ObjectiveMore children are surviving critical illness but are at risk of residual or new health conditions. An evidence-informed and stakeholder-recommended core outcome set is lacking for pediatric critical care outcomes. Our objective was to create a multinational, multi-stakeholder-recommended Pediatric Critical Care Core Outcome Set for inclusion in clinical and research programs. Design A 2-round modified Delphi electronic survey was conducted with 333 invited research, clinical, and family/advocate stakeholders. Stakeholders completing the first round were invited to participate in the second. Outcomes scoring > 69% "critical" and < 15% "not important" advanced to round 2 with write-in outcomes considered. The Steering Committee held a virtual consensus conference to determine the final components. Setting Multinational survey. Patients Stakeholder participants from 6 continents representing clinicians, researchers, and family/advocates. Main Results Overall response rates were 75% and 82% for each round. Participants voted on 7 Global Domains and 45 Specific Outcomes in Round 1, and 6 Global Domains and 30 Specific Outcomes in Round 2. Using Overall (3 stakeholder groups combined) results, consensus was defined as outcomes scoring > 90% "critical" and < 15% "not important" and were included in the final PICU COS: 4 Global domains (Cognitive, Emotional, Physical and Overall Health) and 4 Specific outcomes (Child Health-Related Quality of Life, Pain, Survival, and Communication). Families (n=21) suggested additional critically important outcomes that did not meet consensus, which were included in the PICU COS -Extended. ConclusionsThe PICU Core Outcome Set and PICU COS-Extended are multi-stakeholderrecommended resources for clinical and research programs that seek to improve outcomes for children with critical illness and their families.

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Objective The aim of this study was to develop evidence-based recommendations for the diagnosis and treatment of sepsis in children in low- and middle-income countries (LMICs), more specifically in Latin America. Design: A panel was formed consisting of 27 experts with experience in the treatment of pediatric sepsis and two methodologists working in Latin American countries. The experts were organized into 10 nominal groups, each coordinated by a member. Methods: A formal consensus was formed based on the modified Delphi method, combining the opinions of nominal groups of experts with the interpretation of available scientific evidence, in a systematic process of consolidating a body of recommendations. The systematic search was performed by a specialized librarian and included specific algorithms for the Cochrane Specialized Register, PubMed, Lilacs, and Scopus, as well as for OpenGrey databases for grey literature. The GRADEpro GDT guide was used to classify each of the selected articles. Special emphasis was placed on search engines that included original research conducted in LMICs. Studies in English, Spanish, and Portuguese were covered. Through virtual meetings held between February 2020 and February 2021, the entire group of experts reviewed the recommendations and suggestions. Result: At the end of the 12 months of work, the consensus provided 62 recommendations for the diagnosis and treatment of pediatric sepsis in LMICs. Overall, 60 were strong recommendations, although 56 of these had a low level of evidence. Conclusions: These are the first consensus recommendations for the diagnosis and management of pediatric sepsis focused on LMICs, more specifically in Latin American countries. The consensus shows that, in these regions, where the burden of pediatric sepsis is greater than in high-income countries, there is little high-level evidence. Despite the limitations, this consensus is an important step forward for the diagnosis and treatment of pediatric sepsis in Latin America.

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