Guidelines and research

Official guidance for paediatric critical care, the evidence behind it, and the latest PICU research.

Open-access systematic reviews, meta-analyses and trials on PICU topics, chosen for relevance and how widely they are cited. Evidence informs guidance but doesn't replace it.

• REstrictive versus StandarD FlUid Management in Mechanically Ventilated ChildrEn Admitted to PICU: a pilot randomized controlled trial (REDUCE-1).Randomised trialPediatric Critical Care Medicine (SCCM/WFPICCS)2026Full text
• High-Frequency Oscillation vs Mechanical Ventilation for Neonatal Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.Randomised trialJAMA Network Open2026Full text
• The Effect of Foot Reflexology Massage on Delirium and Physiological Indicators in Children Admitted to Pediatric Intensive Care Unit: A Randomized Clinical Trial.Randomised trialTheScientificWorldJournal2026Full text
• Laryngeal mask vs. laryngeal tube trial in paediatric patients (LaMaTuPe): a single-blinded, open-label, randomised-controlled trial.Randomised trialEuropean Journal of Emergency Medicine2025Full text
• Intubating laryngeal airway vs. direct laryngoscope: a crossover randomized controlled neonatal manikin trial.Randomised trialItalian Journal of Pediatrics2025Full text
• Management of Ventilator-Associated Pneumonia Caused by Pseudomonas and Acinetobacter Organisms in a Pediatric Center: A Randomized Controlled Study.Randomised trialMedicina (Kaunas)2024Full text
• Low-cost versus high-fidelity pediatric simulators for difficult airway management training: a randomized study in continuing medical education.Randomised trialBrazilian Journal of Anesthesiology (Elsevier)2023Full text
• Video versus direct laryngoscopy to improve the success rate of nasotracheal intubations in the neonatal intensive care setting: a randomised controlled trial.Randomised trialBMJ Paediatrics Open2023Full text
• Comparison of hemodynamic consequences of hand ventilation versus machine ventilation for transportation of post-operative pediatric cardiac patients.Randomised trialAnnals of Cardiac Anaesthesia2023Full text
• The Infant KIdney Dialysis and Utrafiltration (I-KID) Study: A Stepped-Wedge Cluster-Randomized Study in Infants, Comparing Peritoneal Dialysis, Continuous Venovenous Hemofiltration, and Newcastle Infant Dialysis Ultrafiltration System, a Novel Infant Hemodialysis Device.Randomised trialPediatric Critical Care Medicine (SCCM/WFPICCS)2023Full text
• Randomized control study of nebulized colistin as an adjunctive therapy in ventilator-associated pneumonia in pediatric postoperative cardiac surgical population.Randomised trialAnnals of Cardiac Anaesthesia2022Full text
• Visual attention during pediatric resuscitation with feedback devices: a randomized simulation study.Randomised trialPediatric Research (Medical University of Vienna)2022Full text
• Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial.Randomised trialNature Communications2022Full text
• Effects of Early versus Standard Central Line Removal on the Growth of Preterm Infants with Very Low Birth Weight: A Non-Inferiority, Randomized Clinical Trial.Randomised trialNutrients (MDPI)2022Full text
• Efficacy of Smartphone Active and Passive Virtual Reality Distraction vs Standard Care on Burn Pain Among Pediatric Patients: A Randomized Clinical Trial.Randomised trialJAMA Network Open2021Full text
• Randomised controlled trial of oxygen therapy and high-flow nasal therapy in African children with pneumonia.Randomised trialIntensive Care Medicine (COAST trial investigators)2021Full text
• Effectiveness of Targeted Interventions on Treatment of Infants With Bronchiolitis: A Randomized Clinical Trial.Randomised trialJAMA Pediatrics2021Full text
• Hypothermia for moderate or severe neonatal encephalopathy in low-income and middle-income countries (HELIX): a randomised controlled trial in India, Sri Lanka, and Bangladesh.Randomised trialThe Lancet Global Health2021Full text
• Effect of a Mobile App on Prehospital Medication Errors During Simulated Pediatric Resuscitation: A Randomized Clinical Trial.Randomised trialJAMA Network Open2021Full text
• 0.9% saline versus Plasma-Lyte as initial fluid in children with diabetic ketoacidosis (SPinK trial): a double-blind randomized controlled trial.Randomised trialCritical Care (London)2020Over 5 years oldFull text
• The Impact of a Tablet App on Adherence to American Heart Association Guidelines During Simulated Pediatric Cardiopulmonary Resuscitation: Randomized Controlled Trial.Randomised trialJournal of Medical Internet Research2020Over 5 years oldFull text
• In-line filtration in very preterm neonates: a randomized controlled trial.Randomised trialScientific Reports2020Over 5 years oldFull text
• A simulation based difficult conversations intervention for neonatal intensive care unit nurse practitioners: A randomized controlled trial.Randomised trialPLoS One2020Over 5 years oldFull text
• Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial.Randomised trialLancet (NIHR HTA-funded EcLiPSE trial)2019Over 5 years oldFull text
• Comparison of Miller laryngoscope and UEScope videolaryngoscope for endotracheal intubation in four pediatric airway scenarios: a randomized, crossover simulation trial.Randomised trialEuropean Journal of Pediatrics2019Over 5 years oldFull text
