pediatric section business meeting -...

Pediatric Section Business Meeting

Monday, February 6, 2012 Jeffrey Burns, MD MPH Chair, Pediatric Section

Society of Critical Care Medicine

Pediatric Section Business Meeting Agenda

•  Section Updates – Jeff Burns •  Fellowship Directors Update – Denise Goodman •  NACHRI – Richard Brilli •  SCCM Learn – Mark Hall •  PALISI Network – Ann Thompson •  PCCSDP – Michael Dean/Michelle Mariscalco •  WFPICS – Niranjan “Tex” Kissoon •  PAS/SPR Meeting – Tom Shanley •  Pediatric Multiprofessional Critical Care Board Review

Course—Heidi Dalton •  2012 Colloquium/Santa Monica—Barry Markovitz •  Editor-in-Chief – Patrick Kochanek

SCCM Pediatric Section

•  There are 1,713 members of the section, 345 are attending this conference.

•  Our budget is $ 23,000 - $10K = $13,000

•  Jerry Zimmerman is our representative to SCCM Council.

•  Vinay Nadkarni won the election for the “at-large” seat on SCCM Council.

2012 Pediatric Section Executive/Steering Committee

Chair–: Ken Tegtmeyer, MD, FCCM Cincinnati Children’s Hospital [email protected] Term: 2012 – 2014

Chair–elect: Derek S. Wheeler, MD Cincinnati Children’s Hospital [email protected] Term: 2012 – 2014

Past-Chair: Jeffrey P. Burns, MD Children’s Hospital Boston [email protected] Term: 2012 – 2014

Members-at-Large

Deb Franzon, MD

Lucille Packard Children’s Hospital [email protected]

Term: 2011 – 2013 Tom Nakagawa, MD

Wake Forest University [email protected]

Term: 2011-2013 Neal J. Thomas, MD, FCCM

Penn State Children’s Hospital [email protected] Term: 2012 – 2014 Raj Anejar, MD

Children’s Hospital Pittsburgh [email protected]

Term: 2012 – 2014

Sub-Committee Chairs & Pediatric SCCM Programs Leaders

Accreditation and Online Learning Committee chair 2012 - 2013); Mark W. Hall; [email protected] American College of Critical Care Medicine; Michelle Moss; [email protected] Billing and Coding Oversight Committee (chair 2013 - 2014); Christine Zawistowski; [email protected] Congress Program Committee (co-chair 2013-2014); Vinay Nadkarni; Pediatrics FCCS (chair 2011-2013); Maureen Madden; [email protected] Pediatrics FCCS (chair 2013-2015); Michael O. Gayle; [email protected] Ethics Committee (chair 2012 - 2014); Alexander A. Kon; [email protected] Fellowship Directors Committee (chair 2010-2012); Denise Goodman; [email protected] Guideline for Neurological Death in Children chair 2007 - 2012); Thomas A. Nakagawa, [email protected]

Sub-Committee Chairs & Pediatric SCCM Programs Leaders

Pediatric Online Practice Exam Committee (2012-2013); Mark Helfaer; [email protected] Pediatric MCCKAP Committee (2012 - 2013); Derek S. Wheeler,; [email protected] & Mark Rowin; [email protected] Pediatric Current Concepts (2011 - 2012 chair for Congress 2012); Thomas A. Nakagawa; [email protected] Pediatric Current Concepts (2012 - 2013 chair for Congress 2013); Brian Jacobs; [email protected] Pediatric Current Concepts (2013 - 2014 chair for congress 2014); Mark Rigby; [email protected] Simulation Task Force (2011 -2015); Glenn Stryjewski; [email protected] Patient and Family Support Committee (chair from 2011 - 2012); Jonathan Feldman; [email protected] Pediatric Comprehensive Critical Care Review Book (2010 - 2014); Co-Editor, Neil Kooy & Jana Stockwell. [email protected]; [email protected] Pediatric Multiprofessional Critical Care Board Review Course; Founding Directors, Heidi Dalton & Anthony Slonim. [email protected]; [email protected] The World Federation of Pediatric Intensive and Critical Care Societies (WFPICCS); Tex Kissoon; [email protected]

Congratulations

Bob Berg received the Laerdal Memorial Lecture

Award.

Ed Conway & Tim Yeh received the Distinguished Service Award

These awards were presented at the American College of Critical Care Medicine (ACCM) Convocation/SCCM Awards Presentation on Monday.

