OPENPediatrics

In this World Shared Practice Forum Podcast, Drs. Danielle DeCourcey and Sabrina Derrington provide their insight on the methodology and development of the 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End-of-Life, sharing actionable guidance for clinicians at the bedside. The authors review GRADE methodology and provide context behind the conditional recommendations. The speakers reflect on next steps including implementation, research, and addressing disparities in end-of-life care.

LEARNING OBJECTIVES
- Understand the design and methodology for the 2026 pediatric and neonatal end-of-life guidelines
- Describe GRADE methodology and its impact on the guideline’s recommendations
- Discuss practical applications of the guidelines for clinicians

AUTHORS
Danielle D'Emilia DeCourcey, MD, MPH
Associate Chief, Division of Medical Critical Care
Boston Children's Hospital
Associate Professor of Pediatrics
Harvard Medical School

Sabrina Derrington, MD, MA, HEC-C, FAAP
Director of the Center for Bioethics
Children's Hospital Los Angeles
Associate Professor of Clinical Pediatrics
Keck School of Medicine,
University of Southern California (USC)

Jeffrey Burns, MD, MPH
Emeritus Chief
Division of Critical Care Medicine
Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Professor of Anesthesia
Harvard Medical School

DATE
Initial publication date: August 25, 2026.

ARTICLES REFERENCED & ADDITIONAL REFERENCES
- Derrington S, Broden Arciprete EG, Lin MC, et al. Executive Summary of Society of Critical Care Medicine 2026 Guidelines on the Care and Management of Pediatric and Neonatal Intensive Care Patients at the End of Life. Pediatr Crit Care Med. 2026;27(4):487-493.
- The Correspondent by Virginia Evans
- Pilgrim at Tinker Creek by Annie Dillard

TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/v66vz9xj5t6qtmjwjkcrmr7/202608_WSP_Derrington_and_DeCourcey_Transcript

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
DeCourcey DD, Derrington S, O’Hara JE, Burns JP. Pediatric End-of-Life Guidelines & Insights. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pediatric-end-of-life-guidelines-and-insights-by-d-decourcey-and-s-derrington-openpediatrics.

This video discusses the preoperative, operative, and postoperative considerations for patients undergoing tracheostomy including: anatomy and pathophysiology, anesthetic and operative approach, and postoperative care.

LEARNING OBJECTIVES
- Explain the anatomy and pathophysiology
- Describe the anesthetic management plan, including intraoperative management
- Review common operative approaches
- Describe postoperative considerations

AUTHORS
Roger Nuss, MD
Associate, Department of Otolaryngology and Communication Enhancement
Assistant Professor of Otolaryngology, Harvard Medical School

Jennifer Perez, MD
Fellow, Division of Critical Care Medicine
Boston Children's Hospital

Jessica Laird-Gion, MD
Department of Pediatrics, Division of Cardiology
Stanford Medicine

DATE
Initial publication date: August 12, 2026.

Please visit: www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Laird-Gion J, Perez J, Nuss R, McFee AM, Marcley S, Wolbrink TA. Tracheostomy. 08/2026. Online Podcast. OPENPediatrics. https://soundcloud.com/openpediatrics/tracheostomy-by-r-nuss-j-perez/s-hIyYqiXKAId?si=25e19540480b43cbb133b57d067213f9&utm_source=clipboard&utm_medium=text&utm_campaign=social_sharing.

In this Complex Care Journal Club podcast episode, Ms. Emily Johnson and Dr. Florence Gagné discuss a scoping review of interventions to assess social needs for children with medical complexity. They describe the different approaches to screening and intervention in the five included studies, implications for practice, and opportunities to engage social workers in research.

SPEAKERS
Emily Johnson, MSW, LICSW
Clinical Social Worker
Boston Children's Hospital

Florence Gagné, MD
Pediatrician
Montréal Children’s Hospital

HOST
Kristina Malik, MD
Assistant Professor of Pediatrics
Medical Director
Pediatrician, Special Care Clinic‌‌
‌University of Colorado School of Medicine
KidStreet
Children’s Hospital Colorado

DATE
Initial publication date: August 11, 2026.

JOURNAL CLUB ARTICLE
Johnson ER, Hadge SM, Wachter SM, Gagné F. Interventions to assess social needs for children with medical complexity and their families: A scoping review. Patient Educ Couns. 2026;148:109555. doi:10.1016/j.pec.2026.109555.

OTHER ARTICLES REFERENCED
Ming DY, Jones KA, Sainz E, Tkach H, Stewart A, Cram A, Morreale MC, Dizon S, deJong NA. Feasibility of implementing systematic social needs assessment for children with medical complexity. Implement Sci Commun. 2021 Nov 21;2(1):130. doi: 10.1186/s43058-021-00237-3. PMID: 34802465; PMCID: PMC8606226.

TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/3sgvpf2qjsvt9zqxvf37xspz/Gagne_and_Johnson_Final_Transcript_8-3-26

Clinicians across healthcare professions, advocates, researchers, and patients/families are all encouraged to engage and provide feedback! You can recommend an article for discussion using this form: https://forms.gle/Bdxb86Sw5qq1uFhW6.

