Nutritional Status and Mechanical Ventilation Practices in Pediatric Acute Respiratory Distress Syndrome: A Secondary Analysis of the 2017-2023 PARDSAsia Study.

Objectives: In this non-prespecified secondary analysis of the PARDSAsia (NCT04068038) 2017-2023 dataset, we describe baseline nutrition status of children with pediatric acute respiratory distress syndrome (PARDS) and determine its association with positive end expiratory pressure (PEEP) during ventilation and mortality. We hypothesized that abnormal nutritional status was associated with adverse outcomes.

Design: The dataset included anthropometric and nutritional data, and body mass index (BMI) z scores were obtained using the World Health Organization standards.

Clinical Profile, Intensive Care Needs, and Outcome of Children with Adenoviral Pneumonia: A Retrospective Study from a Tertiary Care Hospital in North India.

Background And Aims: Adenoviral pneumonia is a significant cause of morbidity and mortality among children. There is limited data about the clinical profile, intensive care needs, and outcomes of children with adenoviral pneumonia from resource-limited settings.

Patients And Methods: This retrospective study was conducted in the pediatric emergency room (PER) and pediatric intensive care unit (PICU) of a tertiary care hospital in North India over a period of a period of 2 years (July 2022 to June 2024).

Are Pediatric early warning scores reliable in malnourished children? A prospective validation study in a resource-limited ED.

Background: To evaluate and compare the predictive performance of five Pediatric Early Warning Scores (PEWS)-Brighton, Cardiac Children's Hospital Early Warning Score (CCHEWS), Cardiff and Vale, Bedside PEWS (BPEWS), and Birmingham and Toronto PEWS-in identifying clinical deterioration in malnourished children presenting to a pediatric emergency department in a low-middle-income country.

Methods: This prospective observational study was conducted in the Pediatric Emergency Department of a tertiary public hospital in northern India. A total of 1326 malnourished children aged 1 month to 12 years were enrolled between January and December 2022.

Serum Ferritin Levels in Critically Ill Children With Severe Sepsis and Their Relationship With Mortality: A Prospective Observational Study (FerriPedS Study).

Objectives: To determine the serum ferritin levels, single-center prevalence of hyperferritinemia and its association with mortality in critically ill children with severe sepsis.

Methods: This prospective study was conducted in pediatric intensive care unit of a tertiary care teaching hospital in North India over a period of 13 months (June 2023-June 2024), including children 3 months-12 years old with severe sepsis. At admission, blood was collected for estimation of serum ferritin levels.

Continuous renal replacement therapy (CRRT) program initiation in PICU of a resource limited setting: a retrospective analysis of challenges and outcomes.

Background: Continuous Renal Replacement Therapy (CRRT) is emerging as an essential component of organ support in critically ill children. In low- and middle- income countries (LMIC), limited resources, lack of technical support, cost, and administrative issues are major barriers in initiating and sustaining a CRRT program.

Methods: A core team, comprising a consultant and two pediatric intensive care fellows, was assigned additional responsibility of initiating and sustaining a CRRT program in the PICU of a tertiary care teaching and referral hospital.

Insulin glargine supplementation during early management phase in children with diabetic ketoacidosis: a double-blinded randomised controlled trial.

Objective: To evaluate the efficacy and safety of early supplementation with insulin glargine (GI) during the acute management of paediatric diabetic ketoacidosis (DKA).

Design: Double-blinded randomised controlled trial conducted from July 2022 to June 2023.

Setting: Emergency department and paediatric intensive care unit of a tertiary care teaching hospital in North India.

Clinical Profile, Intensive Care Needs, and Short-Term Outcome of Acute Necrotizing Encephalopathy of Childhood: A Retrospective Study From a Tertiary Care Hospital in North India.

Background: Acute necrotizing encephalopathy of childhood (ANEC) is a rare parainfectious clinicoradiological syndrome characterized by rapid neurological deterioration and poor outcomes.

Methods: We conducted a retrospective study over 11 years (2014-2024) in the pediatric emergency and intensive care units of a quaternary hospital in North India. Children aged one month to 12 years diagnosed with ANEC were enrolled.

Serial Serum Immunoglobulin G Levels and Correlation with Outcomes in Children with Guillain Barre Syndrome.

Objectives: Guillain-Barré Syndrome (GBS) has variable severity, inconsistent therapy response, and uncertain recovery. Intravenous immunoglobulins (IVIG) are used to treat this immune-mediated disorder. The authors investigated serial IgG levels and outcomes in IVIG-treated GBS patients.