Congratulations-Travel Grant Awards

Yi-‐Chen LAI, MD-‐-‐ #3-‐-‐Altered Cardiac Conduc2on and Increased Arrhythmogenic Poten2al as a Candidate Mechanism for Sudden Unexplained Death in Epilepsy John D. WHITT, MD-‐-‐#10-‐-‐ A Case Control Study on the Impact of Ven2lator Associated Tracheobronchi2s (VAT) in the Pediatric ICU Andy Y. WEN, MD-‐-‐#127-‐-‐Cyclic AMP -‐Responsive Element Binding Protein Modulates Cytokine and Chemokine Expression in Bone Marrow Macrophages

2012 Presidential Citation Award Recipients Pediatric Section

Michael S.D. AGUS, MD Raj ANJEA, MD Ivor Berkowitz, MBBBCh Katherine V. BIAGAS, MD, FCCM Dana BRANER, MD, FCCM Ira M. CHEIFETZ, MD, FCCM Edward E. CONWAY Jr., MD, MS, FCCM Heidi J. DALTON, MD, FCCM Jeffrey R. FINEMAN, MD Lorry R. FRANKEL, MD, FCCM Deborah E. FRANZON, MD Denise M. GOODMAN, MD, MS, FCCM Mark W. HALL, MD Patrick KOCHANEK, MD, FCCM

Maureen A. MADDEN, MSN, PCCNP, FCCM Vicki L. MONTGOMERY, MD, FCCM Wynne E. MORRISON, MD Vinay M. NADKARNI, MD, FCCM Thomas A. NAKAGAWA, MD, FCCM Adrienne G. RANDOLPH, MD Mark R. RIGBY, MD, PhD Anthony SLONIM, MD Philip C. SPINELLA, MD John P. STRAUMANIS, MD, FCCM Ken TEGTMEYER, MD, FCCM Neal J. THOMAS, MD, FCCM Derek S. WHEELER, MD Jacqueline A. WILLIAMS-PHILLIPS, MD, FCCM

How can I get involved in SCCM?

To get involved you need to become a member of the Creative Community go to: http://www.sccm.org/Membership/Volunteers/Pages/default.aspx and complete the Committee Application. Committee applications are accepted at any time, however, in order to be eligible to participate on a committee the following year, the deadline date for submitting the committee application is May 30. Notification of appointment will be in September or October. Committee terms will begin at Congress. Once appointed to a committee, the Volunteer Code of Conduct and Conflict of Interest, Assignment of Rights, Disclosure Policy, must be completed and returned to SCCM.

Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

Agenda •  Section Updates – Jeff Burns •  Fellowship Directors Update – Denise Goodman •  NACHRI – Richard Brilli •  SCCM Learn – Mark Hall •  PALISI Network – Ann Thompson •  PCCSDP – Michael Dean/Michelle Mariscalco •  WFPICS – Niranjan “Tex” Kissoon •  PAS/SPR Meeting – Tom Shanley •  Pediatric Multiprofessional Critical Care Board Review


Fellowship Directors Update

Denise M. Goodman, MD Fellowship Director

Children’s Memorial Hospital Associate Professor of Pediatrics,

Northwestern University Chicago, Illinois


PICU CLABSI Collaborative: National Association of Children's Hospitals and Related Institutions

Richard J. Brilli, MD Chief Medical Officer

Nationwide Children’s Hospital

Columbus, Ohio

Fellowship PALISI PCICS SCCM Learn SPR PCCSDP AAP WFPICS NACHRI Editor-in-chief Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

PICU BSI Leadership Team includes Richard Brilli, MD Debbie Campbell, RN Angela Morgan, RN Michele Moss, MD MaShew Niedner, MD Tom Rice, MD Deb Ridling, RN Pete Silver, MD


What do we KNOW: •  75 disparate, competitive PICUs can work together to

reduce CLA-BSI •  75 PICUs can share data, even w CMS breathing on us •  Central Line maintenance care matters •  Higher compliance with the central line bundle elements

is associated with lower CLA-BSI rates

•  Reduced CLA-BSI rates saves $$ to the healthcare system

SCCM Ped Section Meeting - BSI Update


Started w 29 units Have now had > 75 units participate

2006 – 2007 CLA-BSI PICU rate 5.4 NHSN rate 6.6

2011 CLA-BSI PICU rate 1.8

NHSN rate (2010)1 1.8

SCCM Pediatric Section Meeting - BSI Update

(1) Dudeck MA, et al. NHSN report. AJIC 2011; 39:798-816


Phase 1 CLA-‐BSI Control Chart Feb 2004 to Aug 2011

5.4

1.8



Mean

UCL

+1 Sigma

+2 Sigma

0.0

0.5

1.0

1.5

2.0

2.5

3.0

3.5

2009.12

2010.02

2010.04

2010.06

2010.08

2010.10

2010.12

2011.02

2011.04

2011.06

2011.08

2011.10

CLA

BS

I R

ate

(per

1000 L

ine

-Days

)

Month

Combined Active and Inactive PICU 1,2,3 Rate since 12/2009 (max n = 72)

CLA-‐BSI Mean Rate = 1.8; nearly 500,000 line days


Total # BSI

Total Line Days

BSI Prevented

Deaths Prevented*

Cost Savings**

PH 1 1007 478059 1627 195 $57M

PH 2 691 308729 1192 143 $42M

PH 3 155 72250 192 23 $6.7M

PH 4 9 5281 12 1 $0.5M

COMBINED 1862 864,319 3,023 363 $106M

Summary Progress to Date -‐ 2011


At least 10 PICUs have gone a year or more CLA-BSI free Most PICU groups have spread the line care practices beyond the walls of the PICU (but not all)




Pediatrics 2010; 125:206-213



Pediatrics 2011; 128:e1077-1083


Study Design – Descriptive Cohorts


Demographics

70% of CLA-BSIs caused by 4 Genera:

•  Staph spp.

