Objective: Many hospitals aim to extubate children early after cardiac surgery, yet it remains unclear how this practice associates with extubation failure (EF). We evaluated adjusted EF rates and duration of postoperative mechanical ventilation (POMV) across hospitals and assessed cardiac intensive care unit (CICU) organizational factors associated with EF. Design: Secondary analysis of the Pediatric Cardiac Critical Care Consortium (PC 4) clinical registry.

Objective: Early extubation following pediatric cardiac surgery is common, but debate exists whether location affects outcome, with some centers performing routine early extubations in the operating room (OR) and others in the cardiac intensive care unit. We aimed to define early extubation practice variation across hospitals and assess impact of location on hospital length-ofstay and other outcomes.Design: Secondary analysis of the Pediatric Cardiac Critical Care Consortium (PC4) registry.Setting: 28 PC4 hospitals.

Aims: To identify clinical andgenetic factors associated with indomethacin treatment failure in preterm neonates with patent ductus arteriosus (PDA). Patients & Methods: This is a multicenter cohort study of 144 preterm infants (22–32 weeks gestational age) at three centers who received at least one treatment course of indomethacin for PDA. Indomethacin failure was defined as requiring subsequent surgical intervention. Results: In multivariate analysis, gestational age (AOR 0.76, 95% CI 0.60–0.96), surfactant use (AOR 9.77, 95% CI 1.15–83.26), and CYP2C9*2 (AOR 3.74; 95% CI 1.34–10.44) were each associated with indomethacin failure. Conclusion: Age, surfactant use, and CYP2C9*2 influence indomethacin treatment outcome in preterm infants with PDA. This combination of clinical and genetic factors may facilitate targeted indomethacin use for PDA.