Neutrophil Lymphocyte Ratio and Clinical Outcome in Children Admitted to PICU: A Prospective Observational Study.

Objectives: To evaluate the association of neutrophil-lymphocyte ratio (NLR) with severity of illness and clinical outcomes in critically-ill children.

Methods: Consecutive children (n = 250) aged 1 mo-12 y in PICU were enrolled during Feb-Sep 2021. They underwent blood counts on day-1, day-4, and day-7.

0.9% Saline versus Ringer's lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial.

Introduction: Ringer's lactate (RL), a balanced crystalloid by regenerating bicarbonate ion, may lead to early diabetic ketoacidosis (DKA) resolution and reduced hyperchloremia as compared with 0.9% saline (NS).

Research Design And Methods: This was a double-blind randomized controlled trial conducted in the pediatric emergency and intensive care units of a teaching hospital.

Balanced Salt Solution Versus Normal Saline as Resuscitation Fluid in Pediatric Septic Shock: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

ObjectiveFluid resuscitation is an important intervention in children with septic shock. The composition of resuscitation fluid is a matter of debate. Our aim was to study the effects of balanced salt solution BSS) versus normal saline (NS) for resuscitation in pediatric septic shock.

Comparison of Six versus Three Doses of Intrapleural Fibrinolytic Therapy in Children with Empyema: A Randomized Controlled Trial.

Objectives: To compare six doses of intrapleural streptokinase (SK) vs. the conventional three doses in children with empyema.

Methods: In this randomized controlled trial, children with empyema received intrapleural streptokinase, either twice daily for 3 d (total 6 doses); or once daily for 3 d (total 3 doses).

Building global collaborative research networks in paediatric critical care: a roadmap.

Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups.

Contextual factors influencing bubble continuous positive airway pressure implementation for paediatric respiratory distress in low-income and middle-income countries: a realist review.

Background: Bubble continuous positive airway pressure (bCPAP) is a low-cost, non-invasive respiratory support therapy for children with respiratory distress, but its effectiveness is dependent on the context. We aimed to understand contextual factors influencing bCPAP implementation for children aged 1-59 months in low-income and middle-income countries (LMICs) and to develop a theory explaining how these factors influence implementation outcomes.

Methods: In this realist review, we generated an initial programme theory comprising candidate context-mechanism-outcome configurations (CMOCs) via review of key references and team discussion.

High Flow Nasal Cannula Versus Conventional Oxygen Therapy and Incidence of Post-Extubation Airway Obstruction in PICU: An Open-Label Randomized Controlled Trial (HiFloCOT-PICU Trial).

Objectives: To study the impact of high flow nasal cannula (HFNC) vs. conventional oxygen therapy (COT) (by simple nasal cannula) as respiratory support after extubation on the rates of post-extubation airway obstruction (PEAO) among mechanically ventilated critically ill children.

Methods: This open-label randomized controlled trial was conducted in pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India over a period of 7 mo (11 August 2021 to 10 March 2022).

Lung-Protective Ventilation for Pediatric Acute Respiratory Distress Syndrome: A Nonrandomized Controlled Trial.

Objectives: Despite the recommendation for lung-protective mechanical ventilation (LPMV) in pediatric acute respiratory distress syndrome (PARDS), there is a lack of robust supporting data and variable adherence in clinical practice. This study evaluates the impact of an LPMV protocol vs. standard care and adherence to LPMV elements on mortality.

Approach to fever in children.

Background: Fever in children is one of the most common reasons for outpatient visits as well as in-patient evaluation, often causing anxiety among parents and caregivers. Fever can be a standalone feature or be associated with other localising symptoms and signs like rash, lymphadenopathy, or any other organ system involvement with or without a focus of infection. The etiologies of fever vary depending on the clinical setting and epidemiology.

Survey of Pediatric Status Epilepticus Treatment Practices and Adherence to Management Guidelines (Pedi-SPECTRUM e-Survey).

Aim: Survey of treatment practices and adherence to pediatric status epilepticus (PSE) management guidelines in India.

Methods: This eSurvey was conducted over 35 days (15th October to 20th November 2023) and included questions related to hospital setting; antiseizure medications (ASMs); ancillary treatment; facilities available; etiology; and adherence to PSE management guidelines.

Results: A total of 170 respondents participated, majority of them were working in tertiary level hospitals (94.