A5102962459- Respiratory Support and Mechanisms
- Airway Management and Intubation Techniques
- Neonatal Respiratory Health Research
- Tracheal and airway disorders
- Sepsis Diagnosis and Treatment
- Hemodynamic Monitoring and Therapy
- Cardiac Arrest and Resuscitation
- Neuroscience of respiration and sleep
- Congenital Diaphragmatic Hernia Studies
- Obstructive Sleep Apnea Research
- Renal function and acid-base balance
- Emergency and Acute Care Studies
- Family and Patient Care in Intensive Care Units
- Anesthesia and Sedative Agents
- Nosocomial Infections in ICU
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Cardiac, Anesthesia and Surgical Outcomes
- Healthcare Technology and Patient Monitoring
- Congenital Heart Disease Studies
- Mechanical Circulatory Support Devices
- Respiratory viral infections research
- Ultrasound in Clinical Applications
- Intensive Care Unit Cognitive Disorders
- Pneumothorax, Barotrauma, Emphysema
- Thermal Regulation in Medicine
Children's Hospital of Los Angeles
2016-2025
University of Southern California
2016-2025
Driscoll Children's Hospital
2014
Radboud University Nijmegen
2014
Radboud University Medical Center
2014
Southern California University for Professional Studies
2012
University of California, San Francisco
1999-2004
University of Montana
2004
Northwestern University
2004
Lucile Packard Children's Hospital
1994
Endothelial nitric oxide synthase (eNOS) is active only as a homodimer. Recent data has demonstrated that exogenous NO can act an inhibitor of eNOS activity both in intact animals and vascular endothelial cells. However, the exact mechanism by which exerts its inhibitory action unclear. Our initial experiments bovine aortic cells indicated decreased NOS with associated decrease dimer levels. We then undertook series studies to investigate disruption. Exposure purified human protein donors or...
Objective: Given pulse oximetry is increasingly substituting for arterial blood gas monitoring, noninvasive surrogate markers lung disease severity are needed to stratify pediatric risk. We sought validate prospectively the comparability of SpO2/Fio2 PaO2/Fio2 and oxygen saturation index oxygenation in children. also derive a injury score. Design: Prospective, multicentered observational study six intensive care units. Patients: One hundred thirty-seven mechanically ventilated children with...
High-flow humidified nasal cannula is often used to provide noninvasive respiratory support in children. The effect of high-flow on effort breathing children has not been objectively studied, and the mechanism by which provided remains unclear. This study uses an objective measure (Pressure. Rate Product) evaluate critically ill children.Prospective cohort study.Quaternary care free-standing academic children's hospital.ICU patients younger than 18 years receiving or whom medical team...
For children with cyanotic congenital heart disease or acute hypoxemic respiratory failure, providers frequently make decisions based on pulse oximetry, in the absence of an arterial blood gas. The study objective was to measure accuracy oximetry saturations from (SpO2) range 65% 97%.This institutional review board-approved prospective, multicenter observational 5 PICUs included 225 mechanically ventilated catheter. With each gas sample, SpO2 and oxygen CO-oximetry (SaO2) were simultaneously...
Rationale: Subglottic edema is the most common cause of pediatric extubation failure, but few studies have confirmed risk factors or prevention strategies. This may be due to subjective assessment stridor inability differentiate supraglottic from subglottic disease.Objectives: Objective 1 was assess utility calibrated respiratory inductance plethysmography (RIP) and esophageal manometry identify clinically significant post-extubation upper airway obstruction (UAO) UAO. 2 for UAO, stratified...
BACKGROUND AND OBJECTIVES: Childhood obesity is epidemic and may be associated with PICU mortality. Using a large multicenter database, we investigated the association between mortality, adjusting for initial severity of illness. We further whether height- weight-based classifications compared classification alone alter mortality distribution. METHODS: This retrospective analysis used prospectively collected data from Virtual Systems database. Height, weight, age, gender were to calculate z...
In the United States and Canada, severe asthma requiring mechanical ventilation has declined over past decade reflecting a rise in noninvasive therapies. When aggressive therapies fail, endotracheal intubation are lifesaving should be planned for advance. As speed is important, most experienced practitioner intubate rapid correction of hypercarbia respiratory acidosis avoided. An elevated minute may cause pulmonary hyperinflation leading to air-leak syndrome and/or hemodynamic instability....
Volumetric capnography dead-space measurements (physiologic dead-space-to-tidal-volume ratio [VD/VT] and alveolar VD/VT) are considered more accurate than the readily available time-based measurement (end-tidal fraction [AVDSF]). We sought to investigate correlation between volumetric measurements.This was a single-center prospective cohort study of 65 mechanically ventilated children with arterial lines. Physiologic VD/VT, AVDSF were calculated each blood gas using data.We analyzed 534...
Current knowledge of the impact socioeconomic factors on risk admission to pediatric intensive care unit (PICU) for asthma is limited. Using composite measures social vulnerability-Social Vulnerability Index (SVI) and Child Opportunity (COI) 2.0-we compared patients admitted status asthmaticus PICU ward at Children's Hospital Los Angeles (CHLA). We hypothesized with a high SVI low COI are higher admission.
Summary Introduction Propofol is an effective sedative for magnetic resonance imaging. Nevertheless, it may cause hemodynamic and respiratory complications in a dose dependent fashion. We investigated the role of low‐dose dexmedetomidine (0.5 μg/kg) as adjuvant to propofol sedation children undergoing hypothesized that would decrease required, airway complications, instability. Methods performed retrospective chart review patients’ age 1 month 20 years. Children were divided into 2 groups;...
Accurate prediction of time to death after withdrawal life-sustaining therapies may improve counseling for families and help identify candidates organ donation cardiac death. The study objectives were to: 1) train a long short-term memory model predict within 1 hour terminal extubation, 2) calculate the positive predictive value number needed alert among potential donors, 3) examine associations between patient's characteristics physiologic variables using Cox regression.Retrospective cohort...
Summary Background The GlideScope Cobalt Video laryngoscope is being used more often in children with challenging laryngoscopy. There are, however, no pediatric trials comparing it to flexible fiberoptic bronchoscopy, the current accepted gold standard. This preliminary manikin study compares first‐attempt intubation success of video bronchoscope when performed by attending anesthesiologists at two major centers. Methods prospective randomized, crossover evaluated 120 attempts (60 each...
Objective Describe the likelihood of hypoxemia and hyperoxemia across ranges oxygen saturation (SpO 2 ), during mechanical ventilation with supplemental oxygenation. Design Retrospective observational study. Setting University affiliated tertiary care neonatal intensive unit. Patients Two groups neonates based on postmenstrual age (PMA): <32 weeks (n=104) >36 (n=709). Main measures Hypoxemia was defined as a PaO <40 mm Hg, >99 Hg normoxemia 50–80 Hg. Twenty-five per cent marked...
Abstract Background Continuous monitoring of SpO 2 in the neonatal ICU is standard care. Changes exposure have been shown to markedly impact outcome, but limiting extreme episodes an arduous task. Much more complicated than setting alarm policy, it fraught with balancing fatigue and compliance. Information on optimum strategies limited. Methods This a retrospective observational study intended describe relative chance normoxemia, risks hypoxemia hyperoxemia at relevant levels ICU. The data,...