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The American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock: Executive Summary

Davis, Alan L. MD, MPH, FAAP, FCCM1; Carcillo, Joseph A. MD2; Aneja, Rajesh K. MD3; Deymann, Andreas J. MD4; Lin, John C. MD5; Nguyen, Trung C. MD6; Okhuysen-Cawley, Regina S. MD, FAAP7; Relvas, Monica S. MD, FAAP, MSHA, FCCM8; Rozenfeld, Ranna A. MD, FCCM9; Skippen, Peter W. MD, MBBS, FRCPC10; Stojadinovic, Bonnie J. DNP, CPNP11; Williams, Eric A. MD, MS, MMM12; Yeh, Tim S. MD, MCCM13; Balamuth, Fran MD14; Brierley, Joe MD, MA15; de Caen, Allan R. MD16; Cheifetz, Ira M. MD, FCCM17; Choong, Karen MSc, MB, Bch18; Conway, Edward Jr MD, MS, FCCM19; Cornell, Timothy MD20; Doctor, Allan MD21; Dugas, Marc-Andre MD, MSc22; Feldman, Jonathan D. MD23; Fitzgerald, Julie C. MD, PhD24; Flori, Heidi R. MD25; Fortenberry, James D. MD, MCCM26; Graciano, Ana Lia MD, FAAP, FCCM27; Greenwald, Bruce M. MD, FAAP, FCCM28; Hall, Mark W. MD, FCCM29; Han, Yong Yun MD30; Hernan, Lynn J. MD31; Irazuzta, Jose E. MD, FCCM32; Iselin, Elizabeth MD33; van der Jagt, Elise W. MD, MPH, FAAP, SFHM34; Jeffries, Howard E. MD, MBA35; Kache, Saraswati MD36; Katyal, Chhavi MD37; Kissoon, Niranjan MD, MCCM, FCCM38; Kon, Alexander A. MD, FCCM39; Kutko, Martha C. MD, FCCM40; MacLaren, Graeme MD, FCCM41–43; Maul, Timothy PhD44; Mehta, Renuka MD, MBBS, FAAP45; Odetola, Fola MD, MPH46; Parbuoni, Kristine BCPS, PharmD47; Paul, Raina MD48; Peters, Mark J. MD, PhD49; Ranjit, Suchitra MD, FCCM50; Reuter-Rice, Karin E. PhD, CPNP-AC, FCCM51; Schnitzler, Eduardo J. MD52; Scott, Halden F. MD53; Torres, Adalberto Jr MD, MS, FCCM54; Weingarten-Abrams, Jacki MD55; Weiss, Scott L. MD56; Zimmerman, Jerry J. MD, PhD, FCCM57; Zuckerberg, Aaron L. MD58,59

Pediatric Critical Care Medicine: September 2017 - Volume 18 - Issue 9 - p 884-890
doi: 10.1097/PCC.0000000000001259
Special Article
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1No institution affiliation.

2Department of Critical Care Medicine and Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.

3Department of Critical Care Medicine and Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA.

4Department of Pediatric Critical Care, Riley Hospital for Children, Indiana University, Bloomington, IN.

5Department of Pediatrics, Washington University School of Medicine, St. Louis, MO.

6Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX.

7Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX.

8Pediatric Critical Care Medicine, Covenant Women and Children’s Hospital, Texas Tech University, Lubbock, TX.

9Department of Pediatrics, Division of Pediatric Critical Care Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.

10Division of Pediatric Critical Care, University of British Columbia, Vancouver, BC, Canada.

11Department of Pediatrics, Division of Pediatric Critical Care Medicine, Medical College of Wisconsin, Milwaukee, WI.

12Department of Pediatrics, Baylor College of Medicine, Houston, TX.

13Department of Pediatrics, Saint Barnabas Medical Center, Livingston, NJ.

14Division of Emergency Medicine and Center for Pediatric Clinical Effectiveness, Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

15Intensive Care & Bioethics, Great Ormond St Hospital for Sick Children, London, United Kingdom.

16Pediatric Critical Care Medicine, Department of Pediatrics, Stollery Children’s Hospital/University of Alberta, Edmonton, AB, Canada.

