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2. UPDATE - 2022 Italian guidelines on the management of bronchiolitis in infants

Author

Manti, Sara, Staiano, Annamaria, Orfeo, Luigi, Midulla, Fabio, Marseglia, Gian Luigi, Ghizzi, Chiara, Zampogna, Stefania, Carnielli, Virgilio Paolo, Favilli, Silvia, Ruggieri, Martino, Perri, Domenico, Di Mauro, Giuseppe, Gattinara, Guido Castelli, D’Avino, Antonio, Becherucci, Paolo, Prete, Arcangelo, Zampino, Giuseppe, Lanari, Marcello, Biban, Paolo, Manzoni, Paolo, Esposito, Susanna, Corsello, Giovanni, and Baraldi, Eugenio

Published
2023
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6. Early Diagnosis of Bronchopulmonary Dysplasia with E-Nose: A Pilot Study in Preterm Infants.

Author

Tenero, Laura, Piazza, Michele, Sandri, Marco, Ferrante, Giuliana, Giacomello, Elisabetta, Ficial, Benjamim, Zaffanello, Marco, Biban, Paolo, and Piacentini, Giorgio

Subjects
PATTERN recognition systems, MACHINE learning, BRONCHOPULMONARY dysplasia, PREMATURE infants, ELECTRONIC equipment, ELECTRONIC noses
Abstract

Bronchopulmonary dysplasia (BPD) is the most common respiratory disease in preterm and is still associated with increased mortality and morbidity. The great interest lies in identifying early biomarkers that can predict the development of BPD. This pilot study explores the potential of e-nose for the early identification of BPD risk in premature infants by analyzing volatile organic compounds (VOCs) in the exhaled breath condensate (EBC). Fourteen mechanically ventilated very preterm infants were included in this study. The clinical parameters and EBC were collected within the first 24 h of life. The discriminative ability of breath prints between preterms who did and did not develop BPD was investigated using pattern recognition, a machine learning algorithm, and standard statistical methods. We found that e-nose probes can significantly predict the outcome of "no-BPD" vs. "BPD". Specifically, a subset of probes (S18, S24, S14, and S6) were found to be significantly predictive, with an AUC of 0.87, 0.89, 0.82, 0.8, and p = 0.019, 0.009, 0.043, 0.047, respectively. The e-nose is an easy-to-use, handheld, non-invasive electronic device that quickly samples breath. Our preliminary study has shown that it has the potential for early prediction of BPD in preterms. [ABSTRACT FROM AUTHOR]

Published
2024
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8. Criteria for Pediatric Sepsis—A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce

Author

Menon, Kusum, Schlapbach, Luregn J., Akech, Samuel, Argent, Andrew, Biban, Paolo, Carrol, Enitan D., Chiotos, Kathleen, Jobayer Chisti, Mohammod, Evans, Idris V. R., Inwald, David P., Ishimine, Paul, Kissoon, Niranjan, Lodha, Rakesh, Nadel, Simon, Oliveira, Cláudio Flauzino, Peters, Mark, Sadeghirad, Benham, Scott, Halden F., de Souza, Daniela C., Tissieres, Pierre, Watson, R. Scott, Wiens, Matthew O., Wynn, James L., Zimmerman, Jerry J., and Sorce, Lauren R.

Published
2021
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16. International Consensus Criteria for Pediatric Sepsis and Septic Shock.

Author

Schlapbach, Luregn J., Watson, R. Scott, Sorce, Lauren R., Argent, Andrew C., Menon, Kusum, Hall, Mark W., Akech, Samuel, Albers, David J., Alpern, Elizabeth R., Balamuth, Fran, Bembea, Melania, Biban, Paolo, Carrol, Enitan D., Chiotos, Kathleen, Chisti, Mohammod Jobayer, DeWitt, Peter E., Evans, Idris, Flauzino de Oliveira, Cláudio, Horvat, Christopher M., and Inwald, David

Subjects
SEPTIC shock, PEDIATRICIANS, SEPSIS, SYSTEMIC inflammatory response syndrome, HOSPITAL mortality, CONSENSUS (Social sciences), CRITICALLY ill, DELPHI method
Abstract

