ReviewInternational journal of emergency medicine2026
Vital signs as biomarkers of early clinical deterioration in pediatric emergency departments: physiology, interpretation, and innovations: a narrative review.
Review in International journal of emergency medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Care Pathway and Outcomes in Pediatric Septic Shock: A Narrative Review from Emergency Department Recognition to PICU Management.Children (Basel, Switzerland) · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly recognition of pediatric deterioration is difficult because age-dependent physiology and compensation mask early shock and safety risks. This narrative review compares vital-sign (VS) biomarkers (heart rate, respiratory rate, blood pressure, oxygen saturation, temperature) with laboratory markers and clinical indicators.
methodsWe searched Embase, Pubmed, and guideline repositories to August 2025 for pediatric studies from emergency, inpatient, and critical-care settings. We summarized accuracy, timeliness, and implementation issues, prioritizing cohort and implementation evaluations.
resultsAge-adjusted, repeated, and continuous analyses of VS—especially multivariate approaches such as shock index pediatric age-adjusted and heart-rate-characteristics analytics—outperformed single thresholds, often anticipating ICU transfer or sepsis by hours. Laboratory biomarkers provided diagnostic specificity for defined syndromes but were slower and unsuitable for continuous surveillance. Composite scores (e.g., PEWS, ED-PEWS, National PEWS) showed moderate to high discrimination yet performed best when integrated with trends and standardized escalation pathways.
conclusionVS biomarkers, leveraged as dynamic trends and combined with context, enable earlier, safer detection of pediatric deterioration than static thresholds or isolated laboratory tests. Priorities include validating continuous models beyond NICUs, ensuring equity and calibration across different ages and comorbidities, and testing wearable sensors and EHR-embedded alerts in pragmatic trials that measure timeliness, unintended harms, and patient-centered outcomes. CLINICAL TRIAL NUMBER: Not applicable.
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