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Pediatrics – Critical Care & Emergencies

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

 

Neurological Effects of COVID-19 in Children.

1 Oct, 2021 | 10:40h | UTC

Neurological Effects of COVID-19 in Children – Pediatric Clinics of North America

 

RCT: Smart glasses for radial arterial catheterization in pediatric patients.

30 Sep, 2021 | 10:17h | UTC

Smart Glasses for Radial Arterial Catheterization in Pediatric Patients: A Randomized Clinical Trial – Anesthesiology

 

Commentary on Twitter

 

RCT confirms antibiotics are not needed for most children with uncomplicated lower respiratory tract infection if pneumonia is not suspected clinically.

24 Sep, 2021 | 09:00h | UTC

Antibiotics for lower respiratory tract infection in children presenting in primary care in England (ARTIC PC): a double-blind, randomised, placebo-controlled trial – The Lancet

 

Commentary on Twitter

 

Podcast: Febrile Infants (based on the new AAP Guideline).

7 Sep, 2021 | 10:31h | UTC

#33: Febrile Infants – When Babies Are Too Hot – The Cribsiders

Original guideline:

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

Commentaries:

Landmark Febrile Neonate, Febrile Infant Guideline from the AAP – JournalFeed

Small Talk – Hot Off The Presses: The Latest AAP Guidelines for the Febrile Neonate – emDocs

Related:

M-A: Low prevalence of bacterial meningitis among well-appearing febrile infants aged 29-60 days with positive urinalysis results – “These results suggest that for these infants, the decision to use lumbar puncture should not be guided by urinalysis results alone”.

Things We Do for No Reason: Lumbar Punctures in Low-Risk Febrile Infants with Bronchiolitis

[Abstract Only] Observational Study Suggests Testing for Meningitis May Not be Necessary for Febrile Well-Appearing Young Infants with Positive Urinalysis

Study: Clinical Prediction Rule to Identify Febrile Infants at Low Risk for Serious Bacterial Infections

Cohort Study: Accuracy of Complete Blood Cell Counts to Identify Febrile Infants 60 Days or Younger With Invasive Bacterial Infections

 

Position paper on the diagnosis and management of pediatric acute liver failure.

6 Sep, 2021 | 10:31h | UTC

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Diagnosis and Management of Pediatric Acute Liver Failure – Journal of Pediatric Gastroenterology and Nutrition

 

Study casts doubt on WHO guidance on antibiotics for neonatal sepsis.

3 Sep, 2021 | 09:57h | UTC

Study casts doubt on WHO guidance on antibiotics for neonatal sepsis – CIDRAP

Original study: Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS) – The Lancet Infectious Diseases

Invited commentary: Antibiotics for neonatal sepsis in low-income and middle-income countries—where to go from here? (free registration required)

 

Commentary on Twitter

 

The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide.

3 Sep, 2021 | 10:00h | UTC

The Role of Lung Ultrasound in the Management of the Critically Ill Neonate—A Narrative Review and Practical Guide – Children

 

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.

2 Sep, 2021 | 08:19h | UTC

Treatment of UTIs in Infants <2 Months: A Living Systematic Review – Hospital Pediatrics

 

Commentary/Podcast: are the AAP guidelines for the evaluation and management of the well-appearing febrile infant the answer to a never ending story?

27 Aug, 2021 | 08:40h | UTC

SGEM#341: are the AAP guidelines for the evaluation and management of the well-appearing febrile infant the answer to a never ending story? – The Skeptics Guide To EM

Original guideline and commentary: Commentary on the Latest AAP Guidelines for the Febrile Neonate.

 

Review: Managing diabetic ketoacidosis in children.

24 Aug, 2021 | 08:46h | UTC

Managing Diabetic Ketoacidosis in Children – Annals of Emergency Medicine

 

Doubts raised about cooling treatment for oxygen-deprived newborns.

19 Aug, 2021 | 08:38h | UTC

Doubts raised about cooling treatment for oxygen-deprived newborns – Nature

Original study: RCT: Therapeutic hypothermia may cause harm in moderate or severe neonatal encephalopathy in low-income and middle-income countries.

 

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

13 Aug, 2021 | 10:01h | UTC

Kawasaki Disease and Multisystem Inflammatory Syndrome in Children: An Overview and Comparison – American Family Physician

Related:

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

 

AARC Guideline: Management of pediatric patients with oxygen in the acute care setting.

8 Aug, 2021 | 23:43h | UTC

AARC Clinical Practice Guideline: Management of Pediatric Patients With Oxygen in the Acute Care Setting – Respiratory Care – American Association for Respiratory Care

 

Pediatric asthma: The REGAP consensus.

8 Aug, 2021 | 23:45h | UTC

Pediatric asthma: The REGAP consensus – Anales de Pediatría

 

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