Key Points: Question: How should children with suspected infection at higher risk of mortality, indicative of sepsis, be identified? Findings: Using an international survey, systematic review, and analysis of more than 3 million pediatric health care encounters, and consensus process, new criteria for sepsis and septic shock in children were developed. Pediatric sepsis in children (<18 years) with suspected infection was identified by at least 2 points in the novel Phoenix Sepsis Score, including dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems; and septic shock as sepsis with at least 1 cardiovascular point in the Phoenix Sepsis Score. Meaning: The new criteria for pediatric sepsis and septic shock are globally applicable. Importance: Sepsis is a leading cause of death among children worldwide. Current pediatric-specific criteria for sepsis were published in 2005 based on expert opinion. In 2016, the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, but it excluded children. Objective: To update and evaluate criteria for sepsis and septic shock in children. Evidence Review: The Society of Critical Care Medicine (SCCM) convened a task force of 35 pediatric experts in critical care, emergency medicine, infectious diseases, general pediatrics, nursing, public health, and neonatology from 6 continents. Using evidence from an international survey, systematic review and meta-analysis, and a new organ dysfunction score developed based on more than 3 million electronic health record encounters from 10 sites on 4 continents, a modified Delphi consensus process was employed to develop criteria. Findings: Based on survey data, most pediatric clinicians used sepsis to refer to infection with life-threatening organ dysfunction, which differed from prior pediatric sepsis criteria that used systemic inflammatory response syndrome (SIRS) criteria, which have poor predictive properties, and included the redundant term, severe sepsis. The SCCM task force recommends that sepsis in children be identified by a Phoenix Sepsis Score of at least 2 points in children with suspected infection, which indicates potentially life-threatening dysfunction of the respiratory, cardiovascular, coagulation, and/or neurological systems. Children with a Phoenix Sepsis Score of at least 2 points had in-hospital mortality of 7.1% in higher-resource settings and 28.5% in lower-resource settings, more than 8 times that of children with suspected infection not meeting these criteria. Mortality was higher in children who had organ dysfunction in at least 1 of 4—respiratory, cardiovascular, coagulation, and/or neurological—organ systems that was not the primary site of infection. Septic shock was defined as children with sepsis who had cardiovascular dysfunction, indicated by at least 1 cardiovascular point in the Phoenix Sepsis Score, which included severe hypotension for age, blood lactate exceeding 5 mmol/L, or need for vasoactive medication. Children with septic shock had an in-hospital mortality rate of 10.8% and 33.5% in higher- and lower-resource settings, respectively. Conclusions and Relevance: The Phoenix sepsis criteria for sepsis and septic shock in children were derived and validated by the international SCCM Pediatric Sepsis Definition Task Force using a large international database and survey, systematic review and meta-analysis, and modified Delphi consensus approach. A Phoenix Sepsis Score of at least 2 identified potentially life-threatening organ dysfunction in children younger than 18 years with infection, and its use has the potential to improve clinical care, epidemiological assessment, and research in pediatric sepsis and septic shock around the world. This article revises criteria to identify sepsis in children after an exhaustive process that involved surveying clinicians, reviewing health record databases, conducting a systematic review and meta-analysis, and undergoing a Delphi consensus process. [ABSTRACT FROM AUTHOR]

Published
2024
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20. Italian pediatric intensive care units admitting critically ill cancer Children: results from a national survey.

Author

MARTINATO, Matteo, COMORETTO, Rosanna I., BIBAN, Paolo, ZANONATO, Elisa, SIMONINI, Alessandro, MONTAGUTI, Alessia, GITTO, Eloisa, CARAMELLI, Fabio, FERRARIO, Stefania, SAGREDINI, Raffaella, ALAIMO, Nicola, ZITO MARINOSCI, Geremia, ROSSETTI, Emanuele, CECCHETTI, Corrado, L'ERARIO, Manuela, VASILE, Beatrice, IVANI, Giorgio, BONANOMI, Ezio, ASTUTO, Marinella, and GREGORI, Dario

Published
2023
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22. Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC)

Author

Kneyber, Martin C. J., de Luca, Daniele, Calderini, Edoardo, Jarreau, Pierre-Henri, Javouhey, Etienne, Lopez-Herce, Jesus, Hammer, Jürg, Macrae, Duncan, Markhorst, Dick G., Medina, Alberto, Pons-Odena, Marti, Racca, Fabrizio, Wolf, Gerhard, Biban, Paolo, Brierley, Joe, Rimensberger, Peter C., and on behalf of the section Respiratory Failure of the European Society for Paediatric and Neonatal Intensive Care

Published
2017
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28. KETASER01 protocol: What went right and what went wrong

Author

Rosati, Anna, primary, L’Erario, Manuela, additional, Bianchi, Roberto, additional, Olivotto, Sara, additional, Battaglia, Domenica Immacolata, additional, Darra, Francesca, additional, Biban, Paolo, additional, Biggeri, Annibale, additional, Catelan, Dolores, additional, Danieli, Giacomo, additional, Mondardini, Maria Cristina, additional, Cordelli, Duccio Maria, additional, Amigoni, Angela, additional, Cesaroni, Elisabetta, additional, Conio, Alessandra, additional, Costa, Paola, additional, Lombardini, Martina, additional, Meleleo, Rosanna, additional, Pugi, Alessandra, additional, Tornaboni, Elena Eve, additional, Santarone, Marta Elena, additional, Vittorini, Roberta, additional, Sartori, Stefano, additional, Marini, Carla, additional, Vigevano, Federico, additional, Mastrangelo, Massimo, additional, Pulitanò, Silvia Maria, additional, Izzo, Francesca, additional, and Fusco, Lucia, additional

Published
2022
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29. KETASER01 protocol: What went right and what went wrong

Author

Rosati, Anna, L'Erario, Manuela, Bianchi, Roberto, Olivotto, Sara, Battaglia, Domenica Immacolata, Darra, Francesca, Biban, Paolo, Biggeri, Annibale, Catelan, Dolore, Danieli, Giacomo, Mondardini, Maria Cristina, Cordelli, Duccio Maria, Amigoni, Angela, Cesaroni, Elisabetta, Conio, Alessandra, Costa, Paola, Lombardini, Martina, Meleleo, Rosanna, Pugi, Alessandra, Tornaboni, Elena Eve, Santarone, Marta Elena, Vittorini, Roberta, Sartori, Stefano, Marini, Carla, Vigevano, Federico, Mastrangelo, Massimo, Pulitanò, Silvia Maria, Izzo, Francesca, Fusco, Lucia, Battaglia, Domenica Immacolata (ORCID:0000-0003-0491-4021), Rosati, Anna, L'Erario, Manuela, Bianchi, Roberto, Olivotto, Sara, Battaglia, Domenica Immacolata, Darra, Francesca, Biban, Paolo, Biggeri, Annibale, Catelan, Dolore, Danieli, Giacomo, Mondardini, Maria Cristina, Cordelli, Duccio Maria, Amigoni, Angela, Cesaroni, Elisabetta, Conio, Alessandra, Costa, Paola, Lombardini, Martina, Meleleo, Rosanna, Pugi, Alessandra, Tornaboni, Elena Eve, Santarone, Marta Elena, Vittorini, Roberta, Sartori, Stefano, Marini, Carla, Vigevano, Federico, Mastrangelo, Massimo, Pulitanò, Silvia Maria, Izzo, Francesca, Fusco, Lucia, and Battaglia, Domenica Immacolata (ORCID:0000-0003-0491-4021)

Abstract

Objective To discuss the results of the KETASER01 trial and the reasons for its failure, particularly in view of future studies. Methods KETASER01 is a multicenter, randomized, controlled, open-label, sequentially designed, non-profit Italian study that aimed to assess the efficacy of ketamine compared with conventional anesthetics in the treatment of refractory convulsive status epilepticus (RCSE) in children. Results During the 5-year recruitment phase, a total of 76 RCSEs treated with third-line therapy were observed in five of the 10 participating Centers; only 10 individuals (five for each study arm; five females, mean age 6.5 +/- 6.3 years) were enrolled in the KETASER01 study. Two of the five patients (40%) in the experimental arm were successfully treated with ketamine and two of the five (40%) children in the control arm, where successfully treated with thiopental. In the remaining six (60%) enrolled patients, RCSE was not controlled by the randomized anesthetic(s). Significance The KETASER01 study was prematurely halted due to low eligibility of patients and no successful recruitment. No conclusions can be drawn regarding the objectives of the study. Here, we discuss the KETASER01 results and critically analyze the reasons for its failure in view of future trials.

Published
2022

30. Criteria for Pediatric Sepsis-A Systematic Review and Meta-Analysis by the Pediatric Sepsis Definition Taskforce

Author

Menon, Kusum, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Akech, Samuel, Argent, Andrew, Biban, Paolo, et al, Menon, Kusum, Schlapbach, Luregn J; https://orcid.org/0000-0003-2281-2598, Akech, Samuel, Argent, Andrew, Biban, Paolo, and et al