•  Enterococcus

•  Enterobacter

•  Candida

DIAGNOSES Gastrointestinal Gastrointestinal bleed 12% Chronic liver failure 10% Acute liver failure 10% GE reflux 6% Esophageal disease 6% Each of remaining <5% Oncologic Leukemia 22% Brain neoplasm 17% Neuroblastoma 5% Each of remaining <5% Other Symptoms NOS 25% Orthopedic 19% Renal / genitourinary 19% Genetic / metabolic 17% Each of remaining <5%


Important Study Findings

•  Risk of CLA-BSI doubles after 7 days dwell time

•  Compared to patients with respiratory illness – CLA-BSI risk highest in patients w GI and oncologic diagnoses

•  Among all patients, including those w > 1 central line, the CLA-BSI risk is lower in those w central line inserted in jugular vein


7 days

99% of patients were BSI free thru day 7, then risk of getting BSI is doubled

Really start to pay attention after day 7 !! Line Dwell Time Daily Risk of CLA-

BSI Day 1-7 0.14% Day 7-100 0.27%

Proportion of patients BSI free over time



•  Have we reached the nadir w current bundle? -‐ maybe

•  We are adding bundle elements §  Clot preven2on §  Decreasing line entry

•  Can we go lower?


Other BSI related Collaboratives

•  Hematology – Oncology collabora2ve •  Nephrology collabora2ve

In just one year, Heme-Onc rate already at 2.2


CLA-‐BSI in the Context of Other Serious Harm

•  What is the correct emphasis and distribu2on of resources?

•  Increasing emphasis by CMS on other Hospital Acquired Condi2ons


Distribution of Serious Harm - Nationwide Children’s Hospital


Ohio Children’s Hospitals SoluUons

for PaUent Safety

•  $5 M grant from CMS to significantly reduce serious hospital acquired condi2ons over next 3 years

•  From among 26 grants awarded – this was only pediatric grant

•  34 hospitals year 1 •  Another 50 hospitals in years 2 & 3 MANY OF YOU WILL HEAR A LOT MORE ABOUT

THIS IN COMING WEEKS AND MONTHS

10 Hospital Acquired CondiUons •  Everyone is likely working on many of these HACs but this is opportunity to have a NATIONAL pediatric network focused on pa2ent harm

•  We will learn from each other •  We will share hospital specific data – even among compe2tors

•  We will IMPROVE faster

•  HACs: 1. CLA-‐BSI 5. Serious Falls 9. Pressure ulcers 2. CA-‐UTI 6. ADEs 10. Obstetrical Events 3. SSI 7. VTE 4. VAP 8. Preventable Readmissions


Thanks


SCCM Learn ICU project - Call for pediatric involvement

Mark W. Hall, MD, Director, Pediatric Critical Care Medicine

Fellowship Program Nationwide Children's Hospital,

Columbus, Ohio


www.LearnICU.org Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

www.LearnICU.org Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

Accredita2on and Online Learning CommiSee

•  12 Pediatric content advisors – AOL commiSee membership – Byline on LearnICU topic page – Goals:

•  Insure pediatric content is properly represented •  Recommend/create future pediatric content

•  2012 Pediatric Webcast Series! – Marke2ng blitz to begin…..now.

Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

2012 Pediatric O2 Series •  Thema2c series of pediatric webcasts following O2 from atmosphere to mitochondria: –  Part 1 (March 2012): Gejng O2 In:

•  Management of pediatric hypoxic respiratory failure –  Michael Gen2le, Ira Cheifetz

–  Part 2 (April 2012): Moving O2 Around: •  RBC biology and pediatric transfusion science

–  Allan Doctor, Phil Spinella –  Part 3 (May 2012): Measuring O2 Adequacy:

•  Invasive and non-‐invasive measurement of O2 delivery –  George Hoffman, Andrew Yates

–  Part 4 (June 2012): Turning O2 into Energy: •  Principles of mitochondrial func2on in cri2cal illness

–  Hülya Bayir, Eliot Crouser (tenta2ve)

Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM Fellowship- NACHRI-SCCM Learn-PALISI-K12- PAS/SPR- Board Review- Colloquium-PCCM

