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Pediatrics – Critical Care & Emergencies

RCT: Lidocaine spray may reduce pain during radial arterial puncture.

21 Jan, 2022 | 09:19h | UTC

Effectiveness of lidocaine spray on radial arterial puncture pain: A randomized double-blind placebo controlled trial – The American Journal of Emergency Medicine (link to abstract – $ for full-text)

 

Expert consensus for plasma and platelet transfusion practice in critically ill children.

20 Jan, 2022 | 08:44h | UTC

Executive Summary of Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children: From the Transfusion and Anemia EXpertise Initiative—Control/Avoidance of Bleeding (TAXI-CAB) – Pediatric Critical Care Medicine

 

RCT: In children with community-acquired pneumonia, outpatient antibiotic therapy for 5 days resulted in similar clinical response rates compared to a standard 10-day strategy.

19 Jan, 2022 | 08:39h | UTC

Short- vs Standard-Course Outpatient Antibiotic Therapy for Community-Acquired Pneumonia in Children: The SCOUT-CAP Randomized Clinical Trial – JAMA Pediatrics (free for a limited period)

Commentaries:

Trial finds 5 days of antibiotics superior to 10 for kids with pneumonia – CIDRAP

Shorter antibiotics treatment is better for young children with outpatient pneumonia – Vanderbilt University Medical Center

Related:

ACP Guidance: Appropriate Use of Short-Course Antibiotics in Common Infections

RCT: 5 days of high-dose amoxicillin therapy noninferior to 10 days for the treatment of pediatric community-acquired pneumonia

RCT: Among children with community-acquired pneumonia discharged within 48 hours from the ED or hospital, lower-dose outpatient oral amoxicillin was noninferior to a higher dose, and a 3-day duration course was noninferior to 7 days.

Treatment of urinary tract infections in infants <2 Months: A Living Systematic Review – short and long duration of parenteral antibiotics were associated with a similar risk of UTI recurrence.

RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.

Randomized Trial: Seven vs. Fourteen Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia

Meta-Analysis: Efficacy of Short-Course Antibiotic Treatments for Community-Acquired Pneumonia

 

Review: Treatment of multisystem inflammatory syndrome (MIS-C) in children and adolescents.

18 Jan, 2022 | 09:46h | UTC

Treatment of MIS-C in Children and Adolescents – Current Pediatrics Reports

See also: Clinical practice guidelines in multisystem inflammatory syndrome (MIS-C) related to COVID-19: a critical review and recommendations – World Journal of Pediatrics

Related:

Review of 4,470 cases of Multisystem Inflammatory Syndrome in Children in the US.

WHO issues guidelines on the treatment of children with multisystem inflammatory syndrome associated with COVID-19.

An Update on Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2.

Ten Things to Know About Multisystem Inflammatory Syndrome in Children (MIS-C).

Cohort study: long term follow-up showed most patients with post–COVID-19 Multisystem Inflammatory Syndrome in Children had good outcomes with no significant medium- or long-term sequelae.

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison.

Cohort study: Six month follow-up of Multisystem Inflammatory Syndrome in Children.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, there was no evidence that recovery differed after primary treatment with intravenous immune globulin (IVIG) alone, IVIG plus glucocorticoids, or glucocorticoids alone.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

Cohort study showed that the incidence of Multisystem Inflammatory Syndrome in Children (MIS-C) was 316 persons per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. The incidence was higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons.

Cohort study showed good recovery for most children 6 months after Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) associated with SARS-CoV-2.

Epidemiology of Multisystem Inflammatory Syndrome in Children: A Step Closer to Understanding Who, Where, and When

Neurologic involvement in children and adolescents with COVID-19 or Multisystem Inflammatory Syndrome

Clinical Update: Acute covid-19 and multisystem inflammatory syndrome in children

Differences in characteristics and outcomes of children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) vs. severe acute COVID-19

Cutaneous findings in SARS-CoV-2-associated Multisystem Inflammatory Disease in Children (MIS-C)

SR: Multisystem inflammatory syndrome in children related to COVID-19

Observational study: The combination of Immunoglobulins + Methylprednisolone was associated with a better course of fever compared to Immunoglobulins alone in Multisystem Inflammatory Syndrome in children

ACR Guidance for pediatric patients with multisystem inflammatory syndrome in children associated with SARS‐CoV‐2

New systematic review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 infection summarizes the clinical features, management, and outcomes of the disease, showing favorable outcomes for the majority of children

 

RCT: In full-term and near-term neonates, drug treatment of all clinically and electrographically detected seizures was not associated with reduced death rates or disability at 2 years compared with the treatment of only the clinically detected seizures.

