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OBJECTIVES Nosocomial infection is a common source of morbidity in critically injured children including those with traumatic brain injury. Risk factors for nosocomial infection in this population, however, are poorly understood. We hypothesized that critically ill pediatric trauma patients with traumatic brain injury would demonstrate higher rates of nosocomial infection than those without traumatic brain injury. DESIGN Retrospective case-control study. SETTING PICU, single institution. PATIENTS Patients under 18 years old who were admitted to the PICU for at least 48 hours following a traumatic injury were included. Patients were admitted between September 2008 and December 2015. Patients with the following injury types were excluded thermal injury, drowning, hanging/strangulation, acute hypoxic ischemic encephalopathy, or nonaccidental trauma. Data collected included demographics, injury information, hospital and PICU length of stay, vital signs, laboratory data, insertion and removal dates for invasive deents, nosocomial infections were more frequently observed in patients admitted following polytrauma with traumatic brain injury than in patients with isolated traumatic brain injury or trauma without traumatic brain injury.OBJECTIVE To determine whether exposure to an immersive virtual reality curriculum on pediatric respiratory distress improves medical students’ recognition of impending respiratory failure. DESIGN Randomized, controlled, prospective study conducted from July 2017 to June 2018. Evaluators blinded to student groupings. SETTING Academic, free-standing children’s hospital. PARTICIPANTS All third-year medical students (n = 168) were eligible. The standard curriculum was delivered to all students during their pediatric rotation with optional inclusion of research data per Institutional Review Board review. A randomized selection of students was exposed to the virtual reality curriculum. INTERVENTION All students received standard training on respiratory distress through didactics and high-fidelity mannequin simulation. Intervention students underwent an additional 30-minute immersive virtual reality curriculum, experienced through an OculusRift headset, with three simulations of an infant with 1) no distress, 2) reory distress and recognition of the need for escalation of care for patients with signs of impending respiratory failure. This study represents a novel application of immersive virtual reality and suggests that it may be effective for clinical assessment training.OBJECTIVES To examine parental experiences of childhood extracorporeal membrane oxygenation survivors to understand 1) the problems children faced and 2) the support received following hospital discharge. DESIGN Single-center descriptive study. SETTING Nationally commissioned center for neonatal and pediatric extracorporeal membrane oxygenation. PATIENTS All traceable survivors less than 18 years old who received extracorporeal membrane oxygenation from January 1998 to April 2013. INTERVENTION Anonymized postal questionnaire completed by parents of extracorporeal membrane oxygenation survivors. MEASUREMENTS AND MAIN RESULTS Parent-reported developmental problems, follow-up, and the degree of satisfaction with any follow-up experience. Parents of 89 of 366 extracorporeal membrane oxygenation survivors (24%) responded. Sixty-six (74%) reported having developmental concerns about their child, including speech and language (n = 32; 36%), concentration (n = 28; 31%), movement/physical difficulties (n = 26; 29%), antion, and provide support to families. Education and sharing of information about extracorporeal membrane oxygenation with general practitioners/family physicians, community professionals, and schools are essential.OBJECTIVES To determine current management of critically ill children and gather views regarding high flow nasal cannula therapy and to evaluate research priorities for a large prospective randomized controlled trial of noninvasive respiratory support in children. DESIGN Multinational cross-sectional questionnaire survey conducted in 2018. SETTING The sample included pediatric intensive care physicians in North and South America, Asia, Europe, and Australia/New Zealand. MEASUREMENT Questions consisted of 1) characteristics of intensivists and hospital, 2) practice of high flow nasal cannula, 3) supportive treatment, and 4) research of high flow nasal cannula. INTERVENTIONS None. MAIN RESULTS We collected data from 1,031 respondents; 919 (North America, 215; Australia/New Zealand, 34; Asia, 203; South America, 186; Europe, 281) were analyzed. Sixty-nine percent of the respondents used high flow nasal cannula in non-PICU settings in their institutions. Ropsacitinib cost For a case of bronchiolitis/pneumonia infant, 2 L/kg/min of initial flow rate was the most commonly used. For a scenario of pneumonia with 30 kg weight, more than 60% of the respondents initiated flow based on patient body weight; while, 18% applied a fixed flow rate. Noninvasive ventilation was considered as a next step in more than 85% of respondents when the patient is failing with high flow nasal cannula. Significant practice variations were observed in clinical practice markers used, flow weaning strategy, and supportive practices. Views comparing high flow nasal cannula to continuous positive airway pressure also noticeably varied across the respondents. CONCLUSIONS Significant practice variations including views of high flow nasal cannula compared to continuous positive airway pressure was found among pediatric intensive care physicians. To expedite establishment and standardization of high flow nasal cannula practice, research aimed at understanding the heterogeneity found in this study should be undertaken.OBJECTIVES To examine validity and reliability of the Japanese version of the Cornell Assessment of Pediatric Delirium. DESIGN Prospective double-blinded observational cohort study. SETTING Eight-bed mixed PICU (post-surgical and internal medicine) from May 2017 to June 2018. PATIENTS All children between the ages of 0-13 years who were admitted to the PICU for at least 24 hours were eligible for inclusion, as long as the child was arousable to verbal stimulation. INTERVENTIONS Two nurses simultaneously and independently assessed each patient for pediatric delirium with the Japanese version of the Cornell Assessment of Pediatric Delirium; this was compared to the gold standard of psychiatric diagnosis based on Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition standards. MEASUREMENTS AND MAIN RESULTS Forty-one children were enrolled and 92 assessments (ranging from one to four per subject) were completed. Congenital heart disease patients accounted for 73 enrollees (79%). Forty-three percent of observations were performed in children on invasive mechanical ventilation.