PALISI: Pediatric Acute Lung Injury and Sepsis Investigators

Ann E. Thompson, MD Professor, Critical Care Medicine,

Anesthesiology and Pediatrics, University of Pittsburgh School of

Medicine


PCCSDP: The Pediatric Critical Care Scientist Development

Program

Michele Mariscalco, MD Associate Dean for Research

University of Kansas School of Medicine For

J. Michael Dean, MD, MBA Chief, Division of Pediatric Critical Care Medicine

University of Utah School of Medicine Salt Lake City, Utah


AAP Section on Critical Care

Richard B. Mink, M.D. Division Chief, Division of Pediatric Critical Care

Professor of Pediatrics Director, Pediatric Critical Care Fellowship Program


WFPICS World Federation of Pediatric Intensive and Critical Care

Societies

Niranjan "Tex" Kissoon, MD, Professor, Pediatric and Surgery University of British Columbia Vice President, Medical Affairs

BC Children's Hospital Vancouver, British Columbia, Canada

Fellowship PALISI PCICS SCCM Learn SPR PCCSDP AAP WFPICS NACHRI Editor-in-chief Fellowship- NACHRI-SCCM Learn-PALISI-K12- WFPICPAS/SPR- Board Review- Colloquium-PCCM

PAS/SPR Meeting

Tom Shanley, MD Associate Dean for Clinical and Translational Research Univ Of Michigan and Director of the Michigan Institute for Clinical &

Health Research Ann Arbor, Michigan


Pediatric Colloquium Santa Monica, California

September 6-9, 2012

Barry Markovitz, MD Director, Critical Care Medicine Children’s Hospital Los Angeles


Report from the Editor-in-Chief: Pediatric Critical Care Medicine

Patrick M. Kochanek, MD

Professor and Vice Chairman of Critical Care Medicine Director of the Safar Center for Resuscitation Research

University of Pittsburgh School of Medicine


Pediatric Cri+cal Care Medicine

State of the Journal

February 6, 2012 Pediatric SecUon Business MeeUng

SCCM Congress

Patrick M. Kochanek, MD Editor

IntroducUon

I am again honored to report on the status of Pediatric Cri+cal Care Medicine

PCCM just completed its 12th year of publicaUon

The most important developments in 2011 1.   A further increase in (2010) IF reaching 2.672 2.   A spectacular immediacy index among pediatric journals 3.   A rapidly rising number of citaUons of arUcles published

in the journal –PCCM has been cited over 4000 Umes 4.   PublicaUon of three outstanding supplements—two in

2011, and one in Jan 2012 5.   ConUnued growth and re-‐tooling of the journal

ISI/Impact Factor

PCCM received its third impact factor (2010) in June of 2011 along with the related citaUon indices

1.   The 2010 IF = citaUons in ISI-‐indexed journals in 2010 of arUcles published in our journal in 2008 and 2009 ÷ number of arUcles we published in 2008 and 2009.

2.   Despite only its third impact factor, PCCM was 14th out of 109 pediatric journals, and 9th out of 23 criUcal care journals.

3.   This is an outstanding IF—parUcularly for a pediatric journal.

Pediatric Journals Remarkably,

IF #14 out of 109 improved from #18 last year Our 3rd IF

Pediatric InfecUous Disease 3.06

Pediatric CriUcal Care Medicine 2.67

Pediatric Pulmonology 2.24

Pediatric Nephrology 2.18

Pediatric Neurology 1.51

Pediatric Cardiology 1.24

Pediatric Emergency Care 0.80

Some relevant Pediatric Specialty Journals: 2010 IFs Pediatrics 5.85

Journal of Pediatrics 4.19 Pediatric Research 2.87 Pediatric CriUcal Care Medicine 2.67

Top General Pediatric Journals: 2010 IFs

PCCM Immediacy Index Comparison to top general pediatric journals

PCCM received an immediacy index of 1.272 which was amazingly #3 out of the 109 pediatric journals and #6 out

of 22 criUcal care journals

Our 2010 immediacy index = The number of citaUons in ISI-‐indexed journals in 2010 of

arUcles published in PCCM in 2010 ÷ the total number of arUcles published in PCCM in 2010

—and thus represents an index of rapid citaUon

Pediatric Journals #3 out of 109 for immediacy index Improved from #7 in 2009

PCCM had a higher immediacy index than Pediatrics and J Peds

2010 Immediacy Index: Top Pediatric Journals

Figure 1. Top Cited Papers Published in PCCM 2006-‐2011

Title Published Citations ISI

Citations Google Scholar

JD Tobias: Dexmedetomidine: Applications in pediatric critical care and pediatric anesthesiology

March 2007 61 97

RJ Brilli: Implementation of a medical emergency team in a large pediatric teaching hospital prevents respiratory and cardiopulmonary arrests outside the intensive care unit

May 2007

56 87

AR Yates: Hyperglycemia is a marker for poor outcome in the postoperative pediatric cardiac patient