Abstract

OBJECTIVE To determine the associations of demographic, clinical, laboratory, organ dysfunction, and illness severity variable values with: 1) sepsis, severe sepsis, or septic shock in children with infection and 2) multiple organ dysfunction or death in children with sepsis, severe sepsis, or septic shock. DATA SOURCES MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from January 1, 2004, and November 16, 2020. STUDY SELECTION Case-control studies, cohort studies, and randomized controlled trials in children greater than or equal to 37-week-old postconception to 18 years with suspected or confirmed infection, which included the terms "sepsis," "septicemia," or "septic shock" in the title or abstract. DATA EXTRACTION Study characteristics, patient demographics, clinical signs or interventions, laboratory values, organ dysfunction measures, and illness severity scores were extracted from eligible articles. Random-effects meta-analysis was performed. DATA SYNTHESIS One hundred and six studies met eligibility criteria of which 81 were included in the meta-analysis. Sixteen studies (9,629 patients) provided data for the sepsis, severe sepsis, or septic shock outcome and 71 studies (154,674 patients) for the mortality outcome. In children with infection, decreased level of consciousness and higher Pediatric Risk of Mortality scores were associated with sepsis/severe sepsis. In children with sepsis/severe sepsis/septic shock, chronic conditions, oncologic diagnosis, use of vasoactive/inotropic agents, mechanical ventilation, serum lactate, platelet count, fibrinogen, procalcitonin, multi-organ dysfunction syndrome, Pediatric Logistic Organ Dysfunction score, Pediatric Index of Mortality-3, and Pediatric Risk of Mortality score each demonstrated significant and consistent associations with mortality. Pooled mortality rates varied among high-, upper middle-, and lower middle-income countries for patients with sepsis, severe sepsis, and s

Published
2022

36. Operationalizing Appropriate Sepsis Definitions in Children Worldwide: Considerations for the Pediatric Sepsis Definition Taskforce

Author

Carrol, Enitan D., Ranjit, Suchitra, Menon, Kusum, Bennett, Tellen D., Sanchez-Pinto, L. Nelson, Zimmerman, Jerry J., Souza, Daniela C., Sorce, Lauren R., Randolph, Adrienne G., Ishimine, Paul, Flauzino de Oliveira, Claudio, Lodha, Rakesh, Harmon, Lori, Watson, R. Scott, Schlapbach, Luregn J., Kissoon, Niranjan, Argent, Andrew C., Schlapbach, Luregn J., Watson, R. Scott, Argent, Andrew, Sorce, Lauren R., Akech, Samuel, Alpern, Elizabeth R., Balamuth, Fran, Bennett, Tellen D., Biban, Paolo, Carcillo, Joe, Carrol, Enitan D, Chiotos, Kathleen, Chisti, Mohammod Jobayer, Evans, Idris, Guoping, Lu, Hall, Mark W., Inwald, David, Ishimine, Paul, Levin, Michael, Kissoon, Niranjan Tex, Lodha, Rakesh, Maitland, Kathryn, Nadel, Simon, Nakagawa, Satoshi, Oliveira, Claudio Flauzino, Peters, Mark, Randolph, Adrienne G., Ranjit, Suchitra, Sanchez-Pinto, L. Nelson, Scott, Halden F., Souza, Daniela C., Tissieres, Pierre, Wardenburg, Juliane Bubeck, Weiss, Scott L., Were, Wilson Milton, Wiens, Matthew O., Wynn, James L., and Zimmerman, Jerry J.

Abstract

Sepsis is a leading cause of global mortality in children, yet definitions for pediatric sepsis are outdated and lack global applicability and validity. In adults, the Sepsis-3 Definition Taskforce queried databases from high-income countries to develop and validate the criteria. The merit of this definition has been widely acknowledged; however, important considerations about less-resourced and more diverse settings pose challenges to its use globally. To improve applicability and relevance globally, the Pediatric Sepsis Definition Taskforce sought to develop a conceptual framework and rationale of the critical aspects and context-specific factors that must be considered for the optimal operationalization of future pediatric sepsis definitions. It is important to address challenges in developing a set of pediatric sepsis criteria which capture manifestations of illnesses with vastly different etiologies and underlying mechanisms. Ideal criteria need to be unambiguous, and capable of adapting to the different contexts in which children with suspected infections are present around the globe. Additionally, criteria need to facilitate early recognition and timely escalation of treatment to prevent progression and limit life-threatening organ dysfunction. To address these challenges, locally adaptable solutions are required, which permit individualized care based on available resources and the pretest probability of sepsis. This should facilitate affordable diagnostics which support risk stratification and prediction of likely treatment responses, and solutions for locally relevant outcome measures. For this purpose, global collaborative databases need to be established, using minimum variable datasets from routinely collected data. In summary, a “Think globally, act locally” approach is required.

