Anti-infective prescribing practices in critically ill children on continuous renal replacement therapy: a multicenter survey of French-speaking countries.

Background: Use of continuous renal replacement therapy in children receiving anti-infective drugs may lead to inappropriate concentrations with risks related to treatment failure, toxicity and emergence of multidrug-resistant bacteria. We aimed to describe anti-infective prescribing practices in critically ill children undergoing continuous renal replacement therapy.

Methods: An online survey to assess continuous renal replacement therapy, anti-infective prescribing and therapeutic drug monitoring practices was sent by e-mail to physicians working in pediatric intensive care units through the French-speaking Group of Pediatric Intensive Care and Emergency medicine (GFRUP).

Low Dosing Norepinephrine Effects on Cerebral Oxygenation and Perfusion During Pediatric Shock.

Background: Cerebral hypoperfusion and impaired oxygen delivery during pediatric critical illness may result in acute neurologic injury with subsequent long-term effects on neurodevelopmental outcome. Yet, the impact of norepinephrine on cerebral hemodynamics is unknown in children with shock. We aimed to describe the norepinephrine effects on cerebral perfusion and oxygenation during pediatric shock.

Prehospital capillary lactate in children differentiates epileptic seizure from febrile seizure, syncope, and psychogenic nonepileptic seizure.

Purpose: The aim of the study was to examine prehospital capillary lactate in children as a diagnostic biomarker to differentiate epileptic seizures from febrile seizures, syncope, and psychogenic nonepileptic seizures (PNES).

Methods: Capillary lactate concentrations taken in a pediatric prehospital setting within 2 h of the paroxysmal event were compared retrospectively between patients with epileptic seizure, febrile seizure, syncope, and PNES, based on the final diagnosis from the hospitalization report.

Results: One hundred and two patients were included, 53 (52%) with epileptic seizures, 41 (40%) with febrile seizures, and 8 (8%) with syncope or PNES.

Assessment of the Effects of a High Amikacin Dose on Plasma Peak Concentration in Critically Ill Children.

Objectives: This study aimed to assess the incidence of amikacin plasma peak concentration (C) below 60 mg·L in critically ill children receiving an amikacin dosing regimen of 30 mg kg·day. Secondary objectives were to identify factors associated with low C and to assess the incidence of acute kidney injury (AKI).

Methods: A retrospective observational study was performed in two French pediatric intensive care units.

A twelve-year neonatal and pediatric high-frequency oscillatory ventilation transport experience.

Objective: To describe the evolution over a 12-year period of a pediatric intensive care unit transport team's (PICU-TT) experience of pediatric and neonatal interhospital transportation on high-frequency oscillation ventilation (HFOV).

Methods: This was a monocentric retrospective observational study from January 2006 to December 2017. All patients aged under 18 years old who were transported on HFOV by the Robert Debré Hospital PICU-TT were included.

Mobile Extracorporeal Membrane Oxygenation: 5-Year Experience of a French Pediatric and Neonatal Center.

Objectives: Extracorporeal membrane oxygenation is an established therapy for refractory cardiac and/or pulmonary failure that is not available in all centers. When infants and children require extracorporeal membrane oxygenation, they are sometimes placed on extracorporeal membrane oxygenation support in peripheral centers where extracorporeal membrane oxygenation is not available and then transferred on extracorporeal membrane oxygenation to specialized centers. The objective of this study is to first describe one of the largest cohorts of infants and children transported by a mobile unit while on extracorporeal membrane oxygenation.

ShiF acts as an auxiliary factor of aerobactin secretion in meningitis Escherichia coli strain S88.

Background: The neonatal meningitis E. coli (NMEC) strain S88 carries a ColV plasmid named pS88 which is involved in meningeal virulence. Transcriptional analysis of pS88 in human serum revealed a strong upregulation of an ORF of unknown function: shiF, which is adjacent to the operon encoding the siderophore aerobactin.

Early Bayesian Dose Adjustment of Vancomycin Continuous Infusion in Children: a Randomized Controlled Trial.

Methicillin-resistant staphylococcal infections are a global burden. Area under the serum concentration-time curve to minimum inhibitory concentration (AUC/MIC) ratio is the pharmacokinetic (PK) parameter that best predicts vancomycin efficacy. Its therapeutic range is narrow, difficult to achieve because of a wide intersubject variability, especially in children, and is not routinely targeted since the AUC is rarely available.

Successful extracorporeal membrane oxygenation transport of a 4-month-old brain-dead infant for organ donation: A case report.

A 4-month-old infant was declared brain-dead 2 days after being initiated on venoarterial ECMO for a refractory septic shock. All brain death diagnostic criteria were fulfilled according to French law, and parental consent was given for organ donation. The hospital where ECMO was initiated had no authorization for organ procurement, and the donor was then transferred to the local referral center for child organ recovery with our mobile ECMO team to maintain organ perfusion.

Piperacillin Population Pharmacokinetics and Dosing Regimen Optimization in Critically Ill Children with Normal and Augmented Renal Clearance.

Background: Critically ill children frequently display observed alterations of pharmacokinetic (PK) parameters, leading to a reduction in β-lactam concentrations. This study aimed to develop a PK population model for piperacillin in order to optimize individual dosing regimens.

Methods: All children aged ≤ 18 years, weighing more than 2.

Achievement of Therapeutic Vancomycin Exposure With Continuous Infusion in Critically Ill Children.

Objective: Describe and assess a continuous infusion dosing scheme of vancomycin therapy in critically ill children.

Design: Retrospective single-center study, January to June 2015.

Setting: PICU located within a French tertiary academic pediatric hospital.

Population Pharmacokinetic Model to Optimize Cefotaxime Dosing Regimen in Critically Ill Children.

Background: During sepsis, optimal plasma antibiotic concentrations are mandatory. Modifications of pharmacokinetic parameters could lead to low drug concentrations and therefore, insufficient therapeutic levels.

Objective: The aim of this study was to build a population pharmacokinetic model for cefotaxime and its metabolite desacetylcefotaxime in order to optimize individual dosing regimens for critically ill children.

Fluoroquinolones in pediatrics: review of hospital prescription use over 2 years.

Objective: Numerous studies have shown that the tolerance of children to fluoroquinolones (FQs) is satisfactory, and some indications have been recently agreed upon. However, vigilance is required when prescribing FQ to children. The aim of our study was to describe the prescription of FQs to children hospitalized in our hospital.