Under Pressure: The Pulmonary Vasculature and Its Role in the Pediatric Cardiac ICU

In their study, Morell et al provide a thoughtful and systematic analysis of risk of mortality in 1,709 neonates, children, and young adults (2,602 medical admissions) with PH who received care in 38 North American pediatric cardiac ICUs (PCICU) between 2014 and 2019. Their findings lend granularity, a new venue, and eye-opening follow up to previous cautionary notes in the literature regarding the fragility of children with pulmonary vascular diseases of various etiologies. However, details of the specific vasoactive agents that were used in the cases under study are not listed in detail. In summary, Morell et al, in what is a first look at patients with PH admitted to PCICUs, bring to light the challenges and risks these patients face as a result of their PH. This work shows the formidable effect pulmonary vascular disease can have on outcomes and the role various therapeutic interventions may have on mortality risk.