30-Second Takeaway
- Preoperative nutritional support sharply reduces early Hirschsprung-associated enterocolitis after pull-through without added harm.
- Automated EEG scoring substantially improves 2-year prognostication in cooled neonates with HIE versus clinical variables alone.
- Prophylactic antiseizure medication strongly associates with fewer early seizures after pediatric TBI, especially in high-risk children.
- Vancomycin monitoring is shifting from trough-based to AUC-based strategies across pediatric ages to limit nephrotoxicity.
- Preterm children, particularly 28–90 days after birth, have markedly higher respiratory hospitalization and mortality than term peers.
Week ending December 20, 2025
Concise updates reshaping perioperative, NICU, hematology, and outpatient pediatric care
Preoperative nutritional support cuts early Hirschsprung-associated enterocolitis after pull-through
In this multicenter randomized trial, 110 children undergoing Hirschsprung pull-through received preoperative nutritional support or standard care. Preoperative nutritional support reduced 3‑month postoperative Hirschsprung-associated enterocolitis from 29.1% to 7.3%, absolute risk reduction 21.8% (p = 0.003). No adverse events were reported from the nutritional intervention, supporting good tolerability. These data support routine assessment and optimization of nutritional status before pull-through to prevent early enterocolitis.
Automated neonatal EEG background score predicts 2-year outcomes in HIE
This secondary analysis of 203 HEAL trial infants evaluated the automated Brain State of the Newborn EEG score for HIE prognosis. Median BSN scores within 24 hours predicted death or severe neurodevelopmental impairment at 2 years, with AUROC 0.90. Adding BSN to clinical variables increased AUROC from 0.79 to as high as 0.93 for death or severe impairment. Automated BSN performance matched expert EEG assessment, suggesting a scalable tool for early counseling and trial stratification.
Prophylactic antiseizure medication linked to fewer early seizures after pediatric TBI
This international observational study followed 697 children with traumatic brain injury across 28 PICUs in 15 countries. Early post-traumatic seizures occurred in 23.1% overall, but only 9.6% with prophylactic antiseizure medication versus 32.1% without. Age ≤ 4 years and Glasgow Coma Scale ≤ 8 independently increased seizure risk. Common prophylactic agents included phenytoin, levetiracetam, and phenobarbital. Despite nonrandomized design, findings strongly support prophylactic therapy in high-risk pediatric TBI to reduce early seizures.
Pediatric vancomycin monitoring is moving from troughs to AUC-based dosing
This Pediatrics review summarizes advances in therapeutic drug monitoring, using vancomycin as the pediatric model. Data show vancomycin troughs poorly predict efficacy or nephrotoxicity in children and neonates. Trough-based strategies increase nephrotoxicity risk without clear clinical benefit. Infectious diseases and pharmacy societies now recommend AUC-guided vancomycin monitoring in all pediatric age groups. The article outlines pharmacokinetic modeling and flexible sampling approaches to implement AUC-guided monitoring in practice.
References
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Additional Reads
Optional additional studies from this edition.