Mechanical Ventilation for Children Approaching End of Life: A PHIS Study, 2010-2019.

Objective: To determine the prevalence of invasive and noninvasive mechanical ventilation (IMV and NIV) for children who die in the hospital, to assess for change over time, and to determine the association between mode(s) of ventilation and hospital resource utilization.

Methods: Multicenter retrospective cohort of 37 children's hospitals in the United States participating in Pediatric Health Information Systems Database. Included 41 091 hospitalizations for patients 0 to 21 years who died in hospital January 2010 to December 2019.

Dynamic Prediction of Mortality Using Longitudinally Measured Pediatric Sequential Organ Failure Assessment Scores: A Joint Modeling Approach.

Objectives: The pediatric Sequential Organ Failure Assessment (pSOFA) score was designed to track illness severity and predict mortality in critically ill children. Most commonly, pSOFA at a point in time is used to assess a static patient condition. However, this approach has a significant drawback because it fails to consider any changes in a patients' condition during their PICU stay and, especially, their response to initial critical care treatment.

Comparing the Quality of Domain-Specific Versus General Language Models for Artificial Intelligence-Generated Differential Diagnoses in PICU Patients.

Objectives: Generative language models (LMs) are being evaluated in a variety of tasks in healthcare, but pediatric critical care studies are scant. Our objective was to evaluate the utility of generative LMs in the pediatric critical care setting and to determine whether domain-adapted LMs can outperform much larger general-domain LMs in generating a differential diagnosis from the admission notes of PICU patients.

Design: Single-center retrospective cohort study.

Factors Associated With Mechanical Ventilation Duration in Pediatric Burn Patients in a Regional Burn Center in the United States.

Objectives: Among burned children who arrive at a burn center and require invasive mechanical ventilation (IMV), some may have prolonged IMV needs. This has implications for patient-centered outcomes as well as triage and resource allocation decisions. Our objective was to identify factors associated with the duration of mechanical ventilation in pediatric patients with acute burn injury in this setting.

Pediatric Resident Engagement With an Online Critical Care Curriculum During the Intensive Care Rotation.

Objectives: Residents are often assigned online learning materials as part of blended learning models, superimposed on other patient care and learning demands. Data that describe the time patterns of when residents interact with online learning materials during the ICU rotation are lacking. We describe resident engagement with assigned online curricula related to time of day and ICU clinical schedules, using website activity data.

Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units.

Importance: The recent and ongoing coronavirus disease 2019 (COVID-19) pandemic has taken an unprecedented toll on adults critically ill with COVID-19 infection. While there is evidence that the burden of COVID-19 infection in hospitalized children is lesser than in their adult counterparts, to date, there are only limited reports describing COVID-19 in pediatric intensive care units (PICUs).

Objective: To provide an early description and characterization of COVID-19 infection in North American PICUs, focusing on mode of presentation, presence of comorbidities, severity of disease, therapeutic interventions, clinical trajectory, and early outcomes.

Clinical Documentation for Intensivists: The Impact of Diagnosis Documentation.

Objectives: The aim of this review is to describe the interaction of clinical documentation with patient care, measures of patient acuity, quality metrics, research database accuracy, and healthcare reimbursement in order to highlight potential areas of improvement for intensivists.

Data Sources: An online search of PubMed was undertaken as well as review of resources published by the American Academy of Pediatrics, the Society of Critical Care Medicine, the American Medical Association, and the Association of Clinical Documentation Improvement Specialists.

Study Selection: Selected publications included those that described coding, medical record documentation, healthcare reimbursement, quality metrics, administrative databases, Clinical Documentation Improvement programs, medical scribe programs, and various payment models.

Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters.

Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains.

Design: A prospective, interventional crossover study conducted from October 2015 to December 2017.

Epidemiology of childhood death in Australian and New Zealand intensive care units.

Purpose: Data on childhood intensive care unit (ICU) deaths are needed to identify changing patterns of intensive care resource utilization. We sought to determine the epidemiology and mode of pediatric ICU deaths in Australia and New Zealand (ANZ).

Methods: This was a retrospective, descriptive study of multicenter data from pediatric and mixed ICUs reported to the ANZ Pediatric Intensive Care Registry and binational Government census.

Frameworks for quality improvement in pediatric intensive care: A concise review.

Quality improvement programs focused on improving care in intensive care units have become standard at pediatric hospitals around the world over the past several decades. However, the methodology or framework by which these programs assess quality is not standard. This review describes the varying quality improvement frameworks that have been promoted by prominent pediatric and critical care societies and the strengths and limitations of these frameworks, as well as several notable international collaboratives in this domain.

Quality improvement in pediatric intensive care: A systematic review of the literature.

Importance: Measuring and improving performance is an essential component of any high-risk industry, including intensive care medicine. We undertook this systematic review to describe the current state of quality improvement efforts in pediatric intensive care medicine.

Objective: To evaluate the quality and rigor of all published literature on quality improvement efforts in the pediatric intensive care unit in the current era.

Growth and Changing Characteristics of Pediatric Intensive Care 2001-2016.

Objectives: We assessed the growth, distribution, and characteristics of pediatric intensive care in 2016.

Design: Hospitals with PICUs were identified from prior surveys, databases, online searching, and clinician networking. A structured web-based survey was distributed in 2016 and compared with responses in a 2001 survey.

The Top Ten Websites in Critical Care Medicine Education Today.

Introduction:: The number of websites for the critical care provider is rapidly growing, including websites that are part of the Free Open Access Med(ical ed)ucation (FOAM) movement. With this rapidly expanding number of websites, critical appraisal is needed to identify quality websites. The last major review of critical care websites was published in 2011, and thus a new review of the websites relevant to the critical care clinician is necessary.