• 'Nasal mask' in comparison with 'nasal prongs' or 'rotation of nasal mask with nasal prongs' reduce the incidence of nasal injury in preterm neonates supported on nasal continuous positive airway pressure (nCPAP): A randomized controlled trial.Randomised trialPLoS One2019Over 5 years oldFull text
• Permissive versus restrictive temperature thresholds in critically ill children with fever and infection: a multicentre randomized clinical pilot trial.Randomised trialCritical Care (BioMed Central)2019Over 5 years oldFull text
• Outcomes of Delaying Parenteral Nutrition for 1 Week vs Initiation Within 24 Hours Among Undernourished Children in Pediatric Intensive Care: A Subanalysis of the PEPaNIC Randomized Clinical Trial.Randomised trialJAMA Network Open2018Over 5 years oldFull text
• A Mixed Lipid Emulsion for Prevention of Parenteral Nutrition Associated Cholestasis in Extremely Low Birth Weight Infants: A Randomized Clinical Trial.Randomised trialThe Journal of Pediatrics2018Over 5 years oldFull text
• The minimally effective dose of sucrose for procedural pain relief in neonates: a randomized controlled trial.Randomised trialBMC Pediatrics2018Over 5 years oldFull text
• Preoperative oral thyroid hormones to prevent euthyroid sick syndrome and attenuate myocardial ischemia-reperfusion injury after cardiac surgery with cardiopulmonary bypass in children: A randomized, double-blind, placebo-controlled trial.Randomised trialMedicine (journal)2018Over 5 years oldFull text
• As-needed endotracheal suctioning protocol vs a routine endotracheal suctioning in Pediatric Intensive Care Unit: A randomized controlled trial.Randomised trialColombia Medica (Universidad del Valle) / Hospital Pablo Tobón Uribe2018Over 5 years oldFull text
• FIRST-line support for Assistance in Breathing in Children (FIRST-ABC): a multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in paediatric critical care.Randomised trialCritical Care (BioMed Central)2018Over 5 years oldFull text
• Efficacy of Prophylactic Dexmedetomidine in Preventing Postoperative Junctional Ectopic Tachycardia After Pediatric Cardiac Surgery.Randomised trialJournal of the American Heart Association2017Over 5 years oldFull text
• A comparison of the Airtraq®, McGrath®, and Macintosh laryngoscopes for difficult paediatric intubation: A manikin study.Randomised trialPLoS One2017Over 5 years oldFull text
• Adherence to AHA Guidelines When Adapted for Augmented Reality Glasses for Assisted Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial.Randomised trialJournal of Medical Internet Research2017Over 5 years oldFull text
• A Mobile Device App to Reduce Time to Drug Delivery and Medication Errors During Simulated Pediatric Cardiopulmonary Resuscitation: A Randomized Controlled Trial.Randomised trialJournal of Medical Internet Research2017Over 5 years oldFull text
• Effects of colloid pre-loading on thromboelastography during elective intracranial tumor surgery in pediatric patients: hydroxyethyl starch 130/0.4 versus 5% human albumin.Randomised trialBMC Anesthesiology2017Over 5 years oldFull text
• Phase I randomized clinical trial of N-acetylcysteine in combination with an adjuvant probenecid for treatment of severe traumatic brain injury in children.Randomised trialPLoS One2017Over 5 years oldFull text
• The effect of intraoperative dexmedetomidine on acute kidney injury after pediatric congenital heart surgery: A prospective randomized trial.Randomised trialMedicine (journal)2017Over 5 years oldFull text
• A randomized controlled trial of daily sedation interruption in critically ill children.Randomised trialIntensive Care Medicine2016Over 5 years oldFull text
• The efficacy of pre-emptive dexmedetomidine versus amiodarone in preventing postoperative junctional ectopic tachycardia in pediatric cardiac surgery.Randomised trialAnnals of Cardiac Anaesthesia2016Over 5 years oldFull text
• A randomized trial of Plasma-Lyte A and 0.9 % sodium chloride in acute pediatric gastroenteritis.Randomised trialBMC Pediatrics2016Over 5 years oldFull text
• Does intravenous sildenafil clinically ameliorate pulmonary hypertension during perioperative management of congenital heart diseases in children? - a prospective randomized study.Randomised trialAnnals of Cardiac Anaesthesia2015Over 5 years oldFull text
• Furosemide versus ethacrynic acid in pediatric patients undergoing cardiac surgery: a randomized controlled trial.Randomised trialCritical Care (BioMed Central)2015Over 5 years oldFull text
• Oxygen saturation targets in infants with bronchiolitis (BIDS): a double-blind, randomised, equivalence trial.Randomised trialLancet (BIDS trial, NIHR HTA)2015Over 5 years oldFull text
• The effect of facilitated tucking during endotracheal suctioning on procedural pain in preterm neonates: a randomized controlled crossover study.Randomised trialGlobal Journal of Health Science2014Over 5 years oldFull text
• A randomised controlled trial of an automated oxygen delivery algorithm for preterm neonates receiving supplemental oxygen without mechanical ventilation.Randomised trialActa Paediatrica2014Over 5 years oldFull text
• SABRE: a multicentre randomised control trial of nebulised hypertonic saline in infants hospitalised with acute bronchiolitis.Randomised trialThorax (SABRE trial investigators, UK)2014Over 5 years oldFull text
• Early resuscitation of dengue shock syndrome in children with hyperosmolar sodium-lactate: a randomized single-blind clinical trial of efficacy and safety.Randomised trialCritical Care (BioMed Central)2014Over 5 years oldFull text