A month on from Singapore and we’re already busy planning for #WFPICCS20 in Mexico City, however, the memory of Singapore is still strong and the buzz from the highly motivated #PedsICU community will stay with me for a while yet. We’ve included some wonderful photos celebrating our community and hope it will bring back some happy and fun memories for you.
WFPICCS is working hard to increase our educational impact beyond the Congress, and we are in the process of setting up a dedicated committee to help move forward our educational agenda. We’ve also started a partnership with the Centre for International Child Health, BC Children’s Hospital, in support of the WHO’s resolution to improve the prevention, diagnosis and clinical management of sepsis. The partnership - the Pediatric Sepsis Data CoLaboratory (Sepsis CoLab) - was formally launched during the #WFPICCS18 in Singapore and kick-started with a special session to establish collaborative efforts in the fight against sepsis. You can learn more about the partnership from the press release http://www.wfpiccs.org/wp-content/uploads/2018/07/sepsis-colab-news-release-13-June-2018.pdf
We hope our quarterly newsletter is a resource that you enjoy seeing in your inbox. It is meant to keep you informed about WFPICCS’ activities and provide insight of what the #PedsICU community is doing globally.
If you have any suggestions how we can make the newsletter even more relevant, please drop us a line.
Looking forward to being in touch.
Announcing WFPICCS' new Board of Directors.....
WFPICCS held its Board and Member meetings in Singapore just prior to #WFPICCS18 and we're delighted to announce our new Board of Directors, whose expertise and motivation will drive forward WFPICCS' mission and vision. Find out who our Board of Officers and Board of Directors are.
A trip down memory lane.....
remembering the incredible get together of the #PedsICU community.
Over 1420 participantsfrom84 countriesgathered in Singapore for days of networking and educational highlights. If you participated, in person or via social media, thanks for making it a huge success.
We're proud to say that in support of our mission, WFPICCS contributed over $50,000, allowing for a considerable registration fee reduction for physicians, nurses, allied health professionals and trainees from low resource settings, to assist them attend #WFPICCS18 in Singapore.
A huge thanks also to the local organising committees (Chairs: Lee Jan Hau & Jackie Ong) and WFPICCS' International Scientific Committee (Chairs: Satoshi Nakagawa & Lyvonne Tume) who did an incredible job.
We are grateful that our sponsors see value in supporting an international PICC congress like ours, without their generous support, #WFPICCS18 would have not been possible - so thank you!
More photos will be available on thecongress websitesoon but here are some sneak previews.
Planning for #WFPICCS20 in Mexico City is underway and we will regularly share updates with you. We're lucky to be working with a group of passionate members of the #PedsICU community in Latin America, representing the whole continent.
Over the coming months we will also introduce our member in Latin America, SLACIP and its members, giving you an insight of what is happening - the success stories and challenges.
So vamos! Come and join us, as we hit the road to Mexico!
Sharing Data to Improve Care
Worldwide, at least 30 million people are afflicted and 7 million die every year due to sepsis (severe infections), the majority in low- and middle-income countries. Neonates, infants and children are disproportionate contributors to this burden of sepsis. Most of these deaths are treatable and preventable. However, there is limited data and research from low and middle-income countries, which is critical to achieve advances in the quality of care and outcomes. These countries that have the highest incidence of infections have some of the worse outcomes. The improvements in sepsis care that have been made in high income countries also need to occur in low and middle income-countries.
During this year’s 4th Annual African Federation of Critical Care Nurses Scientific Conference (Oct 3-5, Diani, Kenya), a team of sepsis experts from around the world will introduce the Pediatric Sepsis Data CoLaboratory (Sepsis CoLab), a new international data sharing network created to address pediatric sepsis mortality and morbidity.
The network, developed in collaboration the African Sepsis Alliance, the World Federation of Pediatric Intensive & Critical Care Societies, and the Center for International Child Health at BC Children’s Hospital, aims is to develop and validate tools for data collection and data sharing, enabling continuous quality improvement of care.
