Marderfeld, Joyce W Y Mak, Gilaad G Kaplan, Siew C Ng, David C Wilson, Fiona Cameron, Paul Henderson, Paulo G Kotze, Jasmine Bhatti, Vixey Fang, Samantha Gerber, Evelyne Guay, Supun Kotteduwa Jayawarden, Leo Kadota, Fernando Maldonado D, Jessica Amankwah Osei, Ryan Sandarage, Amanda Stanton, Melissa Wan, Eric I Benchimol
BACKGROUND & AIMS: The incidence of inflammatory bowel disease (IBD) is increasing internationally, particularly in nations with historically low rates. Previous reports of the epidemiology of pediatric-onset IBD identified a paucity of data. We systematically reviewed the global trends in incidence and prevalence of IBD diagnosed in individuals <21 years old over the first 2 decades of the 21st century. METHODS: We systematically reviewed studies indexed in MEDLINE, EMBASE, Airiti Library, and SciELO from January 2010 to February 2020 to identify population-based studies reporting the incidence and/or prevalence of IBD, Crohn's disease, ulcerative colitis, and/or IBD-unclassified...
April 2022: Gastroenterology
Ryan J Felling, Mubeen F Rafay, Timothy J Bernard, Jessica L Carpenter, Nomazulu Dlamini, Sahar M A Hassanein, Lori C Jordan, Michael J Noetzel, Michael J Rivkin, Kevin A Shapiro, Mahmoud Slim, Gabrielle deVeber
OBJECTIVE: To characterize predictors of recovery and outcome following pediatric arterial ischemic stroke, hypothesizing that age influences recovery after stroke. METHODS: We studied children enrolled in the International Pediatric Stroke Study between January 1, 2003 and July 31, 2014 with 2-year follow-up after arterial ischemic stroke. Outcomes were defined at discharge by clinician grading and at 2 years by the Pediatric Stroke Outcome Measure. Demographic, clinical, and radiologic outcome predictors were examined...
June 2020: Annals of Neurology
Jerry J Zimmerman, Russell Banks, Robert A Berg, Athena Zuppa, Christopher J Newth, David Wessel, Murray M Pollack, Kathleen L Meert, Mark W Hall, Michael Quasney, Anil Sapru, Joseph A Carcillo, Patrick S McQuillen, Peter M Mourani, Hector Wong, Ranjit S Chima, Richard Holubkov, Whitney Coleman, Samuel Sorenson, James W Varni, Julie McGalliard, Wren Haaland, Kathryn Whitlock, J Michael Dean, Ron W Reeder
OBJECTIVES: A companion article reports the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. In this article, the investigators examine critical illness factors associated with these adverse outcomes. DESIGN: Prospective, cohort-outcome study, conducted 2013-2017. SETTING: Twelve United States academic PICUs. PATIENTS: Critically ill children, 1 month to 18 years, with community-acquired septic shock requiring vasoactive-inotropic support...
March 2020: Critical Care Medicine
Markita L Suttle, Margaret A Chase, William C Sasser, Melissa Moore-Clingenpeel, Tensing Maa, Jason A Werner, Meredith F Bone, Donald L Boyer, Karen J Marcdante, Katherine E Mason, Megan E McCabe, Richard B Mink, Felice Su, David A Turner
OBJECTIVES: Assess the overall level of burnout in pediatric critical care medicine fellows and examine factors that may contribute to or protect against its development. DESIGN: Cross-sectional observational study. SETTING: Accreditation Council for Graduate Medical Education-accredited pediatric critical care medicine fellowship programs across the United States. SUBJECTS: Pediatric critical care medicine fellows and program directors...
June 2020: Critical Care Medicine
Keith Sacco, Riccardo Castagnoli, Svetlana Vakkilainen, Can Liu, Ottavia M Delmonte, Cihan Oguz, Ian M Kaplan, Sara Alehashemi, Peter D Burbelo, Farzana Bhuyan, Adriana A de Jesus, Kerry Dobbs, Lindsey B Rosen, Aristine Cheng, Elana Shaw, Mikko S Vakkilainen, Francesca Pala, Justin Lack, Yu Zhang, Danielle L Fink, Vasileios Oikonomou, Andrew L Snow, Clifton L Dalgard, Jinguo Chen, Brian A Sellers, Gina A Montealegre Sanchez, Karyl Barron, Emma Rey-Jurado, Cecilia Vial, Maria Cecilia Poli, Amelia Licari, Daniela Montagna, Gian Luigi Marseglia, Francesco Licciardi, Ugo Ramenghi, Valentina Discepolo, Andrea Lo Vecchio, Alfredo Guarino, Eli M Eisenstein, Luisa Imberti, Alessandra Sottini, Andrea Biondi, Sayonara Mató, Dana Gerstbacher, Meng Truong, Michael A Stack, Mary Magliocco, Marita Bosticardo, Tomoki Kawai, Jeffrey J Danielson, Tyler Hulett, Manor Askenazi, Shaohui Hu, Jeffrey I Cohen, Helen C Su, Douglas B Kuhns, Michail S Lionakis, Thomas M Snyder, Steven M Holland, Raphaela Goldbach-Mansky, John S Tsang, Luigi D Notarangelo
Pediatric Coronavirus Disease 2019 (pCOVID-19) is rarely severe; however, a minority of children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might develop multisystem inflammatory syndrome in children (MIS-C), with substantial morbidity. In this longitudinal multi-institutional study, we applied multi-omics (analysis of soluble biomarkers, proteomics, single-cell gene expression and immune repertoire analysis) to profile children with COVID-19 (n = 110) and MIS-C (n = 76), along with pediatric healthy controls (pHCs; n = 76)...
May 2022: Nature Medicine
Stephanie M Ware, Surbhi Bhatnagar, Phillip J Dexheimer, James D Wilkinson, Arthi Sridhar, Xiao Fan, Yufeng Shen, Muhammad Tariq, Jeffrey A Schubert, Steven D Colan, Ling Shi, Charles E Canter, Daphne T Hsu, Neha Bansal, Steven A Webber, Melanie D Everitt, Paul F Kantor, Joseph W Rossano, Elfriede Pahl, Paolo Rusconi, Teresa M Lee, Jeffrey A Towbin, Ashwin K Lal, Wendy K Chung, Erin M Miller, Bruce Aronow, Lisa J Martin, Steven E Lipshultz
To understand the genetic contribution to primary pediatric cardiomyopathy, we performed exome sequencing in a large cohort of 528 children with cardiomyopathy. Using clinical interpretation guidelines and targeting genes implicated in cardiomyopathy, we identified a genetic cause in 32% of affected individuals. Cardiomyopathy sub-phenotypes differed by ancestry, age at diagnosis, and family history. Infants < 1 year were less likely to have a molecular diagnosis (p < 0.001). Using a discovery set of 1,703 candidate genes and informatic tools, we identified rare and damaging variants in 56% of affected individuals...
February 3, 2022: American Journal of Human Genetics
Raffaella Pizzolato Umeton, Michael Waltz, Gregory S Aaen, Leslie Benson, Mark Gorman, Manu Goyal, Jennifer S Graves, Yolanda Harris, Lauren Krupp, Timothy E Lotze, Nikita M Shukla, Soe Mar, Jayne Ness, Mary Rensel, Teri Schreiner, Jan-Mendelt Tillema, Shelly Roalstad, Moses Rodriguez, John Rose, Emmanuelle Waubant, Bianca Weinstock-Guttman, Charles Casper, Tanuja Chitnis
BACKGROUND AND OBJECTIVE: Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune condition, which can lead to significant disability, and up to 3% to 5% of the cases have a pediatric onset. There are limited studies to guide physicians in disease-modifying treatment (DMT) choices for children with NMOSD. METHODS: This retrospective cohort study evaluated children with NMOSD cases followed at 12 clinics in the US Network of Pediatric MS Centers. Cases were classified as Aquaporin-4 antibody positive (AQP4+) and double-seronegative (DS) when negative for AQP4+ and for myelin oligodendrocyte glycoprotein (MOG) antibody...
December 2, 2022: Neurology
Jeffrey A Alten, David S Cooper, Joshua J Blinder, David T Selewski, Sarah Tabbutt, Jun Sasaki, Michael G Gaies, Rebecca A Bertrandt, Andrew H Smith, Garrett Reichle, Katja M Gist, Mousumi Banerjee, Wenying Zhang, Kristal M Hock, Santiago Borasino
OBJECTIVES: Cardiac surgery-associated acute kidney injury occurs commonly following congenital heart surgery and is associated with adverse outcomes. This study represents the first multicenter study of neonatal cardiac surgery-associated acute kidney injury. We aimed to describe the epidemiology, including perioperative predictors and associated outcomes of this important complication. DESIGN: This Neonatal and Pediatric Heart and Renal Outcomes Network study is a multicenter, retrospective cohort study of consecutive neonates less than 30 days...
October 1, 2021: Critical Care Medicine
Kristen M Krysko, Jennifer S Graves, Mary Rensel, Bianca Weinstock-Guttman, Alice Rutatangwa, Gregory Aaen, Anita Belman, Leslie Benson, Tanuja Chitnis, Mark Gorman, Manu S Goyal, Yolanda Harris, Lauren Krupp, Timothy Lotze, Soe Mar, Manikum Moodley, Jayne Ness, Moses Rodriguez, John Rose, Teri Schreiner, Jan-Mendelt Tillema, Michael Waltz, T Charles Casper, Emmanuelle Waubant
OBJECTIVE: To assess real-world effectiveness of initial treatment with newer compared to injectable disease-modifying therapies (DMTs) on disease activity in pediatric multiple sclerosis (MS) and clinically isolated syndrome (CIS). METHODS: This is a cohort study of children with MS/CIS followed at 12 clinics in the US Network of Pediatric MS Centers, who received initial therapy with newer (fingolimod, dimethyl fumarate, teriflunomide, natalizumab, rituximab, ocrelizumab) or injectable (interferon-β, glatiramer acetate) DMTs...
July 2020: Annals of Neurology
Ryan W Morgan, Ron W Reeder, Kathleen L Meert, Russell Telford, Andrew R Yates, John T Berger, Kathryn Graham, William P Landis, Todd J Kilbaugh, Christopher J Newth, Joseph A Carcillo, Patrick S McQuillen, Rick E Harrison, Frank W Moler, Murray M Pollack, Todd C Carpenter, Daniel Notterman, Richard Holubkov, J Michael Dean, Vinay M Nadkarni, Robert A Berg, Robert M Sutton
OBJECTIVES: The objective of this study was to compare survival outcomes and intra-arrest arterial blood pressures between children receiving cardiopulmonary resuscitation for bradycardia and poor perfusion and those with pulseless cardiac arrests. DESIGN: Prospective, multicenter observational study. SETTING: PICUs and cardiac ICUs of the Collaborative Pediatric Critical Care Research Network. PATIENTS: Children (< 19 yr old) who received greater than or equal to 1 minute of cardiopulmonary resuscitation with invasive arterial blood pressure monitoring in place...
June 2020: Critical Care Medicine
Mike A Leonis, Alexander G Miethke, Lin Fei, Sean Maynor, Catherine A Chapin, Jacob J H Bleesing, Estella M Alonso, Robert H Squires
BACKGROUND AND AIMS: Immune dysregulation contributes to the pathogenesis of pediatric acute liver failure (PALF). Our aim was to identify immune activation markers (IAMs) in PALF that are associated with a distinct clinical phenotype and outcome. APPROACH AND RESULTS: Among 47 PALF study participants, 12 IAMs collected ≤6 days after enrollment were measured by flow cytometry and IMMULITE assay on blood natural killer and cluster of differentiation 8-positive (CD8+ ) lymphocytes and subjected to unsupervised hierarchical analyses...
January 2021: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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