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Children
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Treatment and Management of Cardiopulmonary Failure in the Pediatric Population
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Treatment and Management of Cardiopulmonary Failure in the Pediatric Population

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Cardiology".

Deadline for manuscript submissions: 10 November 2026 | Viewed by 2707

Editor

Dr. Ranjit Philip

E-Mail Website
Guest Editor
LeBonheur Children’s Hospital, University of Tennessee, 51 North Dunlap St., Memphis, TN 38104, USA
Interests: patent ductus arteriosus; pulmonary hypertension; preterm infant; congestive heart failure; pediatrics; neonatology; surgical ligation of pda; trans-catheter pda closure; pulmonary vascular resistance
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Cardiopulmonary failure in the pediatric population, driven by congenital heart disease, cardiomyopathy, acute myocarditis, severe respiratory failure, sepsis, and post-cardiac surgery complications, remains a leading cause of morbidity and mortality. Advances in ventilation strategies, extracorporeal life support (ECLS/ECMO), pediatric ventricular assist devices (VADs), pulmonary hypertension therapies, and perioperative critical care are rapidly changing outcomes. The Special Issue will synthesize current evidence, highlight innovations, address resource variability, and set priorities for research and practice across neonates through adolescents.

Dr. Ranjit Philip
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2400 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • heart transplant
  • myocarditis
  • cardiomyopathy
  • tracorporeal life support (ECMO)
  • pulmonary hypertension

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Published Papers (2 papers)

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Research

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12 pages, 2130 KB  
Article
Implementation of Paediatric Life Support Recommendations: A Survey in the D-A-CH Region
by Franziska Markel, Bettina Lück, Michael Sasse, Philipp Jung, Florian Hoffmann, Ellen Heimberg, Martin Olivieri, Sebastian Brenner, Bernd Landsleitner, Francesco Cardona, Eva Maria Jordi-Ritz and Benjamin W. Ackermann
Children 2026, 13(8), 986; https://doi.org/10.3390/children13080986 - 24 Jul 2026
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Abstract
Background: Implementing recommendations to improve in-hospital resuscitation is a complex process. The extent to which an advisory statement formulating ten theses to improve resuscitation quality in paediatrics is applied in clinical practice across Germany, Austria, and Switzerland (D-A-CH-region) remains unclear. Methods: A web-based [...] Read more.
Background: Implementing recommendations to improve in-hospital resuscitation is a complex process. The extent to which an advisory statement formulating ten theses to improve resuscitation quality in paediatrics is applied in clinical practice across Germany, Austria, and Switzerland (D-A-CH-region) remains unclear. Methods: A web-based cross-sectional survey was conducted among paediatric physicians in the D-A-CH region between November 2022 and May 2023, comprising 50 questions focusing on experience and safety in paediatric emergency management and on the structural conditions at hospitals required to implement the ten theses. Ethics approval was obtained from the Ethics Committee Leipzig, Germany (218/19-ek). Results: Structural recommendations were implemented to varying and often limited degrees: An emergency telephone chain was available in 91% of workplaces, 19% had a Paediatric Early Warning System, and 38% had a designated resuscitation supervisor. Although in-house training was available to 89% of respondents, 31% had not participated in in-house training in the preceding 12 months, and 37% had not attended a certified resuscitation course in the last five years. A total of 48% of respondents reported that structured debriefings following emergency events were rarely or never conducted. Internal guidelines for post-resuscitation care were available in 26% of institutions. Only seven respondents (less than 1%) worked in a setting where all the recommendations surveyed were in place. No significant differences were observed according to hospital size or type. Conclusions: Structural implementation of paediatric resuscitation recommendations remains markedly inadequate across the D-A-CH region, with likely multifactorial causes that are not yet fully understood. Full article
(This article belongs to the Special Issue Treatment and Management of Cardiopulmonary Failure in the Pediatric Population)
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Review

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18 pages, 861 KB  
Review
Sotatercept in Children with Pulmonary Hypertension—A Narrative Review
by Johanna Schulz, Veronika C. Stark, Lars Harbaum, Rainer Kozlik-Feldmann, Thomas S. Mir, Fridrike Stute and Jakob Olfe
Children 2026, 13(4), 465; https://doi.org/10.3390/children13040465 - 28 Mar 2026
Cited by 1 | Viewed by 1959
Abstract
Background/Objectives: Pulmonary arterial hypertension (PAH) is a rare but life-threatening disease that presents particular therapeutic challenges in children. It is characterized by pulmonary vasoconstriction and vascular remodeling, leading to right ventricular strain and eventually right heart failure. Although advances in pharmacotherapy have improved [...] Read more.
Background/Objectives: Pulmonary arterial hypertension (PAH) is a rare but life-threatening disease that presents particular therapeutic challenges in children. It is characterized by pulmonary vasoconstriction and vascular remodeling, leading to right ventricular strain and eventually right heart failure. Although advances in pharmacotherapy have improved outcomes, treatment options remain limited. This review aims to evaluate the potential role of sotatercept, a novel fusion protein recently approved for adult PAH, and to assess the translatability of adult data to the pediatric population. Methods: A narrative synthesis of preclinical studies and randomized controlled trials was conducted to summarize the current evidence on sotatercept. In addition, pathophysiological, developmental, and therapeutic differences between adult and pediatric PAH were critically examined to assess relevance and applicability to younger patients. Results: Clinical trials in adults (PULSAR, STELLAR, ZENITH, HYPERION) confirm sotatercept’s efficacy on background therapy, with significant reductions in pulmonary vascular resistance, improvements in 6 min walk distance, enhanced right ventricular function, and risk reductions in clinical worsening events. However, extrapolation to pediatric PAH faces challenges including etiological differences (e.g., PAH-CHD predominance, PPHN in infants), age-inappropriate endpoints (e.g., 6MWD infeasible in young children), variable growth-related pharmacokinetics, and compensatory RV physiology delaying overt failure. Safety concerns are manageable in adults but raise pediatric-specific alarms: activin inhibition’s theoretical tumorigenic potential (dual tumor suppressor/promoter role), pubertal/fertility disruption (FSH suppression, gonadal maturation delay), and skeletal growth interference—unproven clinically yet demanding long-term monitoring. The ongoing MOONBEAM trial will provide initial pharmacokinetic/safety data in children. Conclusions: Sotatercept represents a promising, first-in-class therapeutic option for PAH with the potential to transform disease management. Nevertheless, dedicated pediatric studies are crucial to confirm safety, efficacy, and appropriate dosing and to define its role in the long-term treatment of children with PAH. Full article
(This article belongs to the Special Issue Treatment and Management of Cardiopulmonary Failure in the Pediatric Population)
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