One of the keynote speakers will be Dr. Niranjan Kissoon, Vice President of Medical Affairs at BC Children’s Hospital, Past President of WFPICCS, and Vice Chair of the Global Sepsis Alliance. Dr. Kissoon will share some of his experiences and expertise in sepsis, and how we can collectively move forward in tackling this growing global health concern.
Thanks to the kind support of Hard Manufacturing Inc, we are able to announce the 2018 -2020 Hard Manufacturing - WFPICCS Pediatric Critical Care Research Grant.
Interested in applying for the HARD Manufacturing-WFPICCS Pediatric Critical Care Research Grant?
Area of Research for Consideration
All areas of research that target the improvement of care of critically ill children, with a particular focus on improvements in the physical environment for patient care.
Some suggested pediatric topics include prevention/treatment of pressure sores, affects of sound/light in the critical care unit, interaction of emerging technologies with sleeping systems and the value of human touch/voice as part of the healing process.
How to Apply
Blank application forms are availablehere. Submit the completed application forms to WFPICCS Office by 1 October, 2018. Grant value US$10,000.
Sapna Kudchadkar, MD, PhD, Associate Editor of Pediatric Critical Care Medicine.
If you’re still not convinced about the power of social media to interact with the pediatric critical care medicine, there is no better example than the recent 2018 WFPICCS Meeting in Singapore. The hashtag for the meeting was #WFPICCS18, and attendees were also encouraged to include #PedsICU in all tweets from the conference. Engagement exceeded all expectations, and included not only those attending the conference but also many “distance attendees” following the conference from their home turf. After all, someone had to stay home and staff the ICUs! By the end of the conference, the numbers said it all. #WFPICCS18 tweets yielded 4.7 million impressions (views) from 5,457 tweets and 551 participants! #WFPICCS18 generated incredible excitement about social media use in PCCM and as a result #PedsICU engagement has skyrocketed over the last 2 months with over 200 new social media accounts tweeting about pediatric critical care.
Why should authors consider opening a Twitter account? First, having a Twitter handle provides a direct conduit between readers and authors. Although the corresponding author’s email addresses are published with each manuscript, in this era of collaborative team science social media provides an opportunity to acknowledge all authors for their contributions. When PCCM tweets a journal article which includes your Twitter handle, it gives readers an opportunity to network with you and potentially opens new avenues for collaboration. I can personally attest that many a new research collaboration have been forged on social media! Additionally, when there is debate or discussion about your work, you have the opportunity (if you choose!) answer questions or engage in the discussion. Your study may even become the focus of an online #PedsICU journal club!
2018 has been an extraordinary year for #PedsICU! For those of you who are new to social media terminology, #PedsICU is our pediatric critical care medicine community’s social media “keyword”. Content on the social media platform Twitter which includes #PedsICU is cohorted such that members of the pediatric critical care community can stay up to date on recent pediatric critical care news, studies and debates. As the social media editor of Pediatric Critical Care Medicine it has been wonderful to watch the international engagement of our pediatric critical care medicine grow exponentially.
As many of you know, in 2017 the PCCM journal implemented the entry of author-generated tweets for all submitted manuscripts. The reason? There is no question that no one knows the central message of their work better than our authors, therefore we felt it was critical that these messages were shared with readers with publication of these important studies. In 2018, we have initiated the option of entering authors’ Twitter handles with each submission so that we may “tag” these investigators on social media if they have a Twitter account.
OPENPediatrics is a non-profit, open access community of clinicians, nurses and healthcare professionals sharing best practices from all resource settings all over the globe. Our mission is to leverage technology to promote worldwide sharing and exchange of knowledge about the care of sick children.
The platform allows healthcare providers access to academically rigorous, peer-reviewed educational resources ranging from didactic lectures and protocols developed by medical experts to being able to practice on one-of-a-kind device simulators.
