Over 30 Years of Neonatal Respiratory Extracorporeal Membrane Oxygenation From a Regional Program.

This referral center's prospective inception-cohort study from 1989 to 2000 (Era 1) and 2000 to 2022 (Era 2) included 232 consecutive children having neonatal respiratory extracorporeal membrane oxygenation (ECMO). Kindergarten-age outcomes determined in 137/139 (95.8%) survivors were Wechsler Preschool and Primary Scales of Intelligence, Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI), and sensorimotor disability, with optimal outcome defined as scores greater than or equal to 80 and without disability.

The determinants of fluid accumulation in critically ill children: a prospective single-center cohort study.

Background: Fluid accumulation (FA) is associated with morbidity and mortality in intensive care. We aimed to determine sources of FA in critically ill children admitted to pediatric intensive care.

Methods: Prospective cohort study of children in a university affiliated tertiary pediatric intensive care unit.

What Lessons can Be Learned From the Management of the COVID-19 Pandemic?

During the COVID-19 pandemic (2020-2023), governments around the world implemented an unprecedented array of non-pharmaceutical interventions (NPIs) to control the spread of SARS-CoV-2. From early 2021, these were accompanied by major population-wide COVID-19 vaccination programmes-often using novel mRNA/DNA technology, although some countries used traditional vaccines. Both the NPIs and the vaccine programmes were apparently justified by highly concerning model projections of how the pandemic could progress in their absence.

Evaluating the Prevalence of Optimal Neurodevelopmental Outcome at 2 Years in Children Previously on Ventricular Assist Device Support.

Background: Literature reporting neurodevelopmental outcomes for patients who undergo ventricular assist device (VAD) therapy is limited to posttransplant cohorts. This study aims to determine the prevalence of optimal neurodevelopmental outcome and factors associated with nonoptimal outcome in patients implanted with a VAD at ≤15 months of age.

Methods: Patients followed by the Complex Pediatric Therapies Follow-Up Program were included in a prospective-inception cohort study if born between January 2006 and December 2022 and implanted with a VAD at ≤15 months of age.

Developmental Care in the Early Years in Pediatric Intensive Care Patients as a Strategy to Mitigate Pediatric Post-Intensive-Care Syndrome: A Narrative Review.

Survivors after pediatric critical care often have adverse sequelae in domains of cognition, executive function, attention, memory, visual-spatial skills, language, motor function, behavior, and emotional functioning, the post-intensive-care syndrome pediatric (PICS-p). The time from birth to approximately age 2 years is a period of rapid structural and functional brain development. The fundamental structural and functional architecture of the brain is in place by the second year of life.

Lumbar Puncture and Brain Herniation in Acute Bacterial Meningitis: An Updated Narrative Review.

The risk of lumbar puncture (LP) to precipitate brain herniation in acute bacterial meningitis (ABM) was reviewed in this journal in 2007. We report the case of an infant with ABM who had acute apnea requiring intubation and tonic posturing (mistaken for seizure), and then had brain herniation within four hours of an LP. The case prompted this updated narrative review, from 2007 to 2024, focused on the twelve points made in 2007.

Survival and Neurocognitive Outcomes After Noncardiac Illness Indications for Extracorporeal Membrane Oxygenation in Young Children.

This referral center prospective inception cohort study included 84 consecutive children having extracorporeal membrane oxygenation (ECMO) for noncardiac illness indications at the age of less than 6 years from 2000 to 2017. Long-term outcomes were survival, neurocognitive ( Wechsler Preschool and Primary Scales of Intelligence ) and functional (General Adaptive Composite) scores, and disability, with optimal outcome defined as scores greater than or equal to 80 and without disability. Age at cannulation was 551 (standard deviation [SD] = 571) days, 40 (47.

Post-Traumatic Stress in Mothers of Children Having Complex Cardiac Surgery Early in Life.

To determine: (i) frequency of probable post-traumatic stress disorder (PTSD) in mothers of infants after complex cardiac surgery (CCS), (ii) predictors of probable PTSD, and (iii) impact on child neurodevelopment. The Impact of Event Scale-Revised (IES-R) was administered to 60 mothers of infants ≥ 6 months after CCS at ≤ 6 weeks of age. The IES-R measures response to a specific traumatic event: Scores < 24, no concern; 24-32, clinical concern; and ≥ 33, probable diagnosis of PTSD.

Behaviour Concerns in Preschool Cardiac Surgery Survivors.

Background: Behaviour concerns (BC) are reported in survivors of complex cardiac surgery (CCSx) with inconsistent evidence about health and demographic variables that impact outcomes.

Methods: A prospective inception-cohort study of infants (without known chromosomal abnormalities) after CCSx from 2001 to 2017 determined Behaviour Assessment System for Children (BASC-II/III) parent rating scales at 4.5 years.

Rapid normalization of vitamin D deficiency in PICU (VITdALIZE-KIDS): study protocol for a phase III, multicenter randomized controlled trial.

Background: The rate of vitamin D deficiency (VDD) in critically ill children worldwide has been estimated at 50%. These children are at risk of multiple organ dysfunction, chronic morbidity, and decreased health related quality of life (HRQL). Pediatric and adult ICU clinical trials suggest that VDD is associated with worse clinical outcomes, although data from supplementation trials are limited and inconclusive.

Evaluating associations between patient-to-nurse ratios and mortality, process of care events and vital sign documentation on paediatric wards: a secondary analysis of data from the EPOCH cluster-randomised trial.

Objective: To describe the associations between patient-to-nurse staffing ratios and rates of mortality, process of care events and vital sign documentation.

Design: Secondary analysis of data from the evaluating processes of care and outcomes of children in hospital (EPOCH) cluster-randomised trial.

Setting: 22 hospitals caring for children in Canada, Europe and New Zealand.

Differences in gross motor and fine motor outcomes for toddlers after early complex cardiac surgery.

Objectives: To determine whether gross motor scores of toddlers after complex cardiac surgery were different from fine motor scores and were adequately represented by motor composite scores and, whether acute care predictors and chronic childhood health markers of gross motor scores differed from those of fine motor.

Methods: This prospective inception-cohort outcomes study included 171 toddlers after complex cardiac surgery with cardiopulmonary bypass at age <6 months, born in Northern Alberta from 2009 to 2019, and without known chromosomal abnormalities. At a mean (standard deviation) age of 21.

The Alberta Infant Motor Scale as an Outcomes Measure of Gross Motor Abilities after Early Complex Cardiac Surgery.

To address the research hypothesis that the Alberta Infant Motor Scale (AIMS) completed following complex cardiac surgery (CCS) is a useful outcomes measure this study determined: (1) AIMS scores at age 8 months after CCS; (2) predictive validity of AIMS at 8 months for Bayley Scales of Infant and Toddler Development-III Gross Motor-scaled scores (GMSS) and diagnosis of cerebral palsy (CP) at 21 months; and (3) predictive demographic and surgical variables of AIMS scores. A prospective cohort study of 250/271 (92.3%) surviving children from Northern Alberta (born 2009-2020) who had CCS at age < 6 months determined AIMS scores at age mean (SD) 8.