Diagnosis (by p-RIFLE and KDIGO) and Risk Factors of Acute Kidney Injury in Pediatric Diabetic Ketoacidosis: A Retrospective Study.

Background: There are two criteria to diagnose and stage acute kidney injury (AKI) in children: pediatric-Risk, Injury, Failure, Loss (p-RIFLE) and Kidney Disease Improving Global Outcomes (KDIGO). This study aims to find out the extent of agreement in diagnosis (by p-RIFLE and KDIGO) and risk factors of AKI in pediatric diabetic ketoacidosis (DKA).

Materials And Methods: A retrospective cohort study involving children aged ≤15 years with DKA was conducted between January 2014 and December 2022.

A Prospective Cohort Study on the Effect of Antiseizure Medications on Thyroid Function in Children Aged 6 Months to 12 Years with Epilepsy.

Objectives: This study aimed to explore the effect of antiseizure medications (ASM) on thyroid function in children with epilepsy.

Methods: A prospective study involving children between 6 months and 12 years of age with new-onset seizures who took ASM within 2 months was conducted in the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India, between August 2019 to March 2022. Thyroid function tests-free T3, free T4 and thyroid stimulating hormone (TSH)-were done at baseline and after completing 3 months by competitive immunoassay using direct chemiluminescent technology.

High-Flow Nasal Cannula Versus Nasal Prong Bubble Continuous Positive Airway Pressure in Children With Moderate to Severe Acute Bronchiolitis: A Randomized Controlled Trial.

Objectives: To compare high-flow nasal cannula (HFNC) versus nasal prong bubble continuous positive airway pressure (b-CPAP) in children with moderate to severe acute bronchiolitis.

Design: A randomized controlled trial was carried out from August 2019 to February 2022. (Clinical Trials Registry of India number CTRI/2019/07/020402).

Assessment of the Endotracheal Tube Tip Position by Bedside Ultrasound in a Pediatric Intensive Care Unit: A Cross-sectional Study.

Introduction: The chest X-ray (CXR) is the standard of practice to assess the tip of the endotracheal tube (ETT) in ventilated children. In many hospitals, it takes hours to get a bedside CXR, and it has radiation exposure. The objective of this study was to find the utility of bedside ultrasound (USG), in assessing the ETT tip position in a Pediatric Intensive Care Unit (PICU).

Effect of Sepsis on Iron Parameters in a Population with High Prevalence of Malnutrition and Iron Deficiency: A Cross-Sectional Case-Control Pilot Study.

There is lack of data on iron metabolism in critically ill sepsis children from population with high prevalence of iron deficiency (ID). The study was designed to study impact of sepsis on iron parameters in children with ID. Sepsis patients (age 6-59 months) and their apparently healthy sibling/cousin as controls were enrolled in this case-control pilot study.

Modified Schwartz formula and Tc-DTPA plasma clearance methods to calculate glomerular filtration rate in critically ill children.

Background: Studies comparing the modified Schwartz formula with measured GFR (m-GFR) are lacking in critically ill children.

Methods: This prospective cohort study enrolled children aged 1 month to 12 years, within 24 h of admission. m-GFR measured by technetium-99m-labeled diethylenetriaminepentaacetic acid (Tc-DTPA) and calculated by Russell's two-sample slope-intercept method.

Threshold of Inotropic Score and Vasoactive-Inotropic Score for Predicting Mortality in Pediatric Septic Shock.

Objective: To determine the threshold of the inotropic score (IS) and vasoactive-inotropic score (VIS) for predicting mortality in pediatric septic shock.

Method: This retrospective cohort study included children aged 1 mo to 13 y with septic shock, requiring vasoactive medication. The area under curve receiver operating characteristic (AUROC) was calculated using mean IS and mean VIS to predict PICU mortality, and Youden index cut points were generated.

Prospective Cohort Study on Cumulative Fluid Balance and Outcome in Critically Ill Children Using a Restrictive Fluid Protocol.

Objective: To study the association of cumulative fluid balance and clinical outcomes in a pediatric intensive care unit (PICU) practicing restrictive fluid protocol.

Methods: In this prospective cohort study, children aged less than 13 y admitted for more than 48 h were screened. Children with unstable hemodynamics throughout the stay were excluded.

Early Goal-Directed Therapy With and Without Intermittent Superior Vena Cava Oxygen Saturation Monitoring in Pediatric Septic Shock: A Randomized Controlled Trial.

Objective: To compare early goal-directed therapy (EGDT) 'with' and 'without' intermittent superior vena cava oxygen saturation (ScvO2) monitoring in pediatric septic shock.

Design: Open label randomized controlled trial.

Setting: Pediatric intensive care unit in a tertiary care center.

A Prospective Cohort Study on Serum Sodium and Clinical Outcome in Pediatric Nontraumatic Coma.

Objective: To study the serum sodium level and clinical outcome in pediatric nontraumatic coma.

Methods: A prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU) from September 2015 to June 2016. Children aged < 13 y with nontraumatic coma [modified-Glasgow Coma Scale (m-GCS) score ≤ 8 or fall of ≥ 3 from baseline within 24 h of admission] were included.

Prospective Inverse Probability of Treatment-Weighting Analysis of the Clinical Outcome of Red Blood Cell Transfusion Practice in Critically Ill Children.

Objective: To study the clinical outcomes of red blood cell (RBC) transfusion practices in critically ill children.

Method: This prospective cohort study was conducted in a tertiary care pediatric intensive care unit (PICU) from March-2015 to January-2018. Inverse probability of treatment weighting (IPTW) using propensity score analysis was used.

Trial of Furosemide to Prevent Acute Kidney Injury in Critically Ill Children: A Double-Blind, Randomized, Controlled Trial.

Objective: To study whether furosemide infusion in early-onset acute kidney injury (AKI) in critically ill children would be associated with a reduced proportion of patients progressing to the higher stage (Injury or Failure) as compared to placebo.

Method: A double-blind, placebo-controlled, randomized pilot trial was conducted. The authors enrolled children aged 1-mo (corrected) to 12-y, who were diagnosed with AKI ("risk" stage) using pediatric-Risk, Injury, Failure, Loss, End stage kidney disease (p-RIFLE) criteria, and achieved immediate resuscitation goals within 24 h of admission.

Epinephrine Plus Vasopressin vs Epinephrine Plus Placebo in Pediatric Intensive Care Unit Cardiopulmonary Resuscitation: A Randomized Double Blind Controlled Clinical Trial.

Objective: To compare the efficacy of epinephrine plus vasopressin vs epinephrine plus placebo in the pediatric intensive care unit (PICU) cardiopulmonary resuscitation (CPR).

Design: Randomized, double-blind controlled clinical trial.

Setting: PICU in a tertiary care institute from February, 2019 to May, 2020.

Low-Dose (0.05 Unit/kg/hour) vs Standard-Dose (0.1 Unit/kg/hour) Insulin in the Management of Pediatric Diabetic Ketoacidosis: A Randomized Double-Blind Controlled Trial.

Objective: To compare the efficacy of insulin infusion of 0.05 Unit/kg/hour vs 0.1 Unit/kg/hour in the management of pediatric diabetic ketoacidosis (DKA).

Retrospective Hospital-Based Cohort Study on Risk Factors of Poor Outcome in Pediatric Snake Envenomation.

Background And Objectives: Among Southeast Asian countries, India has reported the highest mortality due to snakebite envenomation. To identify the risk factors of poor outcome (mortality/mechanical ventilation/renal replacement therapy-RRT) in pediatric snakebite envenomation.

Method: Case records of children aged less than 13 years with snakebite envenomation admitted between June 2009 and July 2015 were reviewed retrospectively.

Use of Honey Versus Standard Care for Hospital-Acquired Pressure Injury in Critically Ill Children: A Multicenter Randomized Controlled Trial.

Objectives: To examine if the use of honey (medicated) for dressing is superior to standard care in terms of time to complete wound healing in stages 1-3 of pressure injuries in children admitted to the PICU.

Design: Multicenter, open-label, parallel-group, randomized trial.

Setting: Tertiary-care PICU from August 2017 to January 2019.

Randomized Clinical Trial of 20% Mannitol Versus 3% Hypertonic Saline in Children With Raised Intracranial Pressure Due to Acute CNS Infections.

Objectives: Mannitol is a commonly used osmotherapy agent in raised intracranial pressure. However, the side effects of mannitol are significant. In traumatic brain injury (adult and pediatric), hypertonic saline (3%) shows varied results in comparison with 20% mannitol.

Incidence, Risk Factors, the Role of Plasma NGAL and Outcome of Contrast-Induced Acute Kidney Injury in Critically Ill Children.

Objectives: To study the incidence of contrast-induced acute kidney injury (CI-AKI), evaluate its risk factors, study the role of plasma neutrophil gelatinase-associated lipocalin (NGAL) and evaluate the outcome of CI-AKI in critically ill children.

Methods: In this prospective cohort study, children aged 1 mo to 12 y who underwent contrast computed tomography (CECT) for various medical indications were included. Patients without renal function test before contrast administration, children with chronic kidney disease, children admitted for less than 48 h, and those with serum bilirubin more than 5 mg per dL were excluded.

Kinetic Estimated Glomerular Filtration Rate and Severity of Acute Kidney Injury in Critically Ill Children.

Objective: To study the Kinetic estimated Glomerular Filtration Rate (KeGFR) using serum creatinine (SCr) for the identification of acute kidney injury (AKI), stages of AKI, and extent of agreement with Kidney Disease Improving Global Outcomes (KDIGO) classification in critically ill children.

Methods: A prospective observational study was conducted in a pediatric intensive care unit (PICU) in a tertiary care institute of South India from July through August 2018. Sixty children were enrolled.

Comparison of Phenytoin, Valproate and Levetiracetam in Pediatric Convulsive Status Epilepticus: A Randomized Double-blind Controlled Clinical Trial.

Objective: To compare the efficacy of phenytoin, valproate, and levetiracetam in the management of pediatric convulsive status epilepticus.

Design: Randomized double-blind controlled clinical trial.

Setting: Pediatric critical care division in a tertiary care institute from June, 2016 to December, 2018.

Online Learning and Residents' Acquisition of Mechanical Ventilation Knowledge: Sequencing Matters.

Objective: Rapid advancements in medicine and changing standards in medical education require new, efficient educational strategies. We investigated whether an online intervention could increase residents' knowledge and improve knowledge retention in mechanical ventilation when compared with a clinical rotation and whether the timing of intervention had an impact on overall knowledge gains.

Design: A prospective, interventional crossover study conducted from October 2015 to December 2017.