July 2006 53 78

C Chrysostomou: Use of dexmedetomidine in children after cardiac and thoracic surgery

March 2006 50 66

D Bailey: Risk factors of acute renal failure in critically ill children: A prospective descriptive epidemiological study

January 2007 47 76

E Hirshberg: Alterations in glucose homeostasis in the pediatric intensive care unit: Hyperglycemia and glucose variability are associated with increased mortality and morbidity

July 2008

45 67

S Essouri: Noninvasive positive pressure ventilation: Five years of experience in a pediatric intensive care unit

July 2006 41 80

S Erickson: Acute lung injury in pediatric intensive care in Australia and New Zealand -‐ A prospec2ve, mul2center, observa2onal study

July 2007 37 52

CL Cua: Early postoperative outcomes in a series of infants with hypoplastic left heart syndrome undergoing stage I palliation operation with either modified Blalock-Taussig shunt or right ventricle to pulmonary artery conduit

May 2006 34

41

M Eisenhut: Pulmonary edema in meningococcal septicemia associated with reduced epithelial chloride transport

March 2006

34 48

• A diverse pormolio of top cited papers for PCCM

• SedaUon, resuscitaUon, hyperglycemia, acute renal failure, ALI, are among the most highly cited topics

• ISI ≠ Google Scholar

Figure 2. Top Cited Papers Published in PCCM 2009

Title Published Citations ISI

Citations Google Scholar

KL Meert: Multicenter cohort study of in-hospital pediatric cardiac arrest

September 24 27

J Tibballs: Reduction of hospital mortality and of preventable cardiac arrest and death on introduction of a pediatric medical emergency team

May 23 40

L Castillo: Secondary hemophagocytic lymphohistiocytosis and severe sepsis/ systemic inflammatory response

May 20 21

CJL Newth: Weaning and extubation readiness in pediatric patients

January 20 27

EC Meyer: Difficult conversa2ons: Improving communica2on skills and rela2onal abili2es in health care

May 15 21

EA Hunt: Survey of pediatric resident experiences with resuscita2on training and aSendance at actual cardiopulmonary arrests

January 14 17

KM Pleacher: Impact of a pediatric donation after cardiac death program

March 14 12

O Efra2: Flexible bronchoscopy and bronchoalveolar lavage in pediatric pa2ents with lung disease

January 13 16

CS Barrett: Neurological injury after extracorporeal membrane oxygenation use to aid pediatric cardiopulmonary resuscitation

July 12 19

JM Duncan: Vasopressin for in-hospital pediatric cardiac arrest: Results from the AHA National Registry of Cardiopulmonary Resuscitation

March 12 20

• 2010 IF not driven by one or two highly

cited papers

Figure 3. Top Cited Papers Published in PCCM 2010 Title Published Citations

ISI Citations

Google Scholar S Baltagi Neurological sequelae of 2009 influenza A (H1N1) in children: A case series observed during a pandemic

March 21 32

JL Lockman: The cri2cally ill child with novel H1N1 influenza A: A case series

March 21 25

C Breatnach : A prospec2ve crossover comparison of neurally adjusted ven2latory assist and pressure-‐support ven2la2on in a pediatric and neonatal intensive care unit popula2on

January 15 19

P Jouvet: Cri2cal illness in children with influenza A/pH1N1 2009 infec2on in Canada

September 13 21

KC Clement: Single-‐ins2tu2on experience with interhospital extracorporeal membrane oxygena2on transport

July 12 10

JA Bengtsson: Neurally adjusted ven2latory assist in children: An observa2onal study

March 11 13

EL Fink: A ter2ary care center's experience with therapeu2c hypothermia auer pediatric cardiac arrest

January 11 19

J Gil-Anton: Pediatric cardiac arrest refractory to advanced life support: Is there a role for terlipressin?

January 11 18

J Tibballs: A cri2que of the apneic oxygena2on test for the diagnosis of "brain death"

July 10 4

AW Loepke: Developmental neurotoxicity of seda2ves and anesthe2cs: A concern for neonatal and pediatric cri2cal care medicine?

March 8 7

D Levin: Empiric an2bio2cs are jus2fied for infants with respiratory syncy2al virus lower respiratory tract infec2on presen2ng with respiratory failure: A prospec2ve study and evidence review

May 8 7

Looking forward

Priority and expedited publicaUon of arUcles on H1N1 during and immediately aner the Pandemic

Web of Science® Citation Report

This report reflects citations to source items indexed within Web of Science, as of January 31, 2012

Figure 4.

