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A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Neonatology".

Deadline for manuscript submissions: 1 December 2024 | Viewed by 20956

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Special Issue Editors

Dr. Martin E.G. Blohm

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Guest Editor

Division of Neonatology and Paediatric Critical Care Medicine, University Medical Center Hamburg – Eppendorf, Hamburg, Germany
Interests: non-invasive hemodynamic monitoring; cardiovascular biomarkers; hemato-oncological and post-transplantational critical care; applied ethics on pediatric intensive care units

Prof. Dr. Dominique Singer

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Guest Editor

Division of Neonatology and Paediatric Critical Care Medicine, University Medical Center Hamburg – Eppendorf, Hamburg, Germany
Interests: (comparative) physiology of perinatal transition; thermal balance and metabolic monitoring in neonates; ethics in prenatal diagnostics; long-term outcome of preterm neonates; pediatric drowning and hypothermia; acid-base disturbances

Special Issue Information

Dear Colleagues,

Pediatric intensive care units (PICUs) are highly specialized medical facilities dealing with both conditions that are unique to children and others that are also found in adults but require a different, age-related approach. Among the former are congenital malformations and metabolic disorders. The latter include infectious diseases, surgical conditions, and trauma sequelae with possible single or multiple organ failure. Despite significant advances in size-adapted techniques and procedures, scientific evidence in pediatric intensive care is often scarce given the predominant off-label use of drugs and the substantial lack of randomized controlled trials.

The purpose of this Special Issue is to collect contributions to pediatric intensive care practice and research. The volume is intended to provide a cross-section of current PICU-specific topics, ranging from diagnosis, monitoring, treatment, and long-term results to organizational, psychosocial, and ethical issues. Contributions on neonatal care are encouraged, though not with a distinct focus on prematurity. In addition to reviews of relevant PICU topics, all types of research papers, from laboratory studies to pro- and retrospective clinical trials, are most welcome. Outstanding case reports with a clear added scientific value are also acceptable.

Please feel free to forward this call for papers to experienced colleagues who might be interested in contributing to this state-of-the-art inventory of PICU practice and research.

Dr. Martin E.G. Blohm
Prof. Dr. Dominique Singer
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

children
pediatrics
intensive care
critical care
research

Published Papers (9 papers)

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14 pages, 845 KiB

Open AccessArticle

Suicidality Prevalence in a Pediatric Psychiatric Clinic: Relation to Social and Environmental Risk Factors

by Stavroula Ilia, Evangelia Sakapeti, Panagiotis Briassoulis, George Gerostergios, Alexandros Vgontzas and George Briassoulis

Children 2023, 10(3), 558; https://doi.org/10.3390/children10030558 - 15 Mar 2023

Cited by 1 | Viewed by 3120

Abstract

Suicidality is a growing public health problem in children and adolescents. The aim of this retrospective data analysis study was to estimate the prevalence of suicidality in pediatric patients admitted to an academic Pediatric Psychiatric Clinic (PPC) and to analyze social and environmental risk factors associated with suicide. Suicidal ideation was assessed by the Self-Injurious Thoughts and Behaviors Interview. Using established psychometric scales, social and stressful events were analyzed. During the four-year study, 249 episodes of care were experienced by 152 individuals (mean age 15.2 ± 2 years, girls/boys 107/45). Twenty-eight patients (11.2%) were admitted from the Pediatric Intensive Care Unit and the Department of Pediatrics, 162 (65.1%) from the Pediatric Emergency Department, and 59 (23.7%) from other Hospitals (p = 0.003). A significant longitudinal increase in admissions to PPC, with increasing trends of suicidal ideation, suicide attempts, and suicidality, was recorded. Suicidal behavior, bullying, internet addiction, friends quarreling, and family problems were risk factors for suicide attempts and suicidality. Our results have implications for prevention programs, highlighting an increasing need for care for suicide attempts and suicidal ideation, related to specific stressful events and contextual socio-environmental status. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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10 pages, 1393 KiB

