Pediatrics — Weekly Evidence Brief

Personalized blood pressure management is crucial for favorable outcomes in pediatric cardiac arrest, with a greater burden of mean arterial pressure (MAP) below the optimal MAP (MAPopt) linked to unfavorable outcomes 1. Conversely, a longer duration of MAP above MAPopt is associated with better outcomes 1. In very-low-birth-weight preterm infants, probiotic supplementation has shown significant benefits by reducing antibiotic resistance gene prevalence and multidrug-resistant pathogen loads, while also helping to restore a healthier early-life gut microbiota profile 2. This highlights a potential strategy for antimicrobial stewardship in a vulnerable population 2.

A recent study revealed that physical restraint is frequently used in hospitalized children during painful or stressful procedures, occurring in over 22% of observed cases 3. Factors such as younger age, higher care dependency, and certain procedures like intravenous medication administration were associated with increased restraint use during painful procedures 3. This underscores the need to re-evaluate current practices and prioritize child-centered approaches to pain and procedure management 3.

For pediatric cancer patients, routine symptom screening interventions, including care pathways, significantly reduced total symptom burden over time 4. The study also found that higher physician staffing ratios correlated with lower overall symptom burden, suggesting modifiable factors can improve patient quality of life 4. Furthermore, early discharge for preterm infants, supported by home nasogastric tube feeding, was found not to compromise breastfeeding rates at four weeks post-discharge or at three months postmenstrual age 5. This approach can facilitate shorter hospital stays without negatively impacting crucial nutritional practices 5.

Despite advancements in care, challenges remain in areas such as global childhood cancer survivorship research, which disproportionately represents high-income countries, limiting insights for the majority of survivors worldwide 6. Similarly, there is a recognized lack of consistent definitions and robust research in feed modification strategies for energy and protein provision in pediatric critical care settings, hindering the establishment of expert consensus and standardized guidelines 7. These areas highlight the ongoing need for targeted research and guideline development to ensure equitable and evidence-based care for all children.