13 Jan, 2022 | 08:24h | UTC

Effect of Treatment of Clinical Seizures vs Electrographic Seizures in Full-Term and Near-Term Neonates: A Randomized Clinical Trial – JAMA Network Open

Commentaries:

Should we treat electrographic seizures? – Neonatal Research

Subclinical Electrographic Seizures in the Newborn—Is More Treatment Better? – JAMA Network Open

Neonatal Seizures: Little Difference Between EEG/Clinical Treatment – Physician’s Weekly

 

Commentary on Twitter

 

International study identifies predictors of severe outcomes in children with COVID-19.

12 Jan, 2022 | 09:05h | UTC

News Release: International study identifies predictors of severe outcomes in children with COVID-19 – University of Calgary

Original Study: Outcomes of SARS-CoV-2–Positive Youths Tested in Emergency Departments: The Global PERN–COVID-19 Study – JAMA Network Open

 

NICE Guideline | Fever in under 5s: assessment and initial management.

17 Dec, 2021 | 08:44h | UTC

Fever in under 5s: assessment and initial management – National Institute for Health and Care Excellence

Related: AAP Guideline: Evaluation and management of well-appearing febrile infants 8 to 60 days old.

 

Sepsis in children: state-of-the-art treatment.

16 Dec, 2021 | 08:56h | UTC

Sepsis in children: state-of-the-art treatment – Therapeutic Advances in Infectious Disease

 

Antibiotics in critically ill children—a narrative review on different aspects of a rational approach.

16 Dec, 2021 | 08:53h | UTC

Antibiotics in critically ill children—a narrative review on different aspects of a rational approach – Pediatric Research

 

Position Paper: Diagnosis, management, and prevention of button battery ingestion in childhood.

15 Dec, 2021 | 08:32h | UTC

Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood: A European Society for Paediatric Gastroenterology Hepatology and Nutrition Position Paper – Journal of Pediatric Gastroenterology and Nutrition

Visual summary: Diagnosis, Management, and Prevention of Button Battery Ingestion in Childhood

 

Commentary on Twitter (thread – click for more)

 

RCT: In preterm infants with respiratory distress syndrome, surfactant administration via a thin catheter did not improve outcomes.

15 Dec, 2021 | 08:26h | UTC

Effect of Minimally Invasive Surfactant Therapy vs Sham Treatment on Death or Bronchopulmonary Dysplasia in Preterm Infants With Respiratory Distress Syndrome: The OPTIMIST-A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Minimally Invasive Surfactant Therapy to Prevent Bronchopulmonary Dysplasia in Extremely Preterm Infants – JAMA (free for a limited period)

Video: Demonstration of the Hobart Method of Minimally Invasive Surfactant Therapy in a Resuscitation Manikin Equivalent to a 27-Week Gestation 1-kg Preterm Infant – JAMA

 

Retrospective study: antimicrobial susceptibility profiles among neonatal early-onset sepsis (EOS) pathogens – “The vast majority of contemporary EOS pathogens are susceptible to the combination of ampicillin and gentamicin”.

14 Dec, 2021 | 08:46h | UTC

Antimicrobial Susceptibility Profiles Among Neonatal Early-onset Sepsis Pathogens – The Pediatric Infectious Disease Journal

 

Commentary on Twitter

 

Case series with 139 adolescents and young adults with suspected myocarditis following mRNA vaccination showed most cases had a mild clinical course and rapid resolution of symptoms.

7 Dec, 2021 | 10:19h | UTC

Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults – Circulation

News Release: Young people recover quickly from rare myocarditis side effect of COVID-19 vaccine – American Heart Association

 

Review of 4,470 cases of Multisystem Inflammatory Syndrome in Children in the US.

7 Dec, 2021 | 10:08h | UTC

Multisystem Inflammatory Syndrome in Children—United States, February 2020–July 2021 – Clinical Infectious Diseases

Related:

WHO issues guidelines on the treatment of children with multisystem inflammatory syndrome associated with COVID-19.

An Update on Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2.

Ten Things to Know About Multisystem Inflammatory Syndrome in Children (MIS-C).

Cohort study: long term follow-up showed most patients with post–COVID-19 Multisystem Inflammatory Syndrome in Children had good outcomes with no significant medium- or long-term sequelae.

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison.

Cohort study: Six month follow-up of Multisystem Inflammatory Syndrome in Children.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, there was no evidence that recovery differed after primary treatment with intravenous immune globulin (IVIG) alone, IVIG plus glucocorticoids, or glucocorticoids alone.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

Cohort study showed that the incidence of Multisystem Inflammatory Syndrome in Children (MIS-C) was 316 persons per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. The incidence was higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons.

Cohort study showed good recovery for most children 6 months after Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) associated with SARS-CoV-2.