Published Items in Each Year

Citations in Each Year

Published Items in Each Year Citations in Each Year

Citations in Each Year

Published Items in Each Year

CitaUons are growing at a remarkable pace for PCCM and 2011 IF looks extremely promising

Looking forward

0

100

200

300

400

500

600

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

114

181

270290

261

328366

341

413

539

440

Figure 5. PCCM Submissions 2001-‐2011 • 91 case report submissions • 38 H1N1

PCCM conUnues to grow

Review, 2011 Reviewer performance 1.   58% of the reviews were done by ad hoc

reviewers 2.   Ad hoc reviewers completed 54% of

assignments (up from 27% in 2010)

Thanks!!

0

5

10

15

20

25

30

35

40

45

2003 2004 2005 2006 2007 2008 2009 2010 2011

44

36

41

32

2523

15

25.923.7

Figure 10. PublicaUon: Time from Submission to First DisposiUon (in days) Time to Epub & PCCM website posUng 3.3 mo. (down from 3.6 mo.) Time from acceptance to print 12 mo. (up from 9.48 mo.)

Strategies to reduce Ume to print

• 200 addiUonal e-‐pages in Nov 2011 issue • Plan to progressively move to monthly publicaUon

• 9 issues in 2013 • Monthly in 2016—maybe sooner

On-‐line only publicaUon –  In 2011, 434 e-‐pages; 700 print pages –  Clinical studies, Brief and Laboratory reports –  AddiUonal categories may move to e-‐only –  UlUmately, PCCM an e-‐journal?

Figure 11. Subscription Rates for Pediatric Journals

We certainly warrant monthly publicaUon and we are working as a team to achieve that

goal

And PCCM is the best deal in the print publicaUon universe!

0%

10%

20%

30%

40%

50%

60%

70%

2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

61%

53%

41%

50%

42%

37%

31%27%

32%28%

Figure 8. PCCM Manuscript Acceptance Rate 2002-‐2011

Supplements, 2011 Abstracts 1.   6th World Congress of Pediatric Intensive and CriUcal Care SocieUes Guest editors: David Schell, Tina Kendrick, Lara Shekerdemian, Sharon Kinney, Samantha Keogh

2.   2011 Abstracts from the AAP secUon on CriUcal Care Guest editor: John Straumanis

Guidelines

Thanks!!

These are major acquisiUons for PCCM!!

Nov 2011 Pediatric Emergency Mass Critical Care

PCCM Online: Most Viewed ArUcles 1 Guidelines for the acute medical management of severe trauma2c brain injury in infants, children, and

adolescents 2 Chapter 5. Indica2ons for intracranial pressure monitoring in pediatric pa2ents with severe trauma2c brain injury 3 Delibera2ons and recommenda2ons of the Pediatric Emergency Mass Cri2cal Care Task Force: Execu2ve

summary 4 Emergency tracheal intuba2on of severely head-‐�injured children: Changing daily prac2ce auer implementa2on of

na2onal guidelines 5 Adjunc2ve cor2costeroid therapy in pediatric severe sepsis: Observa2ons from the RESOLVE study 6 Pediatric Neurointensive Care: 2008 Update for the Rogers' Textbook of Pediatric Intensive Care 7 The diagnos2c dilemma of ven2lator-‐�associated pneumonia in cri2cally ill children 8 An update and review of acute kidney injury in pediatrics 9 Pediatric sepsis defini2ons: Past, present, and future 10 Chapter 7. Intracranial pressure monitoring technology 11 Rela2onship between hypoglycemia and mortality in cri2cally ill children 12 Red blood cell transfusion in cri2cally ill children: A narra2ve review 13 World Federa2on of Pediatric Intensive Care and Cri2cal Care Socie2es: Global Sepsis Ini2a2ve 14 Thrombo2c disease in cri2cally ill children 15 A trial of methadone tapering schedules in pediatric intensive care unit pa2ents exposed to prolonged seda2ve

infusions 16 Methemoglobinemia: Toxicity of inhaled nitric oxide therapy 17 Chapter 11. Use of hyperosmolar therapy in the management of severe pediatric trauma2c brain injury 18 World Federa2on of Pediatric Intensive and Cri2cal Care Socie2es-‐�Its global agenda 19 Defini2ons of bloodstream infec2on in the newborn 20 Twenty-‐�three thousand unnecessary deaths every day: What are you doing about it?

PCCM Print CirculaUon

0

500

1,000

1,500

2,000

2,500

2003 2004 2005 2006 2007 2008 2009 2010 2011

Pediatric Critical Care Medicine

Intl. Nonmember

US Nonmember

Members

2003 2004 2005 2006 2007 2008 2009 2010 2011 US Ind 209 236 272 251 218 185 142 146 127 US Inst 53 51 50 53 55 50 48 37 37 US Res/Stu/Nrs

30 17 17 12 9 8 7 11 11

Sponsored

65 Total US 292 304 339 316 282 243 197 259 175 Intl Ind 151 159 145 144 130 105 83 91 95 Intl Inst 72 48 69 67 74 70 62 61 51 Intl Res/Stu/Nrs 5 3 5 7 5 1 5 2 4 Total Int