Open AccessArticle

Prevalence of High Blood Pressure in Pediatric Patients with Sleep-Disordered Breathing, Reversibility after Treatment: The KIDS TRIAL Study Protocol

by María Castillo-García, Esther Solano-Pérez, Sofía Romero-Peralta, María Esther Viejo-Ayuso, Laura Silgado-Martínez, Leticia Álvarez-Balado, Rosa Mediano San Andrés, Pilar Resano-Barrio, Francisco García-Rio, Irene Cano-Pumarega, Manuel Sánchez-de-la-Torre, Alfonso Ortigado, Ana López-Dueñas, Laura Fidalgo, Ángel Rodríguez, Olga Mediano and Spanish Sleep Network

Children 2022, 9(12), 1849; https://doi.org/10.3390/children9121849 - 28 Nov 2022

Cited by 1 | Viewed by 1762

Abstract

Current data support an increase in the prevalence of high blood pressure (HBP) in pediatric patients with sleep-disordered breathing (SDB). Adeno-tonsillectomy has been shown to be an effective treatment for most patients. Our objective was to determine the prevalence of HBP in pediatric patients with SDB and the impact of adeno-tonsillectomy with a multicenter, longitudinal, and prospective study that included 286 children referred for suspected SDB. The diagnosis of SDB was established by polysomnography (PSG) and the diagnosis of HBP by 24-h ambulatory blood pressure monitoring (ABPM). In patients without SDB and SDB without treatment indication, these tests were repeated six months after the baseline visit. For patients with medical treatment for SDB, the tests were repeated six months after the treatment initiation. Finally, in patients with surgery indication, ABPM was performed just before surgical treatment and ABPM and PSG six months after the intervention. The study contributes to elucidating the association between SDB and HBP in pediatric patients. Moreover, it contributes to determining if intervention with adeno-tonsillectomy is associated with BP reduction. The results have direct implications for the management of SDB, providing essential information on treatment indications for existing clinical guidelines. NCT03696654. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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12 pages, 890 KiB

Open AccessArticle

PICU Survivorship: Factors Affecting Feasibility and Cohort Retention in a Long-Term Outcomes Study

by Sarah A. Sobotka, Emma J. Lynch, Ayesha V. Dholakia, Anoop Mayampurath and Neethi P. Pinto

Children 2022, 9(7), 1041; https://doi.org/10.3390/children9071041 - 13 Jul 2022

Cited by 1 | Viewed by 1377

Abstract

Our understanding of longitudinal outcomes of Pediatric Intensive Care Unit (PICU) survivors is limited by the heterogeneity of follow-up intervals, populations, and outcomes assessed. We sought to demonstrate (1) the feasibility of longitudinal multidimensional outcome assessment and (2) methods to promote cohort retention. The objective of this presented study was to provide details of follow-up methodology in a PICU survivor cohort and not to present the outcomes at long-term follow-up for this cohort. We enrolled 152 children aged 0 to 17 years admitted to the PICU in a prospective longitudinal cohort study. We examined resource utilization, family impact of critical illness, and neurodevelopment using the PICU Outcomes Portfolio (POP) Survey which included a study-specific survey and validated tools: 1. Functional Status Scale, 2. Pediatric Evaluation of Disability Inventory Computer Adaptive Test, 3. Pediatric Quality of Life Inventory, 4. Strengths and Difficulties Questionnaire, and 5. Vanderbilt Assessment Scales for Attention Deficit-Hyperactivity Disorder. POP Survey completion rates were 89%, 78%, and 84% at 1, 3, and 6 months. Follow-up rates at 1, 2, and 3 years were 80%, 55%, and 43%. Implementing a longitudinal multidimensional outcome portfolio for PICU survivors is feasible within an urban, tertiary-care, academic hospital. Our attrition after one year demonstrates the long-term follow-up challenges in this population. Our findings inform ongoing efforts to implement core outcome sets after pediatric critical illness. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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8 pages, 819 KiB