17Department of Pediatrics, Division of Pediatric Critical Care Medicine, Duke Children’s, Durham, NC.

18Departments of Pediatrics and Critical Care, Clinical Epidemiology and Biostatistics, McMaster University, Pediatric Intensive Care Unit, McMaster Children’s Hospital, Hamilton, ON, Canada.

19Beth Israel Medical Center, Hartsdale, NY.

20Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI.

21Departments of Pediatrics and Biochemistry, Washington University in Saint Louis School of Medicine, St. Louis, MO.

22Department of Pediatrics, Centre mère-enfant Soleil du CHU de Québec-Université Laval, Québec City, QC, Canada.

23Department of Inpatient Pediatrics, Kaiser Santa Clara Medical Center, Santa Clara, CA.

24Department of Anesthesiology and Critical Care Medicine, University of Pennsylvania Perelman School of Medicine and The Children’s Hospital of Philadelphia, Philadelphia, PA.

25Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Mott C.S. Children’s Hospital, Ann Arbor, MI.

26Division of Critical Care, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA.

27Department of Pediatrics-Critical Care Medicine, University of Maryland School of Medicine, Baltimore, MD.

28Division of Pediatric Critical Care Medicine, Weill Cornell Medical College, New York, NY.

29Department of Pediatrics, Division of Critical Care Medicine, Nationwide Children’s Hospital, Columbus, OH.

30Department of Critical Care Medicine, Children’s Mercy Hospital, Kansas City, MO.

31Department of Pediatrics, Texas Tech University Health Sciences Center, El Paso, TX.

32Division of Pediatric Critical Care, University of Florida, Jacksonville, FL

33Bon Secours St. Mary’s Hospital, Glen Allen, VA.

34Department of Pediatrics/Division of Pediatric Critical Care, University of Rochester School of Medicine and Dentistry, Rochester, NY.

35Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.

36Department of Pediatrics, Division of Critical Care, Stanford University School of Medicine, Palo Alto, CA.

37Pediatric Critical Care Medicine, The Children’s Hospital at Montefiore, The Pediatric Hospital for Albert Einstein College of Medicine, Bronx, NY.

38Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

39Department of Pediatrics, Naval Medical Center San Diego and University of California San Diego School of Medicine, San Diego, CA.

40Department of Pediatrics and Pediatric Critical Care Medicine, The Valley Hospital, Ridgewood, NJ.

41Cardiothoracic ICU, National University Hospital, Singapore.

42Paediatric ICU, The Royal Children’s Hospital, Parkville, VIC, Australia.

43Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.

44Children’s Hospital of Pittsburgh, Pittsburgh, PA.

45Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, GA.

46Department of Pediatrics, Division of Critical Care Medicine, University of Michigan, Ann Arbor, MI.

47Department of Pharmacy Practice, Loma Linda University School of Pharmacy, Loma Linda, CA.

48Division of Emergency Medicine, Ann and Robert Lurie Children’s Hospital of Chicago, Feinberg School of Medicine at Northwestern University, Chicago, IL.

49UCL Great Ormond Street Institute of Child Health and Paediatric Intensive Care Unit, Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom.

50Pediatric Intensive Care and Emergency Services, Apollo Children’s Hospital, Chennai, India.

51Department of Pediatrics, Division of Pediatric Critical Care, Duke University School of Nursing and School of Medicine, Durham, NC.

52Pediatrics School of Medicine, Austral University, Pcia de Buenos Aires, Argentina.

53Departments of Pediatrics and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO.

54Critical Care and Transport, Nemours Children’s Hospital, Orlando, FL.

55Department of Pediatrics, Critical Care Medicine, Albert Einstein College of Medicine, Bronx, NY.

56Department of Anesthesiology and Critical Care, The Children’s Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.

57Department of Pediatrics, Division of Pediatric Critical Care Medicine, University of Washington School of Medicine, Seattle, WA.

58Departments of Pediatrics & Anesthesiology, Sinai Hospital/NAPA, Baltimore, MD.

59Department of Pediatrics, University of Maryland Medical School, Baltimore, MD.

