Trinity Health Mid-Atlantic was formed in October 2018 by the joining together of Mercy Catholic Medical Center—Mercy Fitzgerald Campus in Darby, Pennsylvania; Mercy Catholic Medical Center Mercy Philadelphia Campus; Nazareth Hospital in Philadelphia, Pennsylvania; Saint Francis Healthcare in Wilmington, Delaware; St. Mary Medical Center in Langhorne, Pennsylvania; and their associated programs and services.
Background and aim:Length-based tapes are extremely useful in critically sick children to estimate weight, emergency drug dosages, size of the equipment, and dose of defibrillation/cardioversion. The Indian Academy of Pediatrics (IAP), Advanced Life Support (ALS), and Basic Life Support (BLS) group felt the need to develop an indigenous tape for Indian children. A color-coded length-based tape [Indian Children Length-based Tape (InChiTape)] was planned to develop and later validate it. Patients and methods:The population included children admitted to the emergency in the age range of 1 month-12 years and weight range of 2.5-40 kg. A color-coded length-based tape was developed using the World Health Organization (WHO) weight-for-length/height charts for boys (≤5 years) and the IAP weight-for-length/height charts for boys (>5 years). The median weights/lengths, corresponding +2SD and -2SD lengths, were marked on the charts for boys starting from 2.5 kg onward. Results:Fourteen centers from all zones of India pooled the data of 1,595 children. The majority of children were in the age range of 1-3.9 years (30%) and weight range of 5-9.9 and 10-14.9 kg (24.9 and 24.4%, respectively). The actual weight of children corresponded to the correct weight range/band on the InChiTape in 69.1% (n = 1,102) children, ranging from 56.6 to 78.4% in different age-groups and 55.5 to 76.3% in different weight ranges. There was a good correlation between actual weight and the average of respective weight range/band on the InChiTape (Pearson correlation of 0.95, p < 0.001). Conclusion:The InChiTape is a rapid, reliable, and accurate method of estimating the weight of Indian children weighing 2.5-40 kg in an emergency. How to cite this article:Angurana SK, Gupta S, Tiwari L, Shamarao S, Khera D, Sarkar M, et al. Development and Validation of Indian Children Length-based Tape (InChiTape) for Use in Critically Sick Children. Indian J Crit Care Med 2026;30(1):35-39.
Identifying the microbial etiology of empyema is crucial to implement contextually appropriate clinical management and prevention strategies. However, there is no systematic review examining this question. This systematic review addressed this knowledge gap by synthesizing evidence on the pathogens identified in children with empyema. PubMed, EMBASE, Cochrane Library, Scopus, Web of Science, major trial registries, and grey literature sources were searched for observational studies in children with empyema. The prevalence of organisms identified in pleural pus, blood, or bronchoalveolar lavage fluid by culture or molecular methods was determined, along with the antimicrobial susceptibility pattern. Risk of bias in the included studies was assessed using the NIH quality assessment tool for observational studies. Meta-analysis was performed using random-effects model, and the certainty of evidence was evaluated using GRADE. Out of 8022 citations retrieved, 36 studies were included. In pleural fluid specimens, S. aureus dominated (38.99
BACKGROUND:Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) improves survival in patients with cardiogenic shock (CS), but data on chronic kidney disease (CKD) as a predictor of mortality in these patients is limited. AIM:To assess the association between CKD and in-hospital mortality in CS patients undergoing VA-ECMO through a systematic review and meta-analysis. METHODS:We reviewed studies up to February 2024 that evaluated CKD's impact on in-hospital mortality in CS patients treated with extracorporeal membrane oxygenation. Databases included PubMed, Google Scholar, EMBASE, and Scopus. A random-effects model was used to calculate the pooled unadjusted odds ratio, I 2 statistics to determine heterogeneity, and leave-one-out sensitivity analysis to assess robustness, with P < 0.05 considered statistically significant. RESULTS:Thirteen studies, involving 12185 CS patients treated with VA-ECMO (mean age 63, 68% males), were included. CKD was significantly associated with an increased in-hospital mortality (odds ratio = 1.89, 95% confidence interval: 1.4-2.55, P < 0.01). Leave-one-out analysis confirms robustness of the association between CKD and increased in-hospital mortality post-extracorporeal membrane oxygenation (I 2 = 75%). Despite substantial heterogeneity, the association remains significant, indicating that CKD is a critical risk factor in these patients. CONCLUSION:CKD is strongly associated with an increased in-hospital mortality in CS patients treated with VA-ECMO. Despite study heterogeneity, this association remains robust, highlighting CKD as a critical prognostic factor.