Our speakers and video instructors are pediatric experts representing some of the best hospitals, university, and organizations around the globe who share in OPENPediatrics mission and values.
OPENPediatrics Quick Concept videos are short videos that describe a key physiological or theoretical concept, or demonstrate a brief procedure. Most Quick Concept videos run between one and four minutes in length. The video description and related content tabs allow the viewer to continue the learning journey beyond the first video. This collection is among our more popular featured collections, with topics for all in the healthcare profession. (Link: https://www.openpediatrics.org/collection/quick-concepts )
Targeting Low Resource Settings
OPENPediatrics strives to make sure the knowledge of how to best care for a sick child is not bound by borders or resources. We have worked to produce and publish content that is ideal for low resource settings.
9th Congress of The World Federation of Pediatric Intensive & Critical Care Societies (WFPICCS)
OPENPediatrics was honored to be a part of the 9th Congress of the World Federation of Pediatric Intensive and Critical Care Societies this past June 2018 in Singapore.
The Program’s Co-Director’s are Dr. Jeffrey Burns, MD, MPH, Chief and Shapiro Chair of Critical Care Medicine at Boston Children’s Hospital, and Dr. Traci Wolbrink, MD, MPH, Associate in Critical Care Medicine, Boston Children’s Hospital. Both Drs. Burns and Wolbrink attended the WFPICCS conference this year, and reflected on their experiences. Please see below for their individual comments.
“WFPICCS is truly the most unique global conference for those who care for critically ill children. No other conference is able to unite everyone from across the world in one place, at one time, and harness everyone’s ideas and experiences on things that truly matter. Where else in the span of 20 minutes in the exhibit hall can you meet colleagues from Iran, Ghana, and Maldives—but that is precisely what happened to me at the recent conference. WFPICCS plays an indispensable role in fostering the global collaboration necessary to move the field of pediatric critical care forward.” - Dr. Jeffrey Burns, OPENPediatrics Program Co-Director and member of the WFPICCS Board of Directors
“The World Congress was a great opportunity to connect with colleagues from around the world. We were able to take the opportunity of being in person together to network and collaborate on projects. I was grateful to be able to listen some incredible talks by world class well-known inspirational speakers that challenged us to think of ways to move the field forward.” - Dr. Traci Wolbrink, OPENPediatrics Program Co-Director.
The OPENPediatrics Program is very much looking forward to participating in the next WFPICCS Congress in June 2020 in Mexico City.
PICU NEWS FROM ASIA
The 16th Asia Pacific Congress of Pediatrics (APCP) 2018 will take place in Nusa Dua - Bali, Indonesia from 25 to 29 August, 2018.
The pre-congress workshop taking place on on 25 & 26 August include topics which will be of interest to the #PedsICU community, such as comprehensive fluid therapy and acid base management in critically ill children: acute kidney injury: neonatal stabilization; GI bleeding in children and pediatric ultrasound / PERCUS.
The main congress program includes speakers well known within our community such as Satoshi Nakagawa, Tang Swee Fong, Lee, Jan Hau, Arun Bansal and many other inspirational regional and local speakers.
Online registrations will close on 12 August, 2018 so if you want to register online or simply find out more about the congress head over to http://apcp-pitika2018.org/
PICU NEWS FROM EUROPE
Clinical Trials in Paediatric Intensive Care Units
Hazel Ann Smith BSc(Hons) MSc, Research Coordinator for the Paediatric Intensive Care Unit,
Children in Paediatric Intensive Care Units (PICUs) are a unique population within paediatrics. They are critically unwell and require specialised health and technical care, which can include invasive monitoring. Their ages can range from preterm neonates up to adults who have not yet transferred to adult services. Reasons for admission can range from post-operative care or reversible conditions to complex chronic and life limiting conditions. PICUs also facilitate organ donation.