228 210 219 218 209 176 150 154 150

Total Non-‐Member 520 514 558 534 491 419 347 413 325 US Mem

757 744 900 940 1,063 1,141 1,270 1299 1321

Intl Mem 840

867 456 506 608 633 657 608 611 Total Mem

1,597 1,611 1,356 1,446 1,671 1,774 1,927 1907 1932

Total 2,117 2,125 1,914 1,980 2,162 2,193 2,274 2,320 2,257

PCCM Online: Visitor Metrics Visit Summary 2011"Visits 214,134 Average per Day 601 Average Visit Duration 00:16:15 Median Visit Duration 00:04:29 International Visits 52.47% Visits of Unknown Origin 3.60% Visits from Your Country: United States (US)

43.94%

Visit Summary 2010"Visits 179,266 Average per Day 503 Average Visit Duration 00:15:13 Median Visit Duration 00:03:53 International Visits 51.44% Visits of Unknown Origin 5.20% Visits from Your Country: United States (US)

43.35%

Referring Site 2011" Referring Site 2010"

Pediatric Critical Care - Medicine Multiple Points of Access

Print Mobile iPad App (July)

Online Ovid

Acknowledgements A thousand thanks to the pediatric secUon

for its support

PCCM Financial Summary

$0

$100,000

$200,000

$300,000

$400,000

$500,000

$600,000

$700,000

2003 2004 2005 2006 2007 2008 2009 2010 2011*

Pediatric Critical Care Medicine

Revenue Costs Income Royalty

2003 2004 2005 2006 2007 2008 2009 2010 2011*

Revenue $316,124 $314,913 $341,841 $408,449 $441,326 $420,036 $429,786 $504,340 $582,713

Costs $234,015 $269,277 $260,113 $321,361 $394,111 $325,056 $354,727 $349,712 $423,606

Income $82,109 $45,636 $81,728 $87,088 $47,215 $94,980 $75,059 $154,628 $159,107

Royalty $39,707 $22,818 $40,864 $43,544 $23,607 $49,390 $50,000 $80,407 $82,736

*Es2mated

Top Downloads IF is only one barometer of the quality of our journal and its success in serving its many missions – Top downloads or accessed vs. most highly cited

•  Rogers’ Texbook updates •  Guidelines

InnovaUon 1.   New PCCM iAPP

– Prototype out; going public in July 2. PCCM website

– CollecUons, Editors picks, top downloads, etc.

Acknowledgements A thousand thanks to the pediatric secUon

for its support

PCCM on Ovid: Most Viewed Articles

1 Interna2onal pediatric sepsis consensus conference: Defini2ons for sepsis and organ dysfunc2on in pediatrics. 2 Randomized controlled trial of interrupted versus con2nuous seda2ve infusions in ven2lated children. 3 Intracranial pressure and cerebral perfusion pressure responses to head eleva2on changes in pediatric trauma2c brain

injury. 4 Fever control and applica2on of hypothermia using intravenous cold saline. 5 The effect of cri2cal illness and inflamma2on on midazolam therapy in children. 6 Characteriza2on of tracheal intuba2on process of care and safety outcomes in a ter2ary pediatric intensive care unit. 7 Neutrophil gela2nase-‐associated lipocalin levels during extracorporeal membrane oxygena2on in cri2cally ill children with

congenital heart disease: Preliminary experience. 8 Invasive intracranial pressure monitoring is a useful adjunct in the management of severe hepa2c encephalopathy

associated with pediatric acute liver failure. 9 Catheter-‐associated bloodstream infec2on in the pediatric intensive care unit: A mul2disciplinary approach. 10 Pediatric mass cri2cal care in a pandemic. 11 Inves2ga2on into the effect of closed-‐system suc2oning on the frequency of pediatric ven2lator-‐associated pneumonia in a

developing country. 12 Nutri2on support and deficiencies in children with severe trauma2c brain injury. 13 Cri2cally ill children with pandemic influenza (H1N1) in pediatric intensive care units in Turkey. 14 Vancomycin pharmacokine2c-‐pharmacodynamic parameters to op2mize dosage administra2on in cri2cally ill children. 15 Toward the inclusion of parents on pediatric cri2cal care unit rounds. 16 Electrical ac2vity of the diaphragm during extuba2on readiness tes2ng in cri2cally ill children. 17 Rescue treatment with terlipressin in different scenarios of refractory hypotension in newborns and infants. 18 Benchmarking, public repor2ng, and pay-‐for-‐performance: A mixed-‐methods survey of California pediatric intensive care

unit medical directors. 19 Mesentric oxygen satura2ons in premature twins with and without necro2zing enterocoli2s. 20 Predic2on of extuba2on outcome in preterm infants by composite extuba2on indices.

