EMpowerment of PArents in THe Intensive Care Questionnaire: Translation and Validation in Italian PICUs.

Objectives: To translate and validate the EMpowerment of PArents in THe Intensive Care questionnaire to measure parent satisfaction and experiences in Italian PICUs.

Design: Prospective, multicenter study.

Setting: Four medical/surgical Italian PICUs in three tertiary hospitals.

The Importance of Mortality Risk Assessment: Validation of the Pediatric Index of Mortality 3 Score.

Objective: To evaluate the performance of the newest version of the Pediatric Index of Mortality 3 score and compare it with the Pediatric Index of Mortality 2 in a multicenter national cohort of children admitted to PICU.

Design: Retrospective, prospective cohort study.

Setting: Seventeen Italian PICUs.

Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.

Background: Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome.

Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial.

Background: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (GA) on neurodevelopment.

Evolution of Noninvasive Mechanical Ventilation Use: A Cohort Study Among Italian PICUs.

Objective: To assess how clinical practice of noninvasive ventilation has evolved in the Italian PICUs.

Design: National, multicentre, retrospective, observational cohort.

Setting: Thirteen Italian medical/surgical PICUs that participated in the Italian PICU Network.

Anesthesia and the developing brain: a way forward for clinical research.

It is now well established that many general anesthetics have a variety of effects on the developing brain in animal models. In contrast, human cohort studies show mixed evidence for any association between neurobehavioural outcome and anesthesia exposure in early childhood. In spite of large volumes of research, it remains very unclear if the animal studies have any clinical relevance; or indeed how, or if, clinical practice needs to be altered.

Continuous positive airway pressure with helmet versus mask in infants with bronchiolitis: an RCT.

Background: Noninvasive continuous positive airway pressure (CPAP) is usually applied with a nasal or facial mask to treat mild acute respiratory failure (ARF) in infants. A pediatric helmet has now been introduced in clinical practice to deliver CPAP. This study compared treatment failure rates during CPAP delivered by helmet or facial mask in infants with respiratory syncytial virus-induced ARF.

Use and reimbursement of off-label drugs in pediatric anesthesia: the Italian experience.

Background: Most of the drugs used in anesthesia are off-label in children even if they present solid clinical evidence in adults. This lack of authorization is caused by multiple factors including the difficulty in conducting research in this area (due to the ethical concerns and/or the low number of available participants, the high variability of the outcome measures) and the lack of economic interest of the pharmaceutical companies (due to the limited market).

Objective: Define a list of medicinal products commonly used off-label in pediatrics anesthesia to be reimbursed by Italian National Health System.

Daily practice of mechanical ventilation in Italian pediatric intensive care units: a prospective survey.

Objectives: To assess how children requiring endotracheal intubation are mechanically ventilated in Italian pediatric intensive care units (PICUs).

Design: A prospective, national, observational, multicenter, 6-month study.

Setting: Eighteen medical-surgical PICUs.

Incidence of and mortality due to sepsis, severe sepsis and septic shock in Italian Pediatric Intensive Care Units: a prospective national survey.

Objectives: The objective was to assess the incidence of sepsis, severe sepsis and septic shock and their mortality in Italian Pediatric Intensive Care Units (PICUs).

Design: This is a prospective, observational, multi-center, 1-year study.

Setting: Fifteen medical-surgical PICUs participated in this study.

Does the Italian pediatric anesthesia training program adequately prepare residents for future clinical practice? What should be done?

Background: Pediatric anesthesia should be considered a subspecialty addressing the complete pediatric population (from preterm to teenager) and requiring particular anatomical, pathophysiological, pharmacological and anesthesiological knowledge. A survey was conducted to evaluate the training in pediatric anesthesia performed by Medical Schools of Anesthesia in Italy and to assess if the European Federation of Associations of Pediatric Anesthesia (FEAPA) guidelines for training in pediatric anesthesia had been adopted.

Methods: The survey was addressed to the Directors of the Departments of Anesthesia and Intensive Care of the Medical Schools throughout Italy using a questionnaire.

Pediatric Index of Mortality 2 score in Italy: a multicenter, prospective, observational study.

Objectives: To assess the performance of the Pediatric Index of Mortality (PIM) 2 score in Italian pediatric intensive care units (PICUs).

Design: Prospective, observational, multicenter, 1-year study.

Setting: Eighteen medical-surgical PICUs.

A case of severe diazoxide toxicity.

Hyperinsulism is a rare cause of persistent hypoglycemia in the neonatal period. Therapy can be accomplished either surgically or pharmacologically. Diazoxide treatment remains the mainstay of medical therapy.