A Systematic Review of the Relationship Between In-Training Examination Scores and Specialty Board Examination Scores.

Background: In-training examinations (ITEs) are intended for low-stakes, formative assessment of residents' knowledge, but are increasingly used for high-stake purposes, such as to predict board examination failures.

Objective: The aim of this review was to investigate the relationship between performance on ITEs and board examination performance across medical specialties.

Methods: A search of the literature for studies assessing the strength of the relationship between ITE and board examination performance from January 2000 to March 2019 was completed.

Always ready, always prepared-preparing for the next pandemic.

A future global pandemic is likely to occur and planning for the care of critically ill children is less robust than that for adults. This review covers the current state of federal and regional resources for pediatric care in pandemics, a strategy for pandemic preparation in pediatric intensive care units and regions focusing on stuff, space, staff and systems, considerations in developing surge capacity and triage protocols, special circumstances such as highly infectious and highly lethal pandemics, and a discussion of ethics in the setting of pediatric critical care in a pandemic.

Use of High-Frequency Ventilation in the Pediatric Intensive Care Unit.

 To evaluate the clinical characteristics, ventilator settings, and gas exchange indices of patients placed on high-frequency percussive ventilation (HFPV) and high-frequency oscillatory ventilation (HFOV).  Retrospective observation of all consecutive patients aged 0 to 18 years with acute respiratory failure managed with high-frequency ventilation from the institution's introduction of HFPV on May 1, 2012, until July 10, 2013.  Twenty-seven patients underwent HFPV as a first mode of high-frequency ventilation and 16 patients underwent HFOV first.

Practice Patterns in Pediatric Critical Care Medicine: Results of a Workforce Survey.

Objective: To obtain current data on practice patterns of the U.S. pediatric critical care medicine workforce.

Risk factors for poor outcomes and therapeutic strategies for seasonal and pandemic influenza.

Seasonal influenza is a leading cause of morbidity and mortality worldwide annually while pandemic influenza, a unique entity, poses distinct challenges. The pediatric population is the primary vector for epidemics and the main focus of this article. While primary prevention with universal influenza vaccination is the best protection against significant illness, the antigenic shift and drift unique to influenza viruses leave a large population at risk even with universal vaccination.

Disaster preparedness, pediatric considerations in primary blast injury, chemical, and biological terrorism.

Both domestic and foreign terror incidents are an unfortunate outgrowth of our modern times from the Oklahoma City bombings, Sarin gas attacks in Japan, the Madrid train bombing, anthrax spores in the mail, to the World Trade Center on September 11(th), 2001. The modalities used to perpetrate these terrorist acts range from conventional weapons to high explosives, chemical weapons, and biological weapons all of which have been used in the recent past. While these weapons platforms can cause significant injury requiring critical care the mechanism of injury, pathophysiology and treatment of these injuries are unfamiliar to many critical care providers.

The evolving model of pediatric critical care delivery in North America.

The past 50 years have witnessed the emergence and evolution of the modern pediatric ICU and the specialty of pediatric critical care medicine. ICUs have become key in the delivery of health care services. The patient population within pediatric ICUs is diverse.

Comparison of severity of illness scores to physician clinical judgment for potential use in pediatric critical care triage.

Objective: A pediatric triage tool is needed during times of resource scarcity to optimize critical care utilization. This study compares the modified sequential organ failure assessment score (M-SOFA), the Pediatric Early Warning System (PEWS) score, the Pediatric Risk of Admission Score II (PRISA-II), and physician judgment to predict the need for pediatric intensive care unit (PICU) interventions.

Methods: This retrospective cohort study evaluates three illness severity scores for all non-neonatal pediatric patients transported and admitted to a single center in 2006.

Anomalous origin of the left coronary artery from the pulmonary artery in Alagille syndrome.

Alagille syndrome is a dominantly inherited multisystem disorder involving multiple organs including the liver, heart, eyes, face, and skeleton. Congenital heart defects, the majority of which are right-sided, contribute significantly to the mortality of these patients. We report a patient with Alagille syndrome who presented with mitral valve regurgitation requiring valvuloplasty and subsequent mitral valve replacement.

Extracorporeal membrane oxygenation for pediatric respiratory failure: Survival and predictors of mortality.

Objective: The last multicentered analysis of extracorporeal membrane oxygenation in pediatric acute respiratory failure was completed in 1993. We reviewed recent international data to evaluate survival and predictors of mortality.

Design: Retrospective case series review.

Critical appraisal of: triaging pediatric critical care resources during a pandemic: ethical and medical considerations.

Objective: To identify the ethical norms that should govern the allocation of pediatric critical care resources during a pandemic.

Design: Narrative review.

Methods: Review the literature on triage and pandemics.

Surgical ligation of a residually patent arterial duct following failed occlusion using transcatheter coils.