Epidemiology of Multisystem Inflammatory Syndrome in Children: A Step Closer to Understanding Who, Where, and When

Neurologic involvement in children and adolescents with COVID-19 or Multisystem Inflammatory Syndrome

Clinical Update: Acute covid-19 and multisystem inflammatory syndrome in children

Differences in characteristics and outcomes of children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) vs. severe acute COVID-19

Cutaneous findings in SARS-CoV-2-associated Multisystem Inflammatory Disease in Children (MIS-C)

SR: Multisystem inflammatory syndrome in children related to COVID-19

Observational study: The combination of Immunoglobulins + Methylprednisolone was associated with a better course of fever compared to Immunoglobulins alone in Multisystem Inflammatory Syndrome in children

ACR Guidance for pediatric patients with multisystem inflammatory syndrome in children associated with SARS‐CoV‐2

New systematic review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 infection summarizes the clinical features, management, and outcomes of the disease, showing favorable outcomes for the majority of children

 

Editorial: The rationale for the recommendations of the European Pediatric Fasting Guideline – “the authors of the 2021 ESAIC pediatric guideline have found reasons to recommend reductions to the minimum fasting times for infant formula to 4 h, for breast milk to 3 h and for clear fluids to 1 h”.

5 Dec, 2021 | 23:26h | UTC

The rationale for the recommendations of the European Paediatric Fasting Guideline: Improving paediatric anaesthesia and perioperative medicine – European Journal of Anaesthesiology

Original Guideline: Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care – European Journal of Anesthesiology

Related:

Pro-Con Debate: 1- vs 2-Hour Fast for Clear Liquids Before Anesthesia in Children.

ESPEN practical guideline: Clinical nutrition in surgery – “Preoperative fasting from midnight is unnecessary in most patients. Patients undergoing surgery, who are considered to have no specific risk of aspiration, shall drink clear fluids until 2 h before anesthesia. Solids shall be allowed until 6 h before anesthesia.”

 

Extravasation injuries of the limbs in neonates and children: development of a treatment algorithm.

28 Nov, 2021 | 21:03h | UTC

Extravasation Injuries of the Limbs in Neonates and Children: Development of a Treatment Algorithm – Deutsches Ärzteblatt International

 

M-A: Techniques and technologies to improve peripheral intravenous catheter outcomes in pediatric patients.

21 Nov, 2021 | 22:46h | UTC

Techniques and Technologies to Improve Peripheral Intravenous Catheter Outcomes in Pediatric Patients: Systematic Review and Meta-Analysis – Journal of Hospital Medicine (free for a limited period)

 

An Update on Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2.

11 Nov, 2021 | 08:52h | UTC

An Update on Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2 – The Pediatric Infectious Diseases Journal

Related:

Ten Things to Know About Multisystem Inflammatory Syndrome in Children (MIS-C).

Cohort study: long term follow-up showed most patients with post–COVID-19 Multisystem Inflammatory Syndrome in Children had good outcomes with no significant medium- or long-term sequelae.

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison.

Cohort study: Six month follow-up of Multisystem Inflammatory Syndrome in Children.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, there was no evidence that recovery differed after primary treatment with intravenous immune globulin (IVIG) alone, IVIG plus glucocorticoids, or glucocorticoids alone.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

Cohort study showed that the incidence of Multisystem Inflammatory Syndrome in Children (MIS-C) was 316 persons per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. The incidence was higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons.

Cohort study showed good recovery for most children 6 months after Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) associated with SARS-CoV-2.

Epidemiology of Multisystem Inflammatory Syndrome in Children: A Step Closer to Understanding Who, Where, and When

Neurologic involvement in children and adolescents with COVID-19 or Multisystem Inflammatory Syndrome

Clinical Update: Acute covid-19 and multisystem inflammatory syndrome in children

Differences in characteristics and outcomes of children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) vs. severe acute COVID-19

Cutaneous findings in SARS-CoV-2-associated Multisystem Inflammatory Disease in Children (MIS-C)

SR: Multisystem inflammatory syndrome in children related to COVID-19

Observational study: The combination of Immunoglobulins + Methylprednisolone was associated with a better course of fever compared to Immunoglobulins alone in Multisystem Inflammatory Syndrome in children

ACR Guidance for pediatric patients with multisystem inflammatory syndrome in children associated with SARS‐CoV‐2

New systematic review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 infection summarizes the clinical features, management, and outcomes of the disease, showing favorable outcomes for the majority of children

 

Ten Things to Know About Multisystem Inflammatory Syndrome in Children (MIS-C).

4 Nov, 2021 | 10:00h | UTC

Ten Things to Know About MIS-C – American College of Cardiology

Related:

Cohort study: long term follow-up showed most patients with post–COVID-19 Multisystem Inflammatory Syndrome in Children had good outcomes with no significant medium- or long-term sequelae.

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison.