All patients deserve the opportunity to participate in research and to have clinical trials investigate and develop better treatments, with fewer side effects, to improve their quality of life. The European Union Clinical Trials Register reports that there are 94 on-going PICU clinical trials and ClinicalTrials.gov have 383 PICU clinical trials registered as recruiting. According to PICUtrials most of these clinical trials are single site studies. This is in comparison to adult intensive care units (ICUs), who have about four times the number of active clinical trials taking place across different sites.
Is the difference due to:
Doctors and nurses being cautious about investigating new or modified treatments for critically unwell children? A lot of practices in PICUs differ not just between different PICUs but between different consultants in the same PICUs. A lot of our practice is not supported by research conducted at a high level. Are staff more cautious because they have had little research experience themselves in their training and previous roles? Should research active sites invite their peers from PICUs with limited research opportunities to ‘shadow’ their research staff to experience running a clinical trial first hand?
Ethical and legal principles of doing a paediatric clinical trial? Consent and assent is something that comes up a lot when discussing paediatric research and the use of deferred consent and assent which is sometimes required for PICU research. Should there be (1) an on-line training course, approved by PICU organisations, on taking consent and assent for clinical trials and this should include an agreed statement on how to implement, where approved, deferred consent and assent?(2) an agreed International Conference on Harmonisation-Good Clinical Practice course for PICUs?
Funding opportunities?Do foundations and funding bodies favour supporting academic clinical trials in adult ICUs over paediatric ICUs? In Ireland, for example, the biggest funder of paediatric research doesn’t have Intensive Care as one of its ‘focus’ areas for their grant calls.
The reasons highlighted above are not an exhaustive list and each PICU will have their own barriers to undertaking clinical trials. I hope this blog (whether you agree or disagree with what I have written) will generate discussion. For those that are interested in further reading on the research landscape for PICUs I would recommend: Peters et al (2017) The intensive care medicine clinical research agenda in paediatrics Intensive Care Med43:1210-1224.
PICU NEWS FROM LATIN AMERICA
IX Symposium of Spanish and Portuguese speaking Pediatric Intensivists. Mauricio Yunge MD PICU. Clinica Las Condes Santiago, Chile On Sunday, June 10th, the IX Symposium of Spanish and Portuguese speaking pediatric intensivists took place within the framework of the World Pediatric Intensive Care Congress. Pedro Celeny García Ramos, MD, has traditionally organized this event, ever since its first edition in 1992. In this opportunity was joined by Mauricio Yunge Bertini, MD, and Werther B. Carvalho, MD (both of them representatives of the Latinamerican Society of Pediatric Intensive Care [SLACIP: Sociedad Latinoamericana de Cuidados Intensivos Pediátricos] at the World Federation of Pediatric Intensive and Critical Care Societies), Carlos Acuña, MD, and María Del Pilar Arias López, MD.
The main topic for this meeting was education in intensive care. It began with an introduction of the problem, offered with great clarity by Bettina von Dessauer (MD, Chile). Then, Angel Carlos Román (MD, Mexico), Jesús López Herce (MD, Spain), Luis Moya Barquín (MD, Guatemala), Cintia Johnston (SB, Brazil), Pedro Celeny García Ramos (MD, Brazil), and Analía Fernández (MD, Argentina) did presentations on the different realities that exist in the region, generating a space to share common problems and challenges and also opportunities to create collaborative instances.
After this first section, a selection of scientific work developed in Latinamerica and Spain, which were accepted for the World Congress, were presented in either Spanish or Portuguese. A total of 25 studies were put forward, and the final program included work from Argentina, Bolivia, Brazil, Chile, Ecuador, Spain, Guatemala, Mexico, Paraguay and Uruguay, some of which had collaboration from latinamerican residents abroad, from the section of the Diaspora. This in particular has allowed the development and presentation of multicentric, local and regional research projects, which without a doubt will continue to promote the establishment of connections between countries and the development of collaborative projects.
