Editor’s Choice Articles for October

Welcome to October 2022 from Pediatric Critical Care Medicine (PCCM). It is an immense privilege and pleasure for me to present articles that our authors and reviewers have worked on–everything in the issue is worthy of your attention. Start by reading my three Editor’s Choices articles (1–3) along with their accompanying editorials (4–6). Next, have a look at the two themes outlined in the section called PCCM Connections for Readers: 1) respiratory critical care topics (7–10); and 2) cardiac arrest (11–13). Then read about a completely new format for PCCM called “PCCM Narratives in Verse” (14,15). Finally, there is all the other excellent content to peruse. WHAT DO WE KNOW ABOUT THE ASSOCIATION BETWEEN DELIRIUM DURING PICU ADMISSION AND SUBSEQUENT READMISSION? Pilato TC, Mauer EA, Gerber LM, et al: Pediatric Delirium and All–Cause PICU Readmissions Within 1 Year (1). My first Editor’s Choice article examines the association between the presence of delirium during PICU admission and subsequent PICU readmission in a cohort of over 1,100 patients assessed in a single-center retrospective study in New York. The authors describe the association between readmission prevalence in those cases (close to 15%) and odds of previous delirium during the index admission (1). Read closely and, as the authors ask, are there avoidable or preventable factors? The accompanying editorial makes us think about new areas for research, and a focus on the vulnerable youngest children in the PICU (4). WHAT DO WE KNOW ABOUT USING ENOXAPARIN PROPHYLAXIS IN POSTOPERATIVE CHILDREN WITH CONGENITAL HEART DISEASE AT RISK FOR CATHETER ASSOCIATED DEEP VEIN THROMBOSIS? Centers GI, Hege KM, Nitu ME, et al: Prophylactic Enoxaparin Against Catheter-Associated Thrombosis In Postoperative Cardiac Children: An Interrupted Time Series Analysis (2). My next Editor’s Choice article looks at protocol implementation using enoxaparin prophylaxis in over 600 postoperative congenital heart disease patients (before versus during implementation, versus after protocol revision) and the temporal association between catheter days on enoxaparin and decrease in rate of thrombosis (2). Read the accompanying editorial and its insightful approach as to what should now follow regarding clinical investigation (5). WHAT DO WE KNOW ABOUT USING EARLY PERITONEAL DIALYSIS AND POSTOPERATIVE OUTCOMES AFTER PEDIATRIC CONGENITAL HEART DISEASE SURGERY? Namachivayam SP, Law S, Millar J, d’Udekem Y: Early Peritoneal Dialysis and Postoperative Outcomes In Infants After Pediatric Cardiac Surgery: A Systematic Review and Meta-Analysis (3). My third Editor’s Choice article is a feature systematic review and meta-analysis of nine articles (a total of more than 750 patients) and asks whether early initiation of peritoneal dialysis is associated with beneficial postoperative outcomes after infant cardiac surgery (3). The accompanying editorial helps us to better understand the context of these data and to think about patient selection, timing of intervention, and methodology of peritoneal dialysis (6). “PCCM CONNECTIONS” FOR READERS In the connections material this month we have four items in the field of respiratory critical care. An article about long-term pulmonary outcomes in children mechanically ventilated for severe bronchiolitis (7)–with a focus on later asthma and pulmonary medication use–with an accompanying editorial (8). At this point, our readers should connect with our recent material about late outcomes after infant pulmonary critical illness (16) and how to evaluate associations (17,18), as this aspect of our practice is becoming increasingly topical (19). Another item in the respiratory theme is a brief report about the relevance of airway resistance in children requiring invasive mechanical ventilation (9). As an aside, it is very important to get back to pulmonary physiology and we welcome further material at PCCM. The last respiratory item for “connection” is an engaging educational PCCM Concise Clinical Science Review about airway bacterial colonization, biofilms and blooms, and acute respiratory infection (10). As usual, in this section you will find great color illustrations. On the theme of cardiac arrest care there are three items for regular readers to focus on. Epinephrine dosing practice using weight-based calculation or flat dosing across 68 of 137 institutions in the United States surveyed (11); it’s not what you may have believed given what we teach in Pediatric Advanced Life Support guidelines. Next, use of sodium bicarbonate during resuscitation as identified in a prespecified secondary analysis of the ICU-RESUScitation project trial (12). Look closely at the propensity matching analysis and the association between dosing and survival to hospital discharge; and please read the accompanying editorial (13). Finally, a completely new format for PCCM called “PCCM Narratives in Verse”. In response to the success of the PCCM Narrative Essays, largely reflecting the editorial talent and hard work of its section leaders Drs. Wynne Morrison and Danielle DeCourcey, PCCM now considers narrative poems as creative reflective contributions for a wider audience. Such works are not unique to PCCM, and this form of writing will be familiar to many graduates of modern health professions education (20). This month, Proulx and associates share their experience of the medical humanities educational initiative used in the Pediatric Critical Care program at the Hospital for Sick Children, Toronto, Canada (14); specifically, the place of narrative medicine and clinicians’ writing portraying aspects of an individual, or the collective experience. The perspective article includes seven poems by members of the Toronto program. Along with this contribution, Dr. Morrison presents our first PCCM Narratives in Verse called “When One of Them Breaks” (15). The format for this work is an introductory paragraph up to 150 words explaining the background to the reflective content, followed by the poem.

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