Open AccessArticle

Impact of Time Point of Extracorporeal Membrane Oxygenation on Mortality and Morbidity in Congenital Diaphragmatic Hernia: A Single-Center Case Series

by Christian Wegele, Yannick Schreiner, Alba Perez Ortiz, Svetlana Hetjens, Christiane Otto, Michael Boettcher, Thomas Schaible and Neysan Rafat

Children 2022, 9(7), 986; https://doi.org/10.3390/children9070986 - 01 Jul 2022

Cited by 2 | Viewed by 1527

Abstract

Since there are no data available on the influence of the time point of ECMO initiation on morbidity and mortality in patients with congenital diaphragmatic hernia (CDH), we investigated whether early initiation of ECMO after birth is associated with a beneficial outcome in severe forms of CDH. All neonates with CDH admitted to our institution between 2010 until 2020 and undergoing ECMO treatment were included in this study and divided into four different groups: (1) ECMO initiation < 12 h after birth (n = 143), (2) ECMO initiation between 12–24 h after birth (n = 31), (3) ECMO initiation between 24–120 h after birth (n = 48) and (4) ECMO initiation > 120 h after birth (n = 14). The mortality rate in the first (34%) and fourth group (43%) was high and in the second group (23%) and third group (12%) rather low. The morbidity, characterized by chronic lung disease (CLD), did not differ significantly in the three groups; only patients in which ECMO was initiated >120 h after birth had an increased rate of severe CLD. Our data, although not randomized and limited due to small study groups, suggest that very early need for ECMO and ECMO initiation > 120 h after birth is associated with increased mortality. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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9 pages, 2178 KiB

Open AccessArticle

A Comparison between Three Different Techniques Considering Quality Skills, Fatigue and Hand Pain during a Prolonged Infant Resuscitation: A Cross-Over Study with Lifeguards

by Roberto Barcala-Furelos, Martín Barcala-Furelos, Francisco Cano-Noguera, Martín Otero-Agra, Alejandra Alonso-Calvete, Santiago Martínez-Isasi, Silvia Aranda-García, Sergio López-García and Antonio Rodríguez-Núñez

Children 2022, 9(6), 910; https://doi.org/10.3390/children9060910 - 17 Jun 2022

Cited by 2 | Viewed by 2644

Abstract

The aim of the study was to compare the quality of CPR (Q-CPR), as well as the perceived fatigue and hand pain in a prolonged infant cardiopulmonary resuscitation (CPR) performed by lifeguards using three different techniques. A randomized crossover simulation study was used to compare three infant CPR techniques: the two-finger technique (TF); the two-thumb encircling technique (TTE) and the two-thumb-fist technique (TTF). 58 professional lifeguards performed three tests in pairs during a 20-min period of CPR. The rescuers performed compressions and ventilations in 15:2 cycles and changed their roles every 2 min. The variables of analysis were CPR quality components, rate of perceived exertion (RPE) and hand pain with numeric rating scale (NRS). All three techniques showed high Q-CPR results (TF: 86 ± 9%/TTE: 88 ± 9%/TTF: 86 ± 16%), and the TTE showed higher values than the TF (p = 0.03). In the RPE analysis, fatigue was not excessive with any of the three techniques (values 20 min between 3.2 for TF, 2.4 in TTE and 2.5 in TTF on a 10-point scale). TF reached a higher value in RPE than TTF in all the intervals analyzed (p < 0.05). In relation to NRS, TF showed significantly higher values than TTE and TTF (NRS minute 20 = TF 4.7 vs. TTE 2.5 & TTF 2.2; p < 0.001). In conclusion, all techniques have been shown to be effective in high-quality infant CPR in a prolonged resuscitation carried out by lifeguards. However, the two-finger technique is less efficient in relation to fatigue and hand pain compared with two-thumb technique (TF vs. TTF, p = 0.01). Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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13 pages, 2073 KiB