The SLACIP Symposium is not only an important and interesting event in terms of high quality scientific content; it is also a space for comradeship. This version, like others before it, included typical snacks from the region, allowing strengthening bonds of regional friendship.
In spanish: IX Simposio de Intensivistas pediátricos de habla española y portuguesa.
El día domingo 10 de junio se llevó a cabo el IX Simposio de Intensivistas de habla española y portuguesa en el contexto del Congreso Mundial de Cuidados Intensivos Pediátricos. Este tradicional evento es organizado desde su primera edición en 1992 por el Dr. Pedro Celeny García Ramos y en este oportunidad ha sido acompañado por los Dres. Mauricio Yunge Bertini y Werther B Carvalho (representantes de la Sociedad Latinoamericana de Cuidados Intensivos Pediátricos ( SLACIP ) ante la Federación Mundial de Cuidados Intensivos Pediátricos ) , el Dr Carlos Acuña y la Dra Maria del Pilar Arias López.
El tema principal de la reunión ha sido Educación en cuidados intensivos. Luego de una introducción al problema presentado con gran claridad por la Dra Bettina von Dessauer (Chile), los Dres. Ángel Carlos Román ( México) , Jesús López Herce (España), Luis Moya Barquín (Guatemala), Lic. Cintia Johnston y Dr Pedro Celeny García Ramos (Brasil) y la Dra Analía Fernández ( Argentina) han presentado en un formato de contenidos común las distintas realidades existentes en la región, generando un espacio donde compartir los problemas y desafíos comunes y a partir del cual generar posibilidades de colaboración.
En una segunda etapa, se ha presentado una selección de los trabajos científicos desarrollados en Latinoamérica y España y aceptados para el Congreso Mundial. En este espacio los investigadores han tenido la oportunidad de exponer sus trabajos en idioma español o portugués. Un total de 25 trabajos científicos han sido postulados para su presentación. El programa final ha incluido experiencias llevadas a cabo en Argentina, Bolivia, Brasil, Chile, Ecuador, España, Guatemala, México, Paraguay y Uruguay en colaboración algunos de ellos con latinoamericanos residente en el exterior , capítulo de la Diaspora. Sin duda, este ámbito que ha facilitado la presentación de investigaciones multicéntricas locales y regionales fomentara el vínculo entre los distintos países y el desarrollo de proyectos de colaboración.
El Simposio SLACIP, no es solamente un evento con interesante contenido científico de calidad, sino un espacio de camaradería . Es por eso que no ha faltado en esta oportunidad, dulces regionales para amenizar el encuentro, permitiendo afianzar lazos de amistad regional.
Seeding the future of our children through global cooperation
“If you want to go fast, go alone. If you want to go far, go together.” —African Proverb.
Today, just over a few weeks after a memorable experience during the WFPICCS 11th Congress (WFPICCS18) in Singapore, it is good to size this great achievement and to realize how much progress has been made.
In 2007, Geneva welcomed the 5th WFPICCS Congress. The vision of the organizing committee in that multicultural environment was to facilitate a "dialogue around the world", bringing together a community of high quality experts who shared and exchanged personal experiences of pediatric critical care providing then a global perspective. Ten years later, in Singapore, the paradigm shift in the PICU community has been consolidated by inclusion and cooperation as fundamentals in the advancement of knowledge.
Cooperation is an integral part of human experience and lives at the heart of all societies. A recent Nature collection describes how cooperation is the key to solving many challenges of the modern world (1). In turn, the importance of including all voices is necessary to establish valid links to make significant changes. During WFPICCS18 there were many instances that made us feel that cooperation and inclusion is flourishing in the world of pediatric intensive care medicine.
Representatives from LARed Network emphasized the commitment and kindness of the WFPICCS and the local organizing committee to invite our Latin American organization to share our recent progress in the knowledge of the status of Bronchiolitis and Asthma, the highest burden of PICU admissions in the Latin American region (2, 3). Dr. Franco Díaz above presented the preliminary results of a continental survey: REAL CIP (Reality of Pediatric Intensive Care in Latin America) (4), our initial approach to understand the strengths and pitfalls of pediatric critical care practice in Latin America.