Transcatheter techniques for occlusion of the persistently patent arterial duct using coils have become standard therapy at many centers for pediatric cardiology, and in selected patients have demonstrated comparable efficacy to surgical ligation. Surgical ligation may still be required in many cases, including premature infants or those born with low weight, those with ducts of large diameter, those with associated structural heart disease, and in circumstances of unsuccessful occlusion subsequent to attempted closure using coils. We report on the successful surgical ligation of an arterial duct of moderate size that exhibited residual patency despite two separate attempts at occlusion using coils.

Isoflurane therapy for status asthmaticus in children: A case series and protocol.

OBJECTIVE: To describe the use of inhaled isoflurane by using a standardized protocol in the treatment of respiratory failure secondary to status asthmaticus in a series of pediatric patients. DESIGN: Case series. SETTING: Pediatric intensive care unit of a tertiary care military medical facility.

Training in pediatric critical care medicine: A survey of pediatric residency training programs.

Background: After completing their critical care rotations, pediatric residents are expected to have acquired skills in the resuscitation of critically ill newborns and children. Recent Accreditation Council on Graduate Medical Education (ACGME) guidelines have limited the time devoted to critical care training during pediatric residency. We sought to determine how individual programs have structured their critical care training experience in light of these changes.

Transport of the mechanically ventilated pediatric patient.

Children deserve quality care when they are critically ill or injured. Specialized pediatric services may be limited outside major medical centers. Transport by specialized pediatric and neonatal transport teams may be required to deliver patients to tertiary pediatric medical centers.

A randomized, blinded comparison of chloral hydrate and midazolam sedation in children undergoing echocardiography.

The objective of this prospective, randomized, and blinded study was to compare the use of chloral hydrate versus oral midazolam sedation in children undergoing echocardiography. No adverse effects (nausea, vomiting, paradoxical agitation, or significant deviations from baseline vital signs) were noted with either medication. No differences were noted in onset of sedation between the 2 groups, however, the time to complete recovery was significantly shorter with midazolam than with chloral hydrate.

Lidocaine toxicity secondary to postoperative bladder instillation in a pediatric patient.

The intravesical use of local anesthetics has been described for a variety of urologic procedures with no previous reports of toxicity. We recently took care of a 2.5- year-old girl with systemic lidocaine toxicity following treatment for postoperative bladder spasms.

Resident training in pediatric critical care transport medicine: a survey of pediatric residency programs.

Objective: The Accreditation Council for Graduate Medical Education (ACGME) Program Requirement for Pediatrics includes specific objectives that pediatric residents participate in both the pre-hospital care of acutely ill or injured patients and the stabilization and transport of patients to critical care areas. Previously, residents were often included as the physician component for many pediatric critical care transport teams. Subsequent regionalization of transport services and development of nurse-only transport teams prompted us to determine the current level of resident participation in pediatric critical care transport as well as how individual residency programs were meeting the educational objectives.

The pediatric critical care experience at Naval Hospital Guam: suggestions for critical care training during residency.

Objectives: To determine the critical care experience encountered by three recently graduated military pediatricians at an overseas military hospital and present one model of maximizing allowable critical care training time during residency.

Method: Retrospective reviews of all admissions to the special care nursery and intensive care unit at U.S.

Pediatric emergency preparedness in the office.

Pediatric office emergencies occur more commonly than is usually perceived by family physicians, and most offices are not optimally prepared to deal with these situations. Obtaining specific training in pediatric emergencies and performing mock "codes" to check office readiness can improve the proper handling of pediatric emergencies. Common airway emergencies include foreign-body aspiration and croup.

Development of a pediatric critical care transport team: experience at a military medical center.

Introduction: A pediatric critical care transport program was initiated and organized at Naval Medical Center San Diego in January 1994. The primary goal of the program was to formally train military pediatric residents in the early stabilization and transport of the critically ill neonatal and pediatric patient. It was also felt that such a program would generate significant cost savings to the Department of Defense.

Streptococcal pyomyositis: case report and review.

Pyomyositis is most often associated with Staphylococcus aureus infections after trauma. We describe an unusual presentation of pyomyositis of the chest wall secondary to group A betahemolytic streptococcus infection in a 15-month-old child with acute abdominal symptoms. In addition, the patient had no history or evidence of trauma to the affected area.

Braided bronchus: a previously undescribed airway anomaly.

Infants with congenital heart disease frequently experience recurrent atelectasis, in many cases associated with anomalous branching of the bronchial tree. The bridging bronchus has been well described and has been associated with both left-sided obstructive lesions and a sling-like left pulmonary artery. We describe a similar, though distinct airway anomaly, the "braided bronchus," associated with a bridging bronchus in a child with coarctation of the aorta and recurrent atelectasis.