BACKGROUND:Alcohol and tobacco use are known carcinogens. Treating alcohol and tobacco co-use can improve treatment and survivorship outcomes among patients diagnosed with cancer. METHODS:We conducted a post hoc analysis of ECOG-ACRIN EAQ171CD trial participants within the NCI Community Oncology Research Program (NCORP), examining changes in alcohol use among adults receiving the virtual sustained treatment (VST) for tobacco use intervention versus enhanced usual care (EUC; Quitline referral). Multivariable logistic regression assessed changes in alcohol use disorder risk at 3 and 6 months using the AUDIT-C. RESULTS:At baseline, participants (N = 305) were classified as no risk (31%), low/minimal risk (38%), moderate risk (23%), or high risk (8%) for alcohol use disorder. The mean age was 55.6 years, participants smoked for an average of 33 years, and 18% had alcohol-associated tumors. Participants randomized to EUC were more likely to shift to a lower alcohol risk category than those in the VST arm at 3 months (39% vs 27%) and 6 months (33% vs 27%). There was no significant difference in the odds of shifting to a lower risk category for VST vs EUC at 3 months (adjusted OR = 0.56, 95% CI 0.26-1.18, p = 0.125) or at 6 months (adjusted OR = 0.57, 95% CI 0.25-1.28, p = 0.172). CONCLUSIONS:Patients diagnosed with cancer and engaging in alcohol and tobacco co-use can achieve reductions in alcohol use and risk. IMPACT:Integrating tailored, co-use-focused strategies into cessation programs may improve changes in modifiable risk behaviors.
Abstract Rationale Long-term anticoagulation is a cornerstone of therapy for chronic thromboembolic pulmonary hypertension (CTEPH). Although direct oral anticoagulants (DOACs) are increasingly used, comparative real-world data on their safety and effectiveness versus warfarin in this population remain limited. Methods We conducted a retrospective, multicenter cohort analysis using the TriNetX U.S. Collaborative Network, comprising electronic health records from 111 healthcare organizations. Adults with CTEPH receiving either warfarin or a DOAC (apixaban or rivaroxaban) were identified. Patients receiving both or switching between anticoagulants were excluded. Propensity score matching (1:1) was performed across demographics, comorbidities, laboratory parameters, and medication profiles, yielding 8,081 matched pairs. Outcomes were assessed beginning 30 days after the index event. Primary endpoints included all-cause mortality and major adverse cardiovascular events (MACE). Secondary endpoints included gastrointestinal (GI) bleeding and hospitalization. Risk differences, odds ratios (OR), and hazard ratios (HR) were derived using TriNetX analytic tools. Results After matching, baseline covariates were balanced (mean age 72.6 ± 15.6 years, 54% female, 70% White). Compared with DOACs, warfarin therapy was associated with higher all-cause mortality (36.8% vs 30.9%; OR 1.30, 95% CI 1.22-1.39; HR 1.29, 95% CI 1.22-1.36; p < 0.001) and greater MACE risk (46.5% vs 43.2%; OR 1.14, 95% CI 1.07-1.21; HR 1.15, 95% CI 1.09-1.20; p < 0.001). Warfarin users also had a higher incidence of GI bleeding (13.6% vs 12.4%; OR 1.11, 95% CI 1.01-1.21; p = 0.03; HR 1.18, 95% CI 1.08-1.29; p < 0.001). Hospitalization rates were similar between groups (2.8% vs 2.4%; p = 0.15). Conclusions In this large real-world cohort of CTEPH patients, DOAC therapy was associated with significantly lower mortality, MACE, and GI bleeding risk compared with warfarin, with comparable hospitalization rates. These findings support the preferential use of DOACs over warfarin for long-term anticoagulation in stable CTEPH, though prospective validation is warranted. This abstract is funded by: None
