Samuel Rosenblatt, MD
Childrens Hospital of Philadelphia
Philadelphia, Pennsylvania
Disclosure information not submitted.
Robert Kavanagh, MD
Assistant Professor of Pediatrics
Pennsylvania State Milton S Hershey Medical Center, United States
Disclosure information not submitted.
Maureen Banigan, MD, MS
Resident - Physician Anesthesiology
Childrens Hospital of Philadelphia, United States
Disclosure information not submitted.
Garrett Keim, MD
Attending physician
Children's Hospital of Philadelphia
Philadelphia, Pennsylvania, United States
Disclosure information not submitted.
Donald Boyer, MD, MSEd
Associate Professor of Clinical Anesthesiology and Critical Care
The Children's Hospital of Philadelphia, United States
Disclosure information not submitted.
Title: Most Impactful References in Pediatric Critical Care Medicine: An International Consensus
Introduction: Over 2,000 critical care medicine-focused articles are published each year. To guide society members to the most important literature, the pediatric cardiac intensive care society published and repeatedly updated the most important references in their field; no such collection of references exists for pediatric critical care medicine (PCCM). As the body of PCCM research grows, collating the most impactful references for community members is helpful for busy clinicians and trainees. Our goal was to identify the top 50 most impactful original science (OS) articles and top 20 guidelines (GL) in the field of PCCM as adjudicated by PCCM organizational leaders around the world.
Methods: Surveys soliciting the most impactful GL and OS articles were sent out worldwide to e-mail listservs of multiple PCCM organizations, shared at national meetings, and distributed via social media in 3 languages. Article nominations were reviewed by the authors to ensure they met inclusion criteria. Review articles were excluded. An international committee of PCCM society leaders voted on the impact of each OS article and GL nominated by the worldwide PCCM community using a 5-point Likert scale. Only most recent updates of GL were used for voting.
Results: There were 176 survey responses (149 English, 29 Spanish, 0 French). Response rate was indeterminable due to overlap in listserv membership and open social media participation. 468 articles (160 GL – 48 unique, 279 OS – 160 unique) were nominated and 29 were excluded. The top 5 most impactful GL: Pediatric sepsis, Pediatric TBI, PALS, BLS, and Pediatric ARDS. The top 3 OS articles: 2000 NEJM ARDSnet lower tidal volume study, 2007 NEJM transfusion strategies in PICUs study, and 2017 NEJM tight glycemic control in critically ill children study. Of the top 50 OS articles, 42% articles were published prior to 2010 with one published in 1963, and NEJM (26), CCM (6), JAMA (5), and PCCM (2) were the most frequently nominated journals.
Conclusions: The top 50 most impactful OS and top 20 most impactful GL were identified through an open nomination process by the international PCCM community and selection by leaders within the field. Identification of these impactful references allows practitioners to build foundational knowledge and further their evidence-based practice of PCCM.