Uploaded November 2024 | Updated September 2026, 2 weeks ago
In this World Shared Practice Forum podcast, Dr. Mark Peters discusses the Oxy-PICU trial, published in The Lancet in January 2024, which compared conservative to liberal oxygenation targets in critically ill children. The study highlighted the importance of pragmatic trial design and the need for larger trials to confirm these findings.
LEARNING OBJECTIVES
-Discuss the background driving the investigation of oxygenation in critically ill children
-Summarize the study design of the Oxy-PICU Trial
-Present the outcomes and challenges of the Oxy-PICU Trial
-Identify the key characteristics of pragmatic trial design and the implication of pragmatic trial results
AUTHORS
Mark Peters, MBChB, MRCP, FFICM, FRCPCH, PhD
Professor of Paediatric Intensive Care
NIHR Senior Investigator
UCL Great Ormond St Institute of Child Health
Hon. Consultant Paediatric Intensivist
Paediatric Intensive Care Unit and
Children’s Acute Transport Service
Great Ormond St Hospital
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: November 26, 2024.
ARTICLES REFERENCED AND ADDITIONAL RESOURCES
Peters MJ, Gould DW, Ray S, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial [published correction appears in Lancet. 2024 Jan 27;403(10424):354. doi: 10.1016/S0140-6736(24)00100-4]. Lancet. 2024;403(10424):355-364. pubmed.ncbi.nlm.nih.gov/38048787
Fan E, Del Sorbo L, Goligher EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome [published correction appears in Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum]. Am J Respir Crit Care Med. 2017;195(9):1253-1263. pubmed.ncbi.nlm.nih.gov/28459336
Peters MJ, Ramnarayan P. Randomized Trials to Reduce Clinical Uncertainty: Gold Standard or Fool's Gold?. Pediatr Crit Care Med. 2024;25(8):775-777. pubmed.ncbi.nlm.nih.gov/39101806
Darnell R, Brown A, Laing E, et al. Protocol for a Randomized Controlled Trial to Evaluate a Permissive Blood Pressure Target Versus Usual Care in Critically Ill Children with Hypotension (PRESSURE). Pediatr Crit Care Med. 2024;25(7):629-637. pubmed.ncbi.nlm.nih.gov/38629915
Taccone FS, Rynkowski Bittencourt C, Møller K, et al. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. JAMA.Published online October 09, 2024. pubmed.ncbi.nlm.nih.gov/39382241
Jones GAL, Eaton S, Orford M, et al. Randomization to a Liberal Versus Conservative Oxygenation Target: Redox Responses in Critically Ill Children. Pediatr Crit Care Med. 2023;24(3):e137-e146. pubmed.ncbi.nlm.nih.gov/36728001
UK-ROX: icnarc.org/research-studies/uk-rox
MegaROX: anzics.org/current-active-endorsed-research/mega-rox
ICU-ROX: thebottomline.org.uk/summaries/icm/icu-rox
TRANSCRIPT
cdn.bfldr.com/D6LGWP8S/as/rq7kgwqkh4hk4nk67584pfj/202411_-_WSP_-_Less_is_more_Oxygenation_Targets_in_Critically_Ill_Children_-_Transcript?position=2
Please visit: 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
Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
CITATION
Peters MJ, Burns JP. Less is More: Oxygenation Targets in Critically Ill Children. 11/2024. OPENPediatrics. Online Podcast: youtu.be/f7h2zyNFM0o.
In this World Shared Practice Forum podcast, Dr. Mark Peters discusses the Oxy-PICU trial, published in The Lancet in January 2024, which compared conservative to liberal oxygenation targets in critically ill children. The study highlighted the importance of pragmatic trial design and the need for larger trials to confirm these findings.
LEARNING OBJECTIVES
-Discuss the background driving the investigation of oxygenation in critically ill children
-Summarize the study design of the Oxy-PICU Trial
-Present the outcomes and challenges of the Oxy-PICU Trial
-Identify the key characteristics of pragmatic trial design and the implication of pragmatic trial results
AUTHORS
Mark Peters, MBChB, MRCP, FFICM, FRCPCH, PhD
Professor of Paediatric Intensive Care
NIHR Senior Investigator
UCL Great Ormond St Institute of Child Health
Hon. Consultant Paediatric Intensivist
Paediatric Intensive Care Unit and
Children’s Acute Transport Service
Great Ormond St Hospital
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: November 26, 2024.
ARTICLES REFERENCED AND ADDITIONAL RESOURCES
Peters MJ, Gould DW, Ray S, et al. Conservative versus liberal oxygenation targets in critically ill children (Oxy-PICU): a UK multicentre, open, parallel-group, randomised clinical trial [published correction appears in Lancet. 2024 Jan 27;403(10424):354. doi: 10.1016/S0140-6736(24)00100-4]. Lancet. 2024;403(10424):355-364. pubmed.ncbi.nlm.nih.gov/38048787
Fan E, Del Sorbo L, Goligher EC, et al. An Official American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine Clinical Practice Guideline: Mechanical Ventilation in Adult Patients with Acute Respiratory Distress Syndrome [published correction appears in Am J Respir Crit Care Med. 2017 Jun 1;195(11):1540. doi: 10.1164/rccm.19511erratum]. Am J Respir Crit Care Med. 2017;195(9):1253-1263. pubmed.ncbi.nlm.nih.gov/28459336
Peters MJ, Ramnarayan P. Randomized Trials to Reduce Clinical Uncertainty: Gold Standard or Fool's Gold?. Pediatr Crit Care Med. 2024;25(8):775-777. pubmed.ncbi.nlm.nih.gov/39101806
Darnell R, Brown A, Laing E, et al. Protocol for a Randomized Controlled Trial to Evaluate a Permissive Blood Pressure Target Versus Usual Care in Critically Ill Children with Hypotension (PRESSURE). Pediatr Crit Care Med. 2024;25(7):629-637. pubmed.ncbi.nlm.nih.gov/38629915
Taccone FS, Rynkowski Bittencourt C, Møller K, et al. Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury: The TRAIN Randomized Clinical Trial. JAMA.Published online October 09, 2024. pubmed.ncbi.nlm.nih.gov/39382241
Jones GAL, Eaton S, Orford M, et al. Randomization to a Liberal Versus Conservative Oxygenation Target: Redox Responses in Critically Ill Children. Pediatr Crit Care Med. 2023;24(3):e137-e146. pubmed.ncbi.nlm.nih.gov/36728001
UK-ROX: icnarc.org/research-studies/uk-rox
MegaROX: anzics.org/current-active-endorsed-research/mega-rox
ICU-ROX: thebottomline.org.uk/summaries/icm/icu-rox
TRANSCRIPT
cdn.bfldr.com/D6LGWP8S/as/rq7kgwqkh4hk4nk67584pfj/202411_-_WSP_-_Less_is_more_Oxygenation_Targets_in_Critically_Ill_Children_-_Transcript?position=2
Please visit: 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
Please note: OPENPediatrics does not support or control any related videos in the sidebar; these are placed by YouTube. We apologize for any inconvenience this may cause.
CITATION
Peters MJ, Burns JP. Less is More: Oxygenation Targets in Critically Ill Children. 11/2024. OPENPediatrics. Online Podcast: youtu.be/f7h2zyNFM0o.









![Immunoparalysis and the Future of Personalized Immunotherapy for Critically Ill Children by M. Hall
In this World Shared Practice Forum Podcast, Dr. Mark Hall discusses immunology and inflammation in pediatric sepsis treatment, using immune phenotyping to personalize treatment for pediatric sepsis.
LEARNING OBJECTIVES
Upon listening to this presentation, learners will be able to:
- Recall the history of understanding the inflammatory response in critically ill children
- Identify the distinction between the pro-inflammatory response and the immune paralysis phenomenon
- Describe the study of immune phenotyping to personalize treatment for pediatric sepsis
AUTHORS
Mark W. Hall, MD, FAAP, FCCM
Chief, Division of Critical Care Medicine
Nationwide Childrens Hospital
Professor in the Department of Pediatrics
Division of Critical Care Medicine
Nationwide Childrens Hospital and The Ohio State University College of Medicine
Jeffrey Burns, MD, MPH
Chief and Shapiro Chair, Division of Critical Care Medicine; Executive Chair, International Health Services
Senior Associate in Critical Care Medicine; Department of Anesthesiology, Critical Care and Pain Medicine
Boston Childrens Hospital
Professor of Anesthesia
Harvard Medical School
DATES
Initial publication: November 27, 2023.
ARTICLES REFERENCED
15:48: Cornell TT, Sun L, Hall MW, et al. Clinical implications and molecular mechanisms of immunoparalysis after cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2012;143(5):1160-1166.e1. doi:10.1016/j.jtcvs.2011.09.011
16:10 Collaborative Pediatric Critical Care Research Network, https://www.cpccrn.org/
17:04 VanBuren JM, Hall M, Zuppa AF, et al. The Design of Nested Adaptive Clinical Trials of Multiple Organ Dysfunction Syndrome Children in a Single Study [published online ahead of print, 2023 Jul 27]. Pediatr Crit Care Med. 2023;10.1097/PCC.0000000000003332. doi:10.1097/PCC.0000000000003332
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 and thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu
CITATION
Hall MW, O’Hara JE, Burns JP. Immunoparalysis and the Future of Personalized Immunotherapy for Critically Ill Children. 11/2023. OPENPediatrics. Online Podcast. https://youtu.be/hImZGqcd1Uo. Immunoparalysis and the Future of Personalized Immunotherapy for Critically Ill Children by M. Hall](https://i.ytimg.com/vi/hImZGqcd1Uo/mqdefault.jpg)
