A5041017359- Cardiac Arrest and Resuscitation
- Mechanical Circulatory Support Devices
- Congenital Heart Disease Studies
- Respiratory Support and Mechanisms
- Sepsis Diagnosis and Treatment
- Neonatal Respiratory Health Research
- Transplantation: Methods and Outcomes
- Pulmonary Hypertension Research and Treatments
- Hemodynamic Monitoring and Therapy
- Intensive Care Unit Cognitive Disorders
- Family and Patient Care in Intensive Care Units
- Emergency and Acute Care Studies
- Congenital Diaphragmatic Hernia Studies
- Viral Infections and Immunology Research
- Electrolyte and hormonal disorders
- Social Sciences and Policies
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Cardiovascular Issues in Pregnancy
- Cardiac Ischemia and Reperfusion
- Ultrasound in Clinical Applications
- Palliative Care and End-of-Life Issues
- Cardiac, Anesthesia and Surgical Outcomes
- Clinical Nutrition and Gastroenterology
- Grief, Bereavement, and Mental Health
- Cardiac Structural Anomalies and Repair
Children's National
2015-2024
George Washington University
1999-2024
University of Groningen
2016-2023
University Medical Center Groningen
2016-2023
Pennsylvania State University
2022
Berger (Canada)
2015-2018
Johns Hopkins University
2018
Children's Hospital of Philadelphia
2011-2018
University of Pennsylvania
2018
University of Utah
2012-2018
Therapeutic hypothermia is recommended for comatose adults after witnessed out-of-hospital cardiac arrest, but data about this intervention in children are limited.We conducted trial of two targeted temperature interventions at 38 children's hospitals involving who remained unconscious arrest. Within 6 hours the return circulation, patients were older than 2 days and younger 18 years age randomly assigned to therapeutic (target temperature, 33.0°C) or normothermia 36.8°C). The primary...
Extracorporeal membrane oxygenation (ECMO) is used for respiratory and cardiac failure in children but complicated by bleeding thrombosis.(1) To measure the incidence of (blood loss requiring transfusion or intracranial hemorrhage) thrombosis during ECMO support; (2) to identify factors associated with these complications; (3) determine impact complications on patient outcome.This was a prospective, observational cohort study pediatric, cardiac, neonatal intensive care units eight hospitals,...
Objective: To investigate significant new morbidities associated with pediatric critical care. Design: Randomly selected, prospective cohort. Setting: PICU patients from eight medical and cardiac PICUs. Patients: This was a randomly cohort of Measurements Main Results: The main outcomes measures were hospital discharge functional status measured by Functional Status Scale scores morbidity defined as an increase in the more than or equal to 3. Of 5,017 patients, there 242 (4.8%), 99 deaths...
Targeted temperature management is recommended for comatose adults and children after out-of-hospital cardiac arrest; however, data on in-hospital arrest are limited.In a trial conducted at 37 children's hospitals, we compared two interventions in who had arrest. Within 6 hours the return of circulation, older than 48 younger 18 years age were randomly assigned to therapeutic hypothermia (target temperature, 33.0°C) or normothermia 36.8°C). The primary efficacy outcome, survival 12 months...
Severity of illness measures have long been used in pediatric critical care. The Pediatric Risk Mortality is a physiologically based score to quantify physiologic status, and when combined with other