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Johnson ER, Gagné F, Malik K. Screen and Intervene: Meeting Social Needs for Children with Medical Complexity. 08/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/screen-and-intervene-meeting-social-needs-for-children-with-medical-complexity.

In this podcast, recorded at the Top Articles of 2025 Session at PEDICRITICON 2025, Dr. Traci Wolbrink interviews Drs. Ashish Agarwal and Ramesh Kumar Ramachandran about two randomized controlled trials. These studies comparing 0.9% normal saline with Ringer’s lactate in diabetic ketoacidosis and the efficacy of high flow nasal cannula versus nasal prong bubble CPAP in bronchiolitis. The conversation reveals challenges in resource-limited settings, emphasizing the importance of protocol adherence, mentorship, and resource management. Valuable insights into fluid management, respiratory support, and research execution are offered for healthcare professionals keen on advancing clinical practice and research knowledge.

Learning Objectives
- Recognize the limitations of using normal saline in diabetic ketoacidosis
- Understand the physiological benefits of balanced fluids like Ringer’s Lactate
- Identify the logistical challenges in conducting trials in resource-limited settings
- Appreciate the role of teamwork and protocol adherence in research success

AUTHORS
Ashish Agarwal, MD
Post Graduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India

Ramachandran Rameshkumar, MD, DM, FRCPCH
Division of Pediatric Critical Care, Department of Pediatrics,
Jawaharlal Institute of Postgraduate Medical Education and
Research (JIPMER), Puducherry, India
Pediatric Intensive Care Unit, Department of Pediatrics,
Mediclinic City Hospital, Mohammed Bin Rashid University
of Medicine and Health Sciences, Dubai, United Arab Emirates

Traci Wolbrink, MD, MPH‌
Co-Director, OPENPediatrics
Senior Associate in Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Associate Professor of Anesthesia
Harvard Medical School

DATE
Initial publication date: July 1, 2026.

ARTICLES REFERENCED
Agarwal A, Jayashree M, Nallasamy K, Dayal D, Attri SV. 0.9% Saline versus Ringer's lactate as initial fluid in children with diabetic ketoacidosis: a double-blind randomized controlled trial. BMJ Open Diabetes Res Care. 2025;13(2):e004623. https://pubmed.ncbi.nlm.nih.gov/40194836/

Maya M, Rameshkumar R, Selvan T, Delhikumar CG. High-Flow Nasal Cannula Versus Nasal Prong Bubble Continuous Positive Airway Pressure in Children With Moderate to Severe Acute Bronchiolitis: A Randomized Controlled Trial. Pediatr Crit Care Med. 2024;25(8):748-757. https://pubmed.ncbi.nlm.nih.gov/38639564/

TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/szcrpthcfg3w4398gkvf9ch/202606_Pedicriticon_Podcast_2025_Transcript

Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Agarwal A, Rameshkumar R, Wolbrink TA. PEDICRITICON 2025: Top Articles in PICU Research. 07/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/pedicriticon-2025-top-articles-in-picu-research.

In this World Shared Practice Forum Podcast, first authors Drs. Frances Balamuth and Chanu Rhee describe the objectives and methodology for their study “National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data” published in the March 2026 edition of JAMA. They discuss the process of modifying the Phoenix Sepsis Criteria to an electronic health record-based Pediatric Sepsis Event (PSE) definition and the methods for validating this definition. The authors share salient findings from their study, noting the limitations, and share their hopes for the future direction of sepsis surveillance research.

LEARNING OBJECTIVES
- Understand the derivation for the Pediatric Sepsis Event definition for electronic health record-based pediatric sepsis surveillance
- Review the validation process for the Pediatric Sepsis Event definition
- Compare the Pediatric Sepsis Event definition to the Phoenix Sepsis Criteria
- Discuss the results and limitations of the electronic health record-based study design
- Express the goals for the future direction of pediatric sepsis surveillance research

AUTHORS
Frances Balamuth, MD, PhD, MSCE
Professor of Pediatrics, Chief of Pediatric Emergency Medicine
University of Pennsylvania Perelman School of Medicine
Children's Hospital of Philadelphia

Chanu Rhee, MD, MPH
Associate Professor of Population Medicine
Harvard Medical School and Harvard Pilgrim Health Care Institute

Traci Wolbrink, MD, MPH‌
Senior Associate in Critical Care Medicine;
Department of Anesthesiology, Critical Care and Pain Medicine
Boston Children's Hospital
Associate Professor of Anesthesia
Harvard Medical School

DATE
Initial publication date: June 23, 2026.

ARTICLES REFERENCED
Rhee C, Balamuth F, Dysart K, et al. National Estimates of Pediatric Sepsis in US Hospitals Using Clinical Data. JAMA. 2026;335(15):1321-1331. https://pubmed.ncbi.nlm.nih.gov/41865411/

TRANSCRIPT
https://cdn.bfldr.com/D6LGWP8S/as/swj4kvkgg686b6p9whmbht/20260622_WSP_Rhee_and_Balamuth_Transcript

Please visit: www.openpediatrics.org

OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children's Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access, thus at no expense to the user.

For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu

CITATION
Balamuth F, Rhee C, O’Hara JE, Wolbrink TA. National Estimates of Pediatric Sepsis. 06/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/new-national-estimates-of.