Published
2023
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37. Parental presence in Italian pediatric intensive care units: a reappraisal of current visiting policies

Author

Giannini, Alberto, Miccinesi, Guido, Prandi, Edi, Dusio, Maria Pia, Greggio, Marta, Laganà, Ignazia, Falcioni, Ilenia, Grieco, Luana, Gentile, Fabio, Bonanomi, Ezio, Vitali, Giuliana, Mondardini, Maria Cristina, Lazzarini, Rossella, Fucà, Antonietta, Gulino, Geltrude, Barzini, Patrizia, Scalfi, Mariarosa, Altadonna, Fiammetta, Vitali, Silvana, Pennica, Michele, Albina, Chiara, Franceschi, Alessia, Giorgini Pasinato, Valentina, Barberi, Elisa, Nardini, Francesca, Zoia, Elena, Deodato, Roberta, Marchesi, Tiziana, Madeo, Mario, Gagliardone, Maria Pia, Ghezzi, Elisa, Isgrò, Giuseppe, Mangiatordi, Stefania, Storti, Maria, Sorrentino, Marianna, Palladino, Maria Teresa, Longobardo, Flavia, Pettenazzo, Andrea, Zaggia, Cristina, Coffaro, Giancarlo, Contino, Antonella, Pulitanò, Silvia, Piazza, Stefania, Bianchi, Roberto, Franci, Marina, Cecchetti, Corrado, Cancani, Federica, Schloderer, Ulrike Inge Elisabeth, Timpani, Sabrina, Corbari, Maurizio, Di Furia, Michela, Ruggeri, Anna, Papoff, Paola, Grasso, Nadia, Trischitta, Giuseppe, Conio, Alessandra, Spiccia, Massimiliano, Iannandrea, Stefania, Bruna, Paola, Furlan, Stefano, Micali, Adriana, Buchini, Sara, Biban, Paolo, Tosin, Chiara, and ODIN Study Group 2

Published
2017
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38. Neuromuscular Blocker Use in critically Ill Children

Author

Daverio, Marco, primary, Sperotto, Francesca, additional, Stefani, Chiara, additional, Mondardini, Maria Cristina, additional, Tessari, Anna, additional, Biban, Paolo, additional, Izzo, Francesca, additional, Montani, Cinzia, additional, Lapi, Maria, additional, Picconi, Enzo, additional, Racca, Fabrizio, additional, Marinosci, Geremia Zito, additional, Savron, Fabio, additional, Wolfler, Andrea, additional, and Amigoni, Angela, additional

Published
2021
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43. Additional file 2 of Surfactant therapies for pediatric and neonatal ARDS: ESPNIC expert consensus opinion for future research steps

Author

Luca, Daniele De, Cogo, Paola, Kneyber, Martin C., Biban, Paolo, Semple, Malcolm Grace, Perez-Gil, Jesus, Conti, Giorgio, Tissieres, Pierre, and Rimensberger, Peter C.

Subjects
GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries)
Abstract

Additional file 2. METHODS - Methods for literature review protocol and consensus methodology)

Published
2021
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49. Characteristics and risk factors for SARS-CoV-2 among children in Italy: a cross-sectional study in 20 pediatric centers

Author

Lazzerini, Marzia, primary, Sforzi, Idanna, additional, Trapani, Sandra, additional, Biban, Paolo, additional, Silvagni, Davide, additional, Mariani, Ilaria, additional, Villa, Giovanna, additional, Tibaldi, Jessica, additional, Bertacca, Luca, additional, Felici, Enrico, additional, Perricone, Giuseppina, additional, Parrino, Roberta, additional, Gioè, Claudia, additional, Lega, Sara, additional, Conte, Mariasole, additional, Marchetti, Federico, additional, Magista, Annamaria, additional, Berlese, Paola, additional, Martelossi, Stefano, additional, Vaienti, Francesca, additional, Valletta, Enrico, additional, Mauro, Margherita, additional, Dall’Amico, Roberto, additional, Fasoli, Silvia, additional, Gatto, Antonio, additional, Chiaretti, Antonio, additional, Dragovic, Danica, additional, Pascolo, Paola, additional, Pilotto, Chiara, additional, Liguoro, Ilaria, additional, Miorin, Elisabetta, additional, Saretta, Francesca, additional, Trobia, Gianluca, additional, Stefano, Antonella Di, additional, Orlandi, Azzurra, additional, Cardinale, Fabio, additional, Lubrano, Riccardo, additional, Testa, Alessia, additional, Binotti, Marco, additional, Moressa, Valentina, additional, Barbi, Egidio, additional, and Armocida, Benedetta, additional

Published
2021
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