Insights from the PRESSURE Trial by D. Inwald | OPENPediatrics‌

In this World Shared Practice Forum podcast, Dr. David Inwald discusses the findings of the recently published PRESSURE randomized clinical trial. The trial evaluated permissive blood pressure targets for critically ill children receiving mechanical ventilation and vasoactive support compared to usual care. Dr. Inwald reviews the rationale that prompted the study, summarizes the primary and secondary outcomes, and discusses clinical implications of the findings. The host and speaker also explore how these results may influence hemodynamic management and evidence-based decision-making across diverse healthcare settings. LEARNING OBJECTIVES - Describe the rationale for investigating permissive blood pressure targets in pediatric critical care that led to the PRESSURE trial - Analyze the study design, inclusion criteria, intervention strategy, and primary outcomes of the PRESSURE randomized clinical trial - Interpret the trial's findings regarding clinical outcomes, safety measures, and adverse events associated with permissive MAP targeting - Evaluate the implications of the PRESSURE trial findings for pediatric critical care practice across diverse healthcare settings AUTHORS David Inwald, MB, BChir, FRCPCH, PhD Service Director, PICU consultant The Portland Hospital, London Jeffrey Burns, MD, MPH Emeritus Chief Division of Critical Care Medicine Department of Anesthesiology, Critical Care and Pain Medicine Boston Children's Hospital Professor of Anesthesia Harvard Medical School DATE Initial publication date: October 27, 2026. REFERENCES Inwald DP, Laing E, Broomhall JM, et al. Permissive Blood Pressure Targets in Pediatric Critical Care: The PRESSURE Randomized Clinical Trial. JAMA. Published online September 28, 2026. doi:10.1001/jama.2026.19747 Bulgakov, M. (1975). A Country Doctor's Notebook (M. Glenny, Trans.). Oxford University Press. (Original work published 1925–1926) TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/as/44tqhjqtkt7cfwhjcxfnnt6/20261021_WSP_Inwald_Transcript Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open-access thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Inwald D, O’Hara J, Burns JP. Insights from the PRESSURE Trial. 10/2026. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/insights-from-the-pressure-trial-d-inwald-openpediatrics.