PCCM Online Institutional Subscriptions - Ovid

Orders Final Final Final YTD YTD 2008 2009 2010 2010 2011

Collec2ons 253 267 316 117 167 A la Carte 86 96 105 40 50 Grand Total 339 363 421 157 217

Reach 1,634 1,705 2,166 2,340

0

500

1000

1500

2000

2500

2006 2007 2008 2009 2010 2011 (est.)

Pediatric CriUcal Care Medicine

Orders Reach

PCCM Geographic Distribution

Top Five Countries Outside US Japan Brazil France Canada India/Australia (2e)

Top Five Countries Outside US China Germany Taiwan United Kingdom Italy/Spain (2e)

Top Five Countries Outside US United Kingdom Unknown Argen2na Spain Japan

66%

34%

Print

US International

44%

52%

4% PCCM Online

US International Unidentified

36%

64%

Ovid

US International

PCCM Online: Visitor Metrics Visitor Summary 2011"Visitors 92,014 Visitors Who Visited Once 78,594 Visitors Who Visited More Than Once

13,420

Avg Visits per Visitor 2.33

Page View Summary 2011"Page Views 484,054 Average per Day 1,359 Page Views per Visit 2.26

Visitor Summary 2010"Visitors 109,473 Visitors Who Visited Once 97,959 Visitors Who Visited More Than Once

11,514

Avg Visits per Visitor 1.64

Page View Summary 2010"Page Views 449,833 Average per Day 1,263 Page Views per Visit 2.51

-‐ 5,000 10,000 15,000 20,000 25,000 30,000 35,000 40,000 45,000

Visits/Month Page views/Month

pccmjournal.com

2009

2010

2011

PCCM Online: Geographic Distribution

Regions"

Countries"Countries Visits % Visits

1. United States (US) 96,461 44% 2. United Kingdom (UK) 15,556 7% 3. Unknown Country 7,875 4% 4. Argentina (AR) 7,870 4% 5. Spain (ES) 6,240 3% 6. Japan (JP) 6,134 3% 7. Canada (CA) 5,985 3% 8. Australia (AU) 4,978 2% 9. France (FR) 4,908 2% 10. India (IN) 4,900 2% 11. China (CN) 4,877 2% 12. Brazil (BR) 4,267 2% 13. Germany (DE) 3,385 2% 14. Chile (CL) 2,688 1% 15. Italy (IT) 2,550 1% 16. Netherlands (NL) 2,458 1% 17. Denmark (DK) 2,375 1% 18. Mexico (MX) 2,157 1% 19. Saudi Arabia (SA) 1,945 1% 20. Taiwan (TW) 1,766 1% 21. Colombia (CO) 1,622 1% 22. Indonesia (ID) 1,440 1% 23. Philippines (PH) 1,389 1% 24. Turkey (TR) 1,273 1% 25. Korea (South) (KR) 1,267 1%

PCCM on Ovid: Activity Trends

-‐

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Sessions/Month Ar2cle views/Month

PCCM on Ovid

2008 (92nd)

2009 (85th)

2010 (74th)

2011 (75th)

PCCM Impact Factor

2.33 2.376 2.672

0

0.5

1

1.5

2

2.5

3

2008 2009 2010

Impact Factor

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

100%

2008 2009 2010

Relative Rank: Critical Care

PCCM

Others

0% 10% 20% 30% 40% 50% 60% 70% 80% 90%

100%

2008 2009 2010

Relative Rank: Pediatrics

PCCM

Others

0.00

0.50

1.00

1.50

2.00

2.50

3.00

2008 2009 2010

2.330 2.376

2.672

ISI Impact Factor

0.00

0.20

0.40

0.60

0.80

1.00

1.20

1.40

2008 2009 2010

0.8980.800

1.272

ISI Immediacy Index

PCCM Advertising •  2011 product print and online advertising revenue was about even

with 2010 •  2011/2012 Print Advertisers

–  Covidien Medela Baxter –  Verathon Transonic –  Teleflex Edwards Lifesciences

•  2011/2012 Online Advertisers –  Baxter Transonic Teleflex MedImmune Verathon

•  2012 Outlook: Advertisers returning in 2012 –  Verathon, Covidien, Medela

•  Classified print and online advertising increased by 13% in 2011.

How can I get involved in SCCM?

To get involved you need to become a member of the Creative Community go to: http://www.sccm.org/Membership/Volunteers/Pages/default.aspx and complete the Committee Application. Committee applications are accepted at any time, however, in order to be eligible to participate on a committee the following year, the deadline date for submitting the committee application is May 30. Notification of appointment will be in September or October. Committee terms will begin at Congress. Once appointed to a committee, the Volunteer Code of Conduct and Conflict of Interest, Assignment of Rights, Disclosure Policy, must be completed and returned to SCCM.


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Now, off to Room 351

Pediatric Year in Review Robert Tasker, MD/ Kurt Stenmark, MD

Good luck Ken!

pediatric section business meeting -...

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