Dr. Davis served as an expert witness regarding a patient who herniated postoperatively. Dr. Aneja received funding from UpToDate royalties. Dr. Relvas participates in AAP PrepICU (editorial board member). Dr. Williams participates in American Academy of Pediatrics (guidelines committee work). Dr. Yeh participates in American Academy of Pediatrics (guidelines committee work). Dr. Brierley received funding from Astellas Pharmaceuticals Speakers Bureau (regarding antifungals in the ICU). He participates as a member in the American Academy of Pediatrics, Academic Pediatric Association, and Society for Academic Emergency Medicine. Dr. de Caen participates in the Royal College of Physicians and Surgeons of Canada and the American Heart Association. Dr. Cheifetz received funding from Philips (medical advisor) and Ikaria (medical advisor). He participates in various volunteer activities for AARC and ATS, and he has served as an expert witness for testimony for medical malpractice cases. Dr. Choong participates as an Executive Member of the Canadian Critical Care Trials Group and is an employee of the Hamilton Health Sciences. Dr. Conway participates as Chair of Section on Pediatric Critical Care Medicine for the AAP. He has served as an expert witness for pediatric Critical Care Medicine/ED defense cases. Dr. Cornwell received grant funding from the Coulter Foundation. He participates in the Society of Pediatric Research. Dr. Doctor received funding from consulting for Novartis, Galera Pharmaceuticals, and Terumo BCT. Dr. Fortenberry participates in AAP, Extracorporeal Life Support Organization. He served as an expert witness for review of PICU cases and testimony in support of physicians providing PICU care. Dr. Greenwald served as an expert witness for testimony regarding course of illness and risk of mortality. Dr. Hall serves as the Editor for the ATS Online Journal Club. Dr. Irazuzta participates in the National Institutes of Health. Dr. van der Jagt received grant funding from University of Rochester (employee/faculty). She participates in NYS Emergency Medical Services for Children Advisory Committee (Vice-Chair), University of Rochester School of Medicine (faculty), AHA Pediatric Advanced Life Support Advanced Life Support Writing Group (member), IPSO National Expert Advisory Committee (member), FAAP, Sr. Fellow Society of Hospital Medicine, and Fellow College of Pediatricians. Dr. Jeffries participates in AAP, Pediatric Cardiac Intensive Care Society, and ACC. Dr. Kache participates on the Global health Educators Committee In Association of Pediatric Program Directors and on the Global Health Education Subcomittee in Consortium of Universities for Global Health. Dr. Kon participates as the President-elect for the American Society for Bioethics and Humanities. He disclosed that he is a government employee. He has served as an expert witness for pediatric critical care and bioethics. Dr. Maclaren received funding from UpToDate (royalties). He participates in the Asia-pacific Chapter of ELSO (Chair) and the Pediatric Cardiac Intensive Care Society (Vice President). Dr. Maul received funding from consulting for Mallinkrodt, Thoratec, and Alung. He received grant funding. He participates in ASAIO (editor) and ELSO (committee member). Dr. Odetola participates as a member of the Sub-Board of Critical Care Medicine, American Board of Pediatrics. Dr. Parbuoni participates in the American Society of Health-System Pharmacists and California Society of Health-System Pharmacists. Dr. Reuter-Rice received funding from J & B Learning (textbook royalties). She received grant funding from RWJK. She participates in PNCB- IPN, AAN, and ISONG. Dr. Schnitzler participates in Sociedad Argentina de Terapia Intensiva, Sociedad Argentina de Calidad en Asistencia Sanitaria, and Instituto Técnico de Acreditación de Establecimientos Sanitarios. Dr. Torres received funding from Abbott Point of Care (speaker). He served as an expert witness for the defense paid for his time. Dr. Weiss received funding from honoraria to grand rounds lectures from Thermo Fisher Scientific (but content of lecture was solely his own responsibility). He participates in AAP and Shock Society. The remaining authors have disclosed that they do not have any potential conflicts of interest.

The American College of Critical Care Medicine (ACCM), which honors individuals for their achievements and contributions to multidisciplinary critical care medicine, is the consultative body of the Society of Critical Care Medicine (SCCM) that possesses recognized expertise in the practice of critical care. The College has developed administrative guidelines and clinical practice parameters for the critical care practitioner. New guidelines and practice parameters are continually developed, and current ones are systematically reviewed and revised.

Copyright © 2017 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies