Advancing Cardiac Critical Care: A Call for Training, Collaboration, and Family Engagement
Abstract The evolution and development of pediatric cardiac critical care as a distinct subspecialty have occurred rapidly over the past 20 years. As the field has grown, models for education, training, and care delivery have changed as well. This review will highlight the current state of education, training, and parental involvement in care delivery for […]
Off-label drug use in a single-center pediatric cardiac intensive care unit
Abstract Background: The frequency of off-label drug use and its association with morbidity and mortality in the cardiac intensive care unit (CICU) has not been previously studied. Methods: Patients less than 18 years of age admitted to the CICU from June to August 2008 were retrospectively identified. Patient demographics were collected for 30 days or […]
Ethical dilemma: offering short-term extracorporeal membrane oxygenation support for terminally ill children who are not candidates for long-term mechanical circulatory support or heart transplantation
Abstract The use of extracorporeal membrane oxygenation (ECMO) in terminally ill pediatric patients who are not candidates for long-term mechanical circulatory support or heart transplantation requires careful deliberation. We present the case of a 16-year-old female with a relapse of acute lymphoid leukemia and acute-on-chronic cardiomyopathy who received short-term ECMO therapy. In addition, we highlight […]
Outcomes of tracheostomy following congenital heart surgery: a contemporary experience
Abstract Introduction: Following congenital heart surgery, pediatric patients may experience persistent respiratory failure that requires tracheostomy placement. Currently, definitive knowledge of the optimal timing for tracheostomy placement in this patient population is lacking. Methods: An 8-year retrospective review of 17 pediatric patients who underwent congenital heart surgery and subsequently required tracheostomy placement was performed. Patients […]
Unplanned Extubations in Children: Impact on Hospital Cost and Length of Stay
Abstract Objective: To determine the attributable hospital cost, both operational and departmental, and length of stay associated with unplanned extubations in children admitted to PICU and cardiac ICU. Design: Retrospective, matched case-control study. Setting: Forty-four-bed PICU and 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. Patients: Cases with an unplanned extubation were retrospectively […]
Monitoring the harm associated with use of anticoagulants in pediatric populations through trigger-based automated adverse-event detection
Abstract Background: The safety profile of anticoagulants, which are being used with increasing frequency in pediatric populations, is not well studied. Automatic triggers built into electronic health record systems (EHR) have been shown to be an effective way to monitor for and identify medication errors. Anticoagulant-associated adverse events were examined through the use of an […]
Clinical Epidemiology of Extubation Failure in the Pediatric Cardiac ICU: A Report From the Pediatric Cardiac Critical Care Consortium
Abstract Objective: To describe the clinical epidemiology of extubation failure in a multicenter cohort of patients treated in pediatric cardiac ICUs. Design: Retrospective cohort study using prospectively collected clinical registry data. Setting: Pediatric Cardiac Critical Care Consortium registry. Patients: All patients admitted to the CICU at Pediatric Cardiac Critical Care Consortium hospitals. Interventions: None. Measurements […]
Training Pathways in Pediatric Cardiac Intensive Care: Proceedings From the 10th International Conference of the Pediatric Cardiac Intensive Care Society
Abstract The increase in pediatric cardiac surgical procedures and establishment of the practice of pediatric cardiac intensive care has created the need for physicians with advanced and specialized knowledge and training. Current training pathways to become a pediatric cardiac intensivist have a great deal of variability and have unique strengths and weaknesses with influences from […]
Pediatric Cardiac Intensive Care Society 2014 Consensus Statement: Pharmacotherapies in Cardiac Critical Care Antihypertensives
Abstract Objective: Hypertension remains a common condition in pediatric cardiac intensive care. The physiologic effects of hypertension in this population are complex and are impacted by patient age, comorbidities, and primary cardiac disease. The objective of this study is to review current pharmacotherapies for the management of systemic hypertension in the pediatric cardiac ICU. Data […]
Dr. Klugman Receives Lifetime Service Award – PCICS
Dr. Darren Klugman, Johns Hopkins Children’s Center director of pediatric cardiac critical care, was awarded the Distinguished Service Award by the Pediatric Cardiac Intensive Care Society, an international organization dedicated to improving the lives of patients with congenital heart disease and their families. PCICS Awards Page