Open AccessArticle

Impact of the First COVID Lockdown on Accident- and Injury-Related Pediatric Intensive Care Admissions in Germany—A Multicenter Study

by Nora Bruns, Lea Y. Willemsen, Katharina Holtkamp, Oliver Kamp, Marcel Dudda, Bernd Kowall, Andreas Stang, Florian Hey, Judith Blankenburg, Hemmen Sabir, Frank Eifinger, Hans Fuchs, Roland Haase, Clemens Andrée, Michael Heldmann, Jenny Potratz, Daniel Kurz, Anja Schumann, Merle Müller-Knapp, Nadine Mand, Claus Doerfel, Peter Dahlem, Tobias Rothoeft, Manuel Ohlert, Katrin Silkenbäumer, Frank Dohle, Fithri Indraswari, Frank Niemann, Peter Jahn, Michael Merker, Nicole Braun, Francisco Brevis Nunez, Matthias Engler, Konrad Heimann, Gerhard K. Wolf, Dominik Wulf, Saskia Hankel, Holger Freymann, Nicolas Allgaier, Felix Knirsch, Martin Dercks, Julia Reinhard, Marc Hoppenz, Ursula Felderhoff-Müser and Christian Dohna-Schwake Show full author list Hide full author list

Children 2022, 9(3), 363; https://doi.org/10.3390/children9030363 - 04 Mar 2022

Cited by 3 | Viewed by 4420

Abstract

Children’s and adolescents’ lives drastically changed during COVID lockdowns worldwide. To compare accident- and injury-related admissions to pediatric intensive care units (PICU) during the first German COVID lockdown with previous years, we conducted a retrospective multicenter study among 37 PICUs (21.5% of German PICU capacities). A total of 1444 admissions after accidents or injuries during the first lockdown period and matched periods of 2017–2019 were reported and standardized morbidity ratios (SMR) were calculated. Total PICU admissions due to accidents/injuries declined from an average of 366 to 346 (SMR 0.95 (CI 0.85–1.05)). Admissions with trauma increased from 196 to 212 (1.07 (0.93–1.23). Traffic accidents and school/kindergarten accidents decreased (0.77 (0.57–1.02 and 0.26 (0.05–0.75)), whereas household and leisure accidents increased (1.33 (1.06–1.66) and 1.34 (1.06–1.67)). Less neurosurgeries and more visceral surgeries were performed (0.69 (0.38–1.16) and 2.09 (1.19–3.39)). Non-accidental non-suicidal injuries declined (0.73 (0.42–1.17)). Suicide attempts increased in adolescent boys (1.38 (0.51–3.02)), but decreased in adolescent girls (0.56 (0.32–0.79)). In summary, changed trauma mechanisms entailed different surgeries compared to previous years. We found no evidence for an increase in child abuse cases requiring intensive care. The increase in suicide attempts among boys demands investigation. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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14 pages, 1370 KiB

Open AccessSystematic Review

State of the Art of Invasive Group A Streptococcus Infection in Children: A Scoping Review of the Literature with a Focus on Predictors of Invasive Infection

by Francesco Mariani, Carolina Gentili, Valentina Pulcinelli, Laura Martino, Piero Valentini and Danilo Buonsenso

Children 2023, 10(9), 1472; https://doi.org/10.3390/children10091472 - 29 Aug 2023

