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Objectives:The objective of this study was to investigate the relationship between C-reactive protein (CRP) and procalcitonin and the diagnosis of delirium in critically ill children. Design: Retrospective cohort studySetting: Tertiary care urban academic Pediatric Intensive Care Unit (PICU) Patients: All PICU patients (ages 0-21 years) admitted between January 1, 2015 and December 31, 2017, who had a CRP and/or procalcitonin level drawn within the first 14 days of their PICU stay. Intervention: NoneMeasurements and Main Results: Each patient was screened for delirium and/or coma twice daily using the Cornell Assessment of Pediatric Delirium. Patient information including demographics, delirium status, and lab values were extracted from the electronic medical record. 734 patients were enrolled, with CRP and procalcitonin levels drawn in 664 and 587 patients respectively. 37% (n=274) of patients were delirious on at least one study day. In bivariate analysis, CRP was not related to either delirium or coma. Procalcitonin was highest on days with coma and lowest on days with delirium. There was no statistically significant relationship between inflammatory markers and any subtype of delirium.Conclusions: Despite evidence of inflammatory markers being predictive of delirium in adults, in this retrospective pediatric cohort, no association was found between CRP or procalcitonin levels and development of delirium.

Background: Decisions about who should perform tracheal intubation in academic settings must balance the needs of trainees to develop competency in pediatric intubation with patient safety. Airway protocols during the COVID-19 pandemic may have reduced opportunities for trainees, representing an opportunity to examine the impact of shifting laryngoscopy responsibilities away from trainees. Methods: This observational study combined data from 11 pediatric emergency departments in North America participating in either the National Emergency Airway Registry for Children (NEAR4KIDS) or a national pediatric emergency medicine airway education collaborative. Sites provided information on airway protocols, patient and procedural characteristics, and clinical outcomes. For the pre-pandemic (January 2017 to March 2020) and pandemic (March 2020 to March 2021) periods, we compared tracheal intubation opportunities by laryngoscopist level of training and specialty. We also compared first-attempt success and adverse airway outcomes between the two periods.

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