Background: The use of continuous glucose monitoring (CGM) in pediatric patients with diabetic ketoacidosis (DKA) remains investigational, and data on its accuracy in pediatric intensive care units (PICU) are limited. This study evaluated the accuracy of three CGM devices in pediatric patients with DKA in the PICU. Methods: We compared 399 matched pairs of CGM and point-of-care capillary glucose (POC) values and grouped patients based on whether they changed their CGM sensor during their PICU stay. Results: Eighteen patients with a mean age of 10.98 ± 4.20 years were included, with three patients in the sensor change group. The overall mean absolute relative difference (MARD) was 13.02%. The Medtronic Guardian Sensor 3 ( n = 331), Dexcom G6 ( n = 41), and Abbott FreeStyle Libre 1 ( n = 27) showed MARD values of 13.40%, 11.12%, and 11.33%, respectively. The surveillance error grid (SEG), Bland–Altman plot, and Pearson's correlation coefficient demonstrated satisfactory clinical accuracy of the CGM devices (SEG zones A and B, 98.5%; mean difference, 15.5 mg/dL; Pearson's correlation coefficient [ r ² ], 0.76, P < 0.0001). MARD was significantly lower in subjects who did not experience a sensor change (11.74% vs. 17.31%, P = 0.048). Also, a statistically significant negative correlation was found between serum bicarbonate levels and POC–CGM values ( r = −0.34, P < 0.001). Conclusions: The severity of DKA has a major effect on reducing the accuracy of the CGM, especially during the first several days in the intensive care unit. The reduced accuracy appears to be related to acidosis, as reflected in the serum bicarbonate levels.

Background: Although the outcome of cardiopulmonary resuscitation (CPR) is still unsatisfactory, there are few studies about temporal trends of in‐hospital CPR incidence and mortality. We aimed to evaluate nationwide trends of in‐hospital CPR incidence and its associated risk factors and mortality in pediatric patients using a database of the Korean National Health Insurance between 2012 and 2018. Methods and Results: We excluded neonates and neonatal intensive care unit admissions. Incidence of in‐hospital pediatric CPR was 0.58 per 1000 admissions (3165 CPR/5 429 471 admissions), and the associated mortality was 50.4%. Change in CPR incidence according to year was not significant in an adjusted analysis ( P =0.234). However, CPR mortality increased significantly by 6.6% every year in an adjusted analysis ( P <0.001). Hospitals supporting pediatric critical care showed 37.7% lower odds of CPR incidence ( P <0.001) and 27.5% lower odds of mortality compared with other hospitals in the adjusted analysis ( P <0.001), and they did not show an increase in mortality ( P for trend=0.882). Conclusions: Temporal trends of in‐hospital CPR mortality worsened in Korea, and the trends differed according to subgroups. Study results highlight the need for ongoing evaluation of CPR trends and for further CPR outcome improvement among hospitalized children.

Choi J, et al. J Korean Med Sci. 2023 May;38(23):e178. https://doi.org/10.3346/jkms.2023.38.e178

Park S, et al. J Korean Med Sci. 2022 Jun;37(24):e192. https://doi.org/10.3346/jkms.2022.37.e192

Purpose: We aimed to evaluate the clinical features of adolescents who visit emergency departments (EDs) with chest discomfort, and analyze the implications of underlying medical conditions for the development of cardiogenic chest discomfort. Methods: We reviewed the medical records of adolescents (13-18 years) with chest discomfort who visited a tertiary hospital ED in Seoul, Korea from 2014 through 2018. Sex, age, duration and character of the discomfort, symptoms and signs, ED length of stay, abnormal findings of vital signs, chest radiograph, electrocardiogram, and elevated concentrations of cardiac enzymes were reviewed. Final diagnosis was based on cardiac