Viewed by 1068

Abstract

Currently, it remains unclear why some children develop invasive group A Streptococcus (iGAS) and how to manage this condition. Therefore, to explore available works in the literature, we performed a scoping review aiming to analyze the current literature on clinical presentation of different illnesses outcomes of iGAS, with a specific focus on predictors of invasive infection, including an assessment of the prodromal stages of the disease and the possible presence of previous non-invasive GAS infections in children that later developed iGAS. Methods: We conducted a systematic search on PubMed and SCOPUS of all pediatric studies reporting iGAS cases, following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. For those studies in which multivariable analysis investigating iGAS risk factors was performed, a second review was performed and reported in detail. Results: A total of 209 studies were included. Five studies investigated risk factors for iGAS, the most relevant being varicella infection, chronic underlying illness, presence of the speC gene in GAS strains, acetaminophen and ibuprofen use, children nonwhite, living in low-income households, exposure to varicella at home, persistent high fever, having more than one other child in the home, and new use of NSAIDs. Although we observed a progressive increase in the number of papers published on this topic, no trials investigating the benefits of clindamycin or intravenous immunoglobulins were found and low-to-middle-income countries were found to be poorly represented in the current literature. Conclusions: Our scoping review highlights important gaps regarding several aspects of iGAS in children, including prodromic presentation and optimal treatment strategies. There is also little representation of low–middle-income countries. The current literature does not allow the performance of systematic reviews or meta-analyses, but this work should inform healthcare professionals, policy makers, and funding agencies on which studies to prioritize on this topic. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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9 pages, 233 KiB

Open AccessCase Report

Toxic Streptococcal Infection in Children: Report on Two Cases with Uncharacteristic Course of Scarlet Fever

by Krystyna Stencel-Gabriel, Dawid Konwant and Karolina Szejnoga-Tułacz

Children 2023, 10(3), 540; https://doi.org/10.3390/children10030540 - 11 Mar 2023

Viewed by 1403

Abstract

Introduction: Scarlet fever is usually a mild childhood disease caused by type A streptococci. This disease is spread by droplets, mainly through direct contact with an infected person or the objects they have used. In pediatrics, these are significant risk factors for the transmission of infectious diseases. However, it is important to remember the possibility of serious complications in the course of scarlet fever. Aim: This paper provides a discussion of two pediatric cases in order to determine the possibilities of diagnosis, differentiation, and treatment of patients with severe, non-obvious courses of scarlet fever. Methods: The case reports of two patients hospitalized in a pediatric department due to Streptococcus pyogenes infection were examined. Results: The patients were admitted to the emergency room with symptoms not directly indicative of type A streptococcal infection, which required further diagnosis. Both patients complained of weakness at the time of presentation. They had an elevated temperature, were dehydrated during the course of gastroenteritis, and passed liquid stools without pathological admixtures. Further stages of diagnosis and treatment required hospitalization in the pediatric department. Therapeutic benefit from the implemented treatment was obtained, and the patients were discharged in good general condition with further recommendations. Conclusions: Medical history, which is often very detailed, can be the key to making the final diagnosis and can supplement the data collected on the basis of laboratory tests. Scarlet fever does not always occur with a mild course, and sometimes its course can be quite non-specific and may require a thorough diagnosis. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

6 pages, 1004 KiB

Open AccessCase Report

Spontaneous Pneumomediastinum in Children with Viral Infections: Report of Three Cases Related to Rhinovirus or Respiratory Syncytial Virus Infection

by Johanna L. Leinert, Alba Perez Ortiz and Neysan Rafat

Children 2022, 9(7), 1040; https://doi.org/10.3390/children9071040 - 13 Jul 2022

Cited by 2 | Viewed by 1926

Abstract

Background: Spontaneous pneumomediastinum (SP) is generally a benign condition which can have various etiologies. Data on SP related to respiratory viral infections in children are rare and there are currently no official guidelines or consistent treatment recommendations for these patients. Aim: To discuss treatment options considering the recommendations for SP with different etiologies. Methods: We report three cases of SP, which were related to rhinovirus or respiratory syncytial virus (RSV) infection. Results: All three patients presented with typical symptoms of a respiratory tract infection and required oxygen supplementation during the hospital stay. All children benefited from a conservative, supportive therapy, and bed rest, and could be discharged after seven days or less without remaining symptoms. Conclusion: Surveillance and monitoring might be reasonable to detect and treat potential complications in children with SP due to viral infections, as one child developed an increasing pneumothorax, which had to be treated with a thoracic drainage. Full article

(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)

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