Pediatric Emergency Research Network (PERN) Update

The clinician researchers in PERN are looking forward to attending the ICEM 2024 conference in Taipei. We will have a presentation updating on the key PERN studies.

  • PERN PROMPT BOLUS study (PRagMatic Pediatric Trial of Balanced vs nOrmaL Saline FlUid in Sepsis)  - Fran Balamuth, Scott Weiss, Nate Kuppermann (led by PECARN, includes PREDICT and PERC)

This open label RCT comparing two different intravenous fluids (normal saline and balanced fluids like lactated Ringer's lactate or Plasmalyte) in sepsis is enrolling at 40 EDs across the US, Canada, New Zealand and Australia. Enrolment is going very well with 5360 of 8800 children with possible sepsis enrolled. 


  • PERN Predicting Severe Pneumonia- Community Acquired Pneumonia -Todd Florin & Nate Kuppermann (led by PECARN, includes multiple networks and individual institutions)

This prospective cohort study of children 3 mo to <14 years with community-acquired pneumonia is at the final analysis and write up stage. Initial data were presented at PAS Pediatric Academic Societies 2023.


  • PERN study on sedation and analgesia in Intussusception- Itai Shavit (led by REPEM and including multiple networks). 
    This cross-sectional study reviewed medical records of children aged 4 to 48 months with attempted reduction of ileocolic intussusception at 86 pediatric tertiary care institutions in 14 countries.

3203 patients included.  Main conclusions as published below in JAMA Network Open: “This cross-sectional study of pediatric ileocolic intussusception found that more than two-thirds of patients received neither analgesia nor sedation. Neither was associated with intestinal perforation or failed reduction, challenging the widespread practice of withholding analgesia and sedation for reduction of ileocolic intussusception in children.”


Recent paper:

  • Poonai N, Cohen DM, MacDowell D, Mistry RD, Mintegi S, Craig S, Roland D, Miller M, Shavit I; Paediatric Emergency Research Networks (PERN) PAINT Study Group.Sedation and Analgesia for Reduction of Pediatric Ileocolic Intussusception.

JAMA Netw Open. 2023 Jun 1;6(6):e2317200. doi: 10.1001/jamanetworkopen.2023.17200.PMID: 37285152


  • Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study- Amy Plint (led by PERC, includes PREDICT)

Placebo controlled RCT assessing steroids and adrenaline in bronchiolitis to reduce hospitalisation at 7 days. It aims to enrol infants aged > 60 days and < 12 months with 680 of 864 children enrolled so far. May complete study this year.


  • PERN Asthma outcomes projectSimon Craig (led by PREDICT, includes multiple networks).

Multistage mixed methods approach to assess how to best measure outcomes in asthma studies. A number of the projects have been completed and Simon is about to submit his PhD on asthma in children!


Recent papers 

  • Craig S, Collings M, Gray C, Benito J, Velasco R, Lyttle MD, Roland D, Schuh S, Shihabuddin B, Kwok M, Mahajan P, Johnson M, Zorc J, Khanna K, Fernandes R, Yock-Corrales A, Santhanam I, Cheema B, Ong GY, Jaiganesh T, Powell C, Nixon G, Dalziel S, Babl FE, Graudins A.
    Analysis of guideline recommendations for treatment of asthma exacerbations in children: a Pediatric Emergency Research Networks (PERN) study.Arch Dis Child. 2024 Feb 7:archdischild-2023-326739


  • Craig S, Xu Y, Robas K, Iramain R, Yock-Corrales A, Soto-Martinez ME, Rino P, Belen Alvarez Ricciardi M, Piantanida S, Mahant S, Ubuane PO, Odusote O, Kwok M, Johnson MD, Paniagua N, Benito Fernandez J, Ong GY, Lyttle MD, Gong J, Roland D, Dalziel SR, Nixon GM, Powell CVE, Graudins A, Babl FE; Pediatric Emergency Research Networks (PERN).

Core outcomes and factors influencing the experience of care for children with severe acute exacerbations of asthma: a qualitative study. BMJ Open Respir Res. 2023 Nov;10(1):e001723. doi: 10.1136/bmjresp-2023-001723