Generating “real world” evidence helps to further adapt EBM recommendations and identify the local and regional magnitude of “common enemies” such as Sepsis and residual morbidity at discharge from PICU. When facing these topics and the variability of treatments among PICU´s, collaborative networking showed to be an important tool to learn and improve the wellbeing of the children and their families in the region.
Immersed in sessions and symposiums with other international working groups (image on the left) the experiences exchanged are seeds for future collaboration. LARed network was invited to participate in the "PICU Registries and Research Consortiums Across the World: Current Status and Opportunities for Collaboration" (image below) joining efforts at global level (ANZICS PSG, CCCTG, ESPNIC, PACCMAN and PALISI networks).
LARed expresses its gratitude to WFPICCS18 organizers and the colleagues in Singapore for its commitment to take transnational cooperation to another level, generating evidence through the philosophy of measuring, learning and sharing, as well as fostering collaboration among Networks. WFPICCS20 in Mexico will harvest what was seeded in Asia during 2018.
Gonzalez-Dambrauskas S, Diaz F, Monteverde-Fernandez N, Carvajal C, Serra JA, Wegner A, Cruces P, Cespedes M, Nuñez-Sanchez M, Guachichulca R, Ferre A, Varela F, Fernandez, A, Courtie C, Menta S, Martinez L, España M. Wide variability of intensive care management for infants with bronchiolitis in a Latin.american collaborative network (LARed). Pediatr Crit Care Med: 2018 Jun; 19 (6S): 230. doi: 10.1097/01.pcc.0000538043.04312.6f
Monteverde-Fernandez N González-Dambrauskas S, Diaz F, Carvajal C, Serra JA, Wegner A, Cordoba T, Bravo A, Aranguiz D, Carbonell M, Alonso B, Pedrozo L, Castro L, Matrai L, Benech E, Carro M, Cruces P, Pastorini J, Ruibal M. Wide variability of intensive care treatment for status asthmaticus among 20 latinamerican PICUs. A report from the latinamerican collaborative network (LARed). Pediatr Crit Care Med: 2018 Jun; 19 (6S): 236–237. doi: 10.1097/01.pcc.0000538065.28847.a4.
Diaz F, Carvajal C, González-Dambrauskas S, Serra A, Monteverde-Fernández N, Nuñez M.J, Cruces P. Organizational characteristics and resources in latin-american pediatric intensive care units. Preliminary report of REAL-CIP (realidad en América Latina de cuidados intensivos pediátricos) study. Pediatr Crit Care Med: 2018 Jun ;19 (6S): 19. doi: 10.1097/01.pcc.0000537386.99956.bf
SATI-Q Program Maria del Pilar Arias Lopez M.D. Quality Manager - Pediatric SATI-Q Management, Quality and Scores Committee Argentine Society of Intensive Care (SATI) & SLACIP President
The SATI-Q Program was founded as a strategic decision of the Argentine Society of Intensive Care (SATI) to optimize the care of critically ill adult and pediatric patients through benchmarking and collaborative research. It is a multi-center network of Intensive Care Units (ICUs), which prospectively record the characteristics of the population admitted, outcomes, procedures and quality indicators predefined in a common data model (CDM).
ICUs can participate by submitting their records in the CDM format or receive the free SATI-Q software, which facilitates standardized registration and allows them easy access to their own data, independent of the central SATI coordinating center. Each ICU also receives an annual report, in which its own data are compared with the general reports of the participating ICUs. SATI-Q is a consolidated program with more than 15 years of experience. Among the pediatric research projects published, we can mention the multicenter studies of validation of the Pediatric Index of Mortality (PIM2) risk score in Argentina and later in Latin America. Currently, we are focused on fostering global collaborative research networks with interoperability in mind.