Pediatric Critical Care Medicine儿科重症监护医学
Pediatric Critical Care Medicine(英文缩写 PEDIATR CRIT CARE ME),ISSN 1529-7535,eISSN 1947-3893,中文译名:儿科重症监护医学 是一本学术期刊。本页汇总该期刊的最新影响因子、分区信息以及最新收录于 PubMed 的文献,帮助您快速了解期刊全貌。
发文量统计区间：2025-09-27 至 2026-09-27，按本站收录文献的发表日期统计。
期刊介绍
历年影响因子趋势
| JCR 数据年份 | 影响因子 | JCR 分区 |
|---|---|---|
| 2021 | 3.971 | Q1 |
| 2022 | 4.100 | Q1 |
| 2023 | 4.000 | Q1 |
| 2024 | 4.500 | Q1 |
| 2025 | 4.900 | Q1 |
Pediatric Critical Care Medicine 最新收录文献
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1. Determination of Death by Neurological Criteria in Children and Its Concordance With Ancillary Testing, Primarily With CT Angiography: Single-Center Experience in Türkiye, 2012-2025.
PMID:期刊:日期:2026-09-24Our practice in Türkiye when determining death using neurologic criteria (DNC) is to combine clinical examination and ancillary radiological investigation. We have: 1) examined the diagnostic concordance between clinical examination for DNC and the initial ancillary investigation; 2) evaluated an age cutoff of 24 months in the diagnostic clinical-radiological concordance; and 3) explored age and radiological diagnostic relationships in children with incomplete clinical assessment for DNC. Single-center retrospective study, 2012-2025. Academic hospital PICU in İstanbul, Türkiye. We included patients younger than 19 years old in whom DNC was suspected. None. DNC was suspected in 86 patients. Clinical examination consistent with DNC was completed in 61 patients (mean age, 82.1 mo; 16 < 24 and 45 ≥ 24 mo) with ancillary investigation, which were concordant with DNC either on the first test (77%) or after two or more tests (23%). CT angiography (CTA) was the most used test (80%). The initial CTAs were not consistent with DNC in 23% (95% CI, 13-36%). Based on age grouping (< 24 or ≥ 24 mo), being younger was associated with greater odds of a discordant result (8/16 vs. 6/45; odds ratio, 6.5; 95% CI, 1.77-29.93; p = 0.005). Last, in 15 patients (mean age, 43.6 mo) with suspected DNC, but either incomplete clinical examination (n = 9) or apnea test (n = 6), DNC was finally confirmed using CTA, with five of 15 patients having more than one test. In Türkiye, where ancillary investigation is mandatory following a clinical examination consistent with DNC, and where more advanced imaging modalities are unavailable, our practice has been to use CTA. Our 2012-2025 experience of determining DNC shows that CTA is used in the pediatric population, even in children under 2 years old.
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2. Meropenem Dosing for Pediatric Critical Care Patients: Multisite Pharmacokinetic Study, 2012-2020.
PMID:期刊:日期:2026-09-23Critically ill children may present with altered pharmacokinetics (PK) and/or pharmacodynamics (PD), leading to suboptimal dosing of meropenem. We aimed to: 1) investigate meropenem PK in critically ill children, 2) identify factors associated with interindividual PK variability, and 3) evaluate the PK/PD target attainment rates of current and alternative dosing strategies against the most used PK/PD targets. Observational PK study with plasma samples taken after the first and steady state doses after receiving IV meropenem. Data were analyzed using nonlinear mixed-effects modeling. Monte Carlo simulations were performed to evaluate the probability of PK/PD target attainment for different dosing strategies within the first 48 hours of treatment. Neonatal and PICU of two Belgian tertiary care hospitals, 2012-2020. Fifty-four critically ill children (7 d to 14.5 yr old) receiving meropenem infusion at 20-40 mg/kg every 6, 8, or 12 hours. None. Four hundred twenty-three plasma samples were used for population PK analysis. A two-compartment model with allometric scaling and a sigmoidal maturation function accounting for the effects of growth and development best described the data. The typical values for clearance, central volume of distribution, intercompartmental clearance, and peripheral volume of distribution were 13.1, 12.5, 23.9 L/hr/70 kg, and 16.3 L/70 kg, respectively. A loading dose of 40 mg/kg, followed by a continuous infusion of 60 mg/kg/d, was required to achieve 100% of the time the unbound concentration above the minimum inhibitory concentration (MIC) against Enterobacterales species and Pseudomonas aeruginosa (MIC ≤ 2 mg/L) without compromising safety. Standard intermittent dosing regimens (20-40 mg/kg every 8 hr over 0.5 hr) are likely to result in subtherapeutic concentrations, thereby risking therapy failure in critically ill children. A loading dose followed by continuous infusion is suggested for optimal target attainment.
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3. Preoperative Pulmonary Blood Flow, Cardiopulmonary Bypass, and Lung Inflammation in Children With Congenital Heart Disease: Post Hoc Analysis of a Single-Center Prospective Cohort.
PMID:期刊:日期:2026-09-17To evaluate inflammatory biomarkers and lipidomic profiles in tracheal aspirates (TA) of infants with congenital heart disease (CHD), by pulmonary blood flow (Qp) high/low grouping at the time of cardiac surgery on cardiopulmonary bypass (CPB), and to examine associations across CHD phenotypes. Post hoc analysis of patient samples obtained from a single-center prospective study. Pediatric Cardiovascular Surgery Unit, Padova, Italy. Samples from 79 infants with CHD who were enrolled in a prospective study were analyzed and classified by Qp (33/79 low and 46/79 high) according to pulmonary valve size at surgery. We also studied 23 infants without cardiorespiratory disease who served as controls. None. Clinical data and lung mechanics at the time of anesthesia induction, at surgery end, and every 6 hours for 24 hours were collected. TA samples collected before and after surgery were used to quantify epithelial lining fluid (ELF) total proteins (TP), surfactant protein B (SP-B), and cytokines. The lipidomic profile was generated by mass spectrometry. Before surgery, ELF TP and SP-B were increased in CHD infants compared with controls. Sphingomyelin and phosphatidylglycerol percentages were significantly increased, whereas lysophosphatidylcholines and plasmalogens were significantly decreased. In the post-surgery samples, proinflammatory cytokines increased, especially in the low Qp group. This inflammatory response was associated with reduced dynamic compliance in the first 12 hours, and with longer respiratory support and ICU stay compared with the high Qp group. In the low Qp group, cytokine increase was associated with reduced oxygen diffusion capacity, and with the degree and length of minimum temperature during CPB. In this post hoc analysis of TA samples from CHD infants undergoing surgery with CPB, we have shown that preoperative Qp phenotype was associated with an enhanced inflammatory response, highlighting potential opportunities for phenotype-specific strategies to improve postoperative outcome.
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4. Inspiratory Flow Amplitude in Pediatric Acute Respiratory Distress Syndrome: Outcomes in a Single-Center Cohort, 2023-2024.
PMID:期刊:日期:2026-09-14To evaluate whether inspiratory flow amplitude is independently associated with time to successful extubation in children with pediatric acute respiratory distress syndrome (PARDS) ventilated within lung-protective targets. Post hoc analysis of a pulmonary physiologic and clinical dataset collected in 2023-2024. Single tertiary PICU. Forty-eight mechanically ventilated children with early PARDS. None. Standardized measurements of ventilatory parameters and respiratory mechanics collected within 2 hours of intubation during volume-controlled ventilation (VCV) with constant inspiratory flow and neuromuscular blockade. Inspiratory flow amplitude was the ventilator-reported mean inspiratory flow in VCV, a derived, setting-dependent metric. Median (interquartile range [IQR]) age was 11 months (IQR, 3-22 mo), and most patients had mild-to-moderate PARDS of viral etiology. Ventilation was delivered within protective limits for tidal volume, plateau pressure, positive end-expiratory pressure, driving pressure, and inspiratory time. The median inspiratory flow amplitude was 0.9 L/min/kg (IQR, 0.6-1.1 L/min/kg). The primary outcome was time to successful extubation. In multivariable Cox proportional hazards regression adjusted for age, oxygenation index, tidal volume, respiratory rate, and resistive airway pressure (peak inspiratory pressure minus plateau pressure), higher inspiratory flow amplitude was independently associated with a lower hazard of successful extubation over time (hazard ratio, 0.20; 95% CI, 0.06-0.75; p = 0.017). Multicollinearity assessment showed no clinically relevant collinearity among covariates. Sensitivity analyses confirmed the robustness and directional consistency of this association. In complementary linear regression, each 0.1 L/min/kg increase in inspiratory flow amplitude was associated with 3.5 hours (95% CI, 0.7-6.3 hr) of prolonged mechanical ventilation. Among children with early PARDS ventilated within lung-protective limits, higher inspiratory flow amplitude was independently associated with delayed extubation. Inspiratory flow amplitude may represent an integrative marker of dynamic ventilatory load not fully captured by conventional static parameters. These findings are observational and hypothesis-generating and support further investigation of inspiratory flow in PARDS.
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5. Secondary analysis of the 2021-2023 Sepsis Epidemiology in Australian and New Zealand Children Observational Dataset: Association Between Presenting Venous Lactate Concentration and 72-Hour Outcomes.
PMID:期刊:日期:2026-09-14In pediatric patients with sepsis, we hypothesized that the initial venous lactate concentration would be associated with subsequent need for extracorporeal life support (ECLS) or death within 72 hours. A planned secondary analysis of data from the multicenter, two-country Sepsis Epidemiology Emergency Departments (SENTINEL) study, collected 2021-2023. Acute care hospitals in Australia and New Zealand. SENTINEL participants were children of 0 to less than 18 years with suspected sepsis admitted to the hospital through 11 emergency departments. None. We used the initial venous lactate concentration (sampling within 4 hr of hospital arrival) as an explanatory variable for subsequent need for ECLS or death within 72 hours. In 4806 children, with a median (interquartile range [IQR]) age of 1.9 years (IQR, 0.2-6.7 yr), 2651 children (55.2%) were males, and 33 children (0.7%) received ECLS or died within 72 hours. The best-performing initial lactate concentration associated with ECLS or death within 72 hours was 3.5 mmol/L and was observed in 745 of 4806 children (15.5%), including 24 of 33 children requiring ECLS or who died within 72 hours. As a "diagnostic" test, lactate greater than or equal to 3.5 mmol/L had sensitivity (95% CI) of 72.7% (95% CI, 54.5-86.7%), specificity of 84.9% (95% CI, 83.9-85.9%), and area under the receiver-operating characteristics curve of 0.79 (95% CI, 0.71-0.87) for ECLS or death within 72 hours, which are in the acceptable-to-fair category. That is, a 4-hour lactate concentration greater than or equal to 3.5 mmol/L takes the pre- to posttest probability of ECLS/death from 0.7% to 3.2%. In this secondary analysis of the 2021-2023 SENTINEL dataset, we have found that at the time children are hospitalized with suspected community-acquired sepsis, an initial venous lactate greater than or equal to 3.5 mmol/L has an acceptable-to-fair association with subsequent need for ECLS, or death, within 72 hours. Clinicians will need to decide whether such testing on its own is useful in decision-making.
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6. Continuous Renal Replacement Therapy for Acute Decompensation in Inborn Errors of Metabolism: Single-Center, Pediatric Cohort, 2014-2025.
PMID:期刊:日期:2026-09-11To review our use and outcomes of continuous renal replacement therapy (CRRT) for acute metabolic decompensation (hyperammonemia or hyperleucinemia) in infants and children with inborn errors of metabolism (i.e., M), and to identify factors associated with complications and mortality. Retrospective cohort identified using local clinical databases. Single-center PICU and neonatal ICU in a tertiary pediatric center in Türkiye. Thirty-eight children (with 49 CRRT sessions) for urea cycle disorders, organic acidemias, or maple syrup urine disease undergoing treatment between August 2014 and June 2025. None. The median (interquartile range, IQR) age at CRRT initiation was 1.4 months (IQR 0.16-33.90); CRRT resulted in substantial metabolite reduction (mean change 87.6% for ammonia and 74.8% for leucine). Younger age was associated with more hemodynamic and metabolic complications. Overall mortality was 11 of 38 (28.9% [95% CI, 17-44.8%]). In the 11 episodes of CRRT that ended in death vs. 38 CRRT episodes with survival to discharge, there was a greater proportion with hypophosphatemia: 6 of 11 vs. 8 of 38, percentage difference 33.4% (95% CI, 2.8-59.6%), p value of equals to 0.03. Last, we failed to identify an association between episodes of CRRT by technique (continuous venovenous hemodiafiltration [CVVHDF] vs. dialysis) and mortality: 6 of 21 vs. 5 of 28, mean difference 10.7% (95% CI, -12.4 to 34.3%), p value of equal to 0.38. In our single-center 11-year experience of using CRRT for metabolic detoxification in critically ill young infants with inborn errors of metabolism, we have found that substantial reductions in ammonia and leucine can be achieved in severe biochemical derangement, irrespective of whether continuous venovenous hemodialysis or CVVHDF was used. Taken together, for us, these findings reinforce our continued practice of timely CRRT as a critical component of acute metabolic crisis management.
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7. Trust, Advocacy, Inequity, and Information: A Qualitative Study of PICU Communication Experiences Among Low-Income Families in the United States.
PMID:期刊:日期:2026-09-11Communication challenges and barriers are common during PICU stays, but prior studies have rarely focused on historically marginalized groups such as families with low socioeconomic status and families of color. We aimed to characterize these experiences. Semi-structured interviews were conducted from October 2023 to April 2025. Interviews were audio-recorded, transcribed verbatim, analyzed, and coded using a constant comparative method. A PICU at a tertiary-care academic center in the United States. Seventeen families, including 13 mothers, 7 fathers, and 2 grandparents of children with income-based Medicaid insurance admitted to the PICU for at least 5 days. None. Thirteen of 22 interviewees were Black, African American, or Multiracial, 7 were White, and 2 did not indicate race. Major themes included 1) healthcare team behaviors that build or lose family trust; 2) importance of parental advocacy and valuing parent perspective; 3) intersection of race and healthcare experience; and 4) diverse preferences for obtaining information. Families' trust in their healthcare team was influenced by both medical and socioemotional behaviors. Parents desired recognition as experts in their child and trusted the team more when their perspective was included. For some families, experiences with discrimination impacted their trust levels and care experiences. Finally, families obtained information from PICU structures such as rounds but also sought a variety of other sources. This interview study characterized PICU communication experiences among low-income families with diverse representation. Our findings identified how communication behaviors can build and erode family trust in the healthcare team. We also elicited preferences for obtaining information, which could inform interventions to improve information sharing. Future research on how to develop and assess interventions that improve family trust and satisfaction in inpatient care is needed.
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8. When the Kidney Is Not the Problem: Continuous Renal Replacement Therapy for Metabolic Detoxification.
PMID:期刊:日期:2026-09-11该文献暂无摘要。
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10. Survival in Extracorporeal Cardiopulmonary Resuscitation for Pediatric In-Hospital Cardiac Arrest: Nationwide Cohort Study in Japan, 2011-2022.
PMID:期刊:日期:2026-09-11To describe the rate, characteristics, and outcomes of pediatric extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest (IHCA) in Japan and evaluate temporal trends. Retrospective cohort using the Japanese Diagnosis Procedure Combination database from April 2011 to March 2022. Nationwide dataset with approximately 50% of all acute care hospitalizations in Japan. Children of less than 18 years who received ECPR for IHCA. None. The primary outcomes were temporal trends in ECPR utilization and survival to hospital discharge. Among the 8209 pediatric patients with IHCA, 312 received ECPR: the median (interquartile range [IQR]) age was 2 years (IQR, 0-13 yr); and 52% were male. Annual need for ECPR was 3.6 (IQR, 2.9-4.8) cases per 100 IHCA events, with a significant upward trend 2011-2022 (p = 0.0001). Annual need for ECPR was 0.038 (IQR, 0.031-0.046) per 1000 pediatric hospital admissions, and we failed to identify an associated upward trend over time (p = 0.056). Survival to hospital discharge increased from 17.6% in 2011 to 37.5% in 2022, with a significant upward trend over time in the unadjusted analysis (p = 0.036); however, the adjusted temporal analysis failed to show an associated upward trend over time. Survival varied by age and illness category. Secondary analyses showed that cardiac diagnoses, as opposed to noncardiac diagnoses, were associated with higher overall survival: 105 of 213 (49.3%) vs. 24 of 89 (27%); percentage difference, 22.3% (95% CI, 11.3-33.4%); p = 0.0002. In our national dataset from Japan 2011-2022, we have found that pediatric ECPR for IHCA was used infrequently. Survival to hospital discharge showed a temporal increase over time. These trends may reflect changes in patient volume, guideline implementation, or more refined patient selection for ECPR, as well as resuscitation processes and better systems of clinical practice.