Cohort study: Six month follow-up of Multisystem Inflammatory Syndrome in Children.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, there was no evidence that recovery differed after primary treatment with intravenous immune globulin (IVIG) alone, IVIG plus glucocorticoids, or glucocorticoids alone.

Cohort study: Among children with Multisystem Inflammatory Syndrome (MIS-C) associated with Covid-19, initial treatment with intravenous immune globulin (IVIG) plus glucocorticoids was associated with a lower risk of new or persistent cardiovascular dysfunction than IVIG alone.

Cohort study showed that the incidence of Multisystem Inflammatory Syndrome in Children (MIS-C) was 316 persons per 1 000 000 SARS-CoV-2 infections in persons younger than 21 years. The incidence was higher among Black, Hispanic or Latino, and Asian or Pacific Islander persons.

Cohort study showed good recovery for most children 6 months after Pediatric Inflammatory Multisystem Syndrome (PIMS-TS) associated with SARS-CoV-2.

Epidemiology of Multisystem Inflammatory Syndrome in Children: A Step Closer to Understanding Who, Where, and When

Neurologic involvement in children and adolescents with COVID-19 or Multisystem Inflammatory Syndrome

Clinical Update: Acute covid-19 and multisystem inflammatory syndrome in children

Differences in characteristics and outcomes of children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C) vs. severe acute COVID-19

Cutaneous findings in SARS-CoV-2-associated Multisystem Inflammatory Disease in Children (MIS-C)

SR: Multisystem inflammatory syndrome in children related to COVID-19

Observational study: The combination of Immunoglobulins + Methylprednisolone was associated with a better course of fever compared to Immunoglobulins alone in Multisystem Inflammatory Syndrome in children

ACR Guidance for pediatric patients with multisystem inflammatory syndrome in children associated with SARS‐CoV‐2

New systematic review of Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 infection summarizes the clinical features, management, and outcomes of the disease, showing favorable outcomes for the majority of children

 

RCT: Among children with community-acquired pneumonia discharged within 48 hours from the ED or hospital, lower-dose outpatient oral amoxicillin was noninferior to a higher dose, and a 3-day duration course was noninferior to 7 days.

3 Nov, 2021 | 09:56h | UTC

Effect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA (free for a limited period)

Related:

RCT: 5 days of high-dose amoxicillin therapy noninferior to 10 days for the treatment of pediatric community-acquired pneumonia

Randomized Trial: Amoxicillin for 3 Days Noninferior to Amoxicillin for 5 Days for Chest-Indrawing Pneumonia in Children

ACP Guidance: Appropriate Use of Short-Course Antibiotics in Common Infections

RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.

RCT: A Seven-days course of antibiotics for the treatment of bloodstream infections by Enterobacterales was noninferior to a 14-days course.

RCT: Among patients with prosthetic joint infection, antibiotic therapy for 6 weeks was NOT shown to be noninferior to antibiotic therapy for 12 weeks and resulted in a higher percentage of patients with unfavorable outcomes.

Randomized Trial: Seven vs. Fourteen Days of Antibiotic Therapy for Uncomplicated Gram-negative Bacteremia

 

Commentary on Twitter

 

Does procalcitonin have clinical utility in the management of pediatric community-acquired pneumonia? A PRO/CON debate.

28 Oct, 2021 | 09:54h | UTC

Does procalcitonin have clinical utility in the management of paediatric community-acquired pneumonia? A PRO/CON debate – JAC-Antimicrobial Resistance

PRO: Procalcitonin has clinical utility in children with community-acquired pneumonia

CON: Procalcitonin does not have clinical utility in children with community-acquired pneumonia

 

Retrospective cohort study: corticosteroid treatment linked to lower odds of surgical drainage among pediatric patients with retropharyngeal and parapharyngeal abscesses.

28 Oct, 2021 | 09:52h | UTC

Corticosteroids in the Treatment of Pediatric Retropharyngeal and Parapharyngeal Abscesses – Pediatrics

 

M-A: Risk factors for poor prognosis in children and adolescents with COVID-19.

22 Oct, 2021 | 10:24h | UTC

Risk factors for poor prognosis in children and adolescents with COVID-19: A systematic review and meta-analysis – EClinicalMedicine

 

Choosing Wisely in Pediatric Hospital Medicine: 5 New Recommendations to Improve Value.

20 Oct, 2021 | 09:58h | UTC

Choosing Wisely in Pediatric Hospital Medicine: 5 New Recommendations to Improve Value – Hospital Pediatrics

See complete lists of low-value practices: Choosing Wisely U.S. / Choosing Wisely UK / Choosing Wisely Australia AND Choosing Wisely Canada

 

Cohort Study: Explanatory diagnoses following hospitalization for a brief resolved unexplained event.

8 Oct, 2021 | 10:03h | UTC

Explanatory Diagnoses Following Hospitalization for a Brief Resolved Unexplained Event – Pediatrics

 

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