Cognitive Development One Year After Infantile Critical Pertussis.

Objectives: Pertussis can cause life-threatening illness in infants. Data regarding neurodevelopment after pertussis remain scant. The aim of this study was to assess cognitive development of infants with critical pertussis 1 year after PICU discharge.

Variability in Usual Care Mechanical Ventilation for Pediatric Acute Respiratory Distress Syndrome: Time for a Decision Support Protocol?

Objectives: Although pediatric intensivists philosophically embrace lung protective ventilation for acute lung injury and acute respiratory distress syndrome, we hypothesized that ventilator management varies. We assessed ventilator management by evaluating changes to ventilator settings in response to blood gases, pulse oximetry, or end-tidal CO2. We also assessed the potential impact that a pediatric mechanical ventilation protocol adapted from National Heart Lung and Blood Institute acute respiratory distress syndrome network protocols could have on reducing variability by comparing actual changes in ventilator settings to those recommended by the protocol.

Potential Acceptability of a Pediatric Ventilator Management Computer Protocol.

Objectives: To examine issues regarding the granularity (size/scale) and potential acceptability of recommendations in a ventilator management protocol for children with pediatric acute respiratory distress syndrome.

Design: Survey/questionnaire.

Setting: The eight PICUs in the Collaborative Pediatric Critical Care Research Network.

Feasibility and perceived benefits of a framework for physician-parent follow-up meetings after a child's death in the PICU.

Objective: To evaluate the feasibility and perceived benefits of conducting physician-parent follow-up meetings after a child's death in the PICU according to a framework developed by the Collaborative Pediatric Critical Care Research Network.

Design: Prospective observational study.

Setting: Seven Collaborative Pediatric Critical Care Research Network-affiliated children's hospitals.

Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing.

Objectives: The aim of this study was to evaluate the relative frequency of pediatric in-hospital cardiopulmonary resuscitation events occurring in ICUs compared to general wards. We hypothesized that the proportion of pediatric cardiopulmonary resuscitation provided in ICUs versus general wards has increased over the past decade, and this shift is associated with improved resuscitation outcomes.

Design: Prospective and observational study.

The ideal time interval for critical care severity-of-illness assessment.

Objective: Determine if the shortest sampling interval for laboratory variables used to estimate baseline severity of illness in pediatric critical care is equivalently sensitive across multiple sites without site-specific bias, while accounting for the vast majority of dysfunction compared with the standard 0- to 12-hour Pediatric Risk of Mortality III score.

Design: Prospective random patient selection.

Setting: General/medical and cardiac/cardiovascular PICUs in eight hospitals.

Critical pertussis illness in children: a multicenter prospective cohort study.

Objective: Pertussis persists in the United States despite high immunization rates. This report characterizes the presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, and critical care therapies among children requiring admission to the PICU.

Design: Prospective cohort study.

Opioid analgesia in mechanically ventilated children: results from the multicenter Measuring Opioid Tolerance Induced by Fentanyl study.

Objective: To examine the clinical factors associated with increased opioid dose among mechanically ventilated children in the pediatric intensive care unit.

Design: Prospective, observational study with 100% accrual of eligible patients.

Setting: Seven pediatric intensive care units from tertiary-care children's hospitals in the Collaborative Pediatric Critical Care Research Network.

Fatal and near-fatal asthma in children: the critical care perspective.

Objective: To characterize the clinical course, therapies, and outcomes of children with fatal and near-fatal asthma admitted to pediatric intensive care units (PICUs).

Study Design: This was a retrospective chart abstraction across the 8 tertiary care PICUs of the Collaborative Pediatric Critical Care Research Network (CPCCRN). Inclusion criteria were children (aged 1-18 years) admitted between 2005 and 2009 (inclusive) for asthma who received ventilation (near-fatal) or died (fatal).

Critical care for pediatric asthma: wide care variability and challenges for study.

Objectives: To describe pediatric severe asthma care, complications, and outcomes to plan for future prospective studies by the Collaborative Pediatric Critical Care Research Network.

Design: Retrospective cohort study.

Setting: : Pediatric intensive care units in the United States that submit administrative data to the Pediatric Health Information System.

The Collaborative Pediatric Critical Care Research Network Critical Pertussis Study: collaborative research in pediatric critical care medicine.

Objective: To provide an updated overview of critical pertussis to the pediatric critical care community and describe a study of critical pertussis recently undertaken.

Setting: The six sites, seven hospitals of the Collaborative Pediatric Critical Care Research Network, and 17 outside sites at academic medical centers with pediatric intensive care units.

Results: Despite high coverage for childhood vaccination, pertussis causes substantial morbidity and mortality in US children, especially among infants.

Weaning and extubation readiness in pediatric patients.

Objective: A systematic review of weaning and extubation for pediatric patients on mechanical ventilation.

Data Selection: Pediatric and adult literature, English language.

Study Selection: Invited review.

Impact of pediatric critical illness and injury on families: a systematic literature review.

Objective: We sought to inform decision-making for children and families by describing what is known and remains unknown about the impact of childhood critical illness and injury on families. This report also was designed as a tool for research planning and design so that meaningful studies are performed and duplication is avoided.

Design: After a national scholarship competition and the identification of 3 medical student summer scholars, a literature search was conducted by using the National Library of Medicine and a PubMed keyword search system at the National Institutes of Health.

Translating civilian and defense technologies for pediatric critical care and rehabilitation research.

A conference sponsored by the National Institutes of Health (NIH) and the Defense Advanced Research Projects Agency (DARPA) titled "Translating Civilian and Defense Technologies for Pediatric Critical Care and Rehabilitation Research" was held on May 16th and 17th, 2005 in Rockville, Maryland. A summary of presentations from the conference is provided. Topics presented addressed: advances in monitoring and imaging devices used in the pediatric intensive care unit, regulatory issues and recent technological developments relating to medical devices for children, the new role that virtual reality is playing in rehabilitation medicine, and the evolving future of assistive devices for rehabilitation.

Pediatric critical care medicine: planning for our research future.

Objective: To introduce to the pediatric critical care medicine community a new program in pediatric critical care medicine at the National Institutes of Health.

Data Source: Summary of literature review and conference proceedings.

Data Synthesis: At the National Institute of Child Health and Human Development (NICHD), a new program in pediatric critical care and rehabilitation research has been established in the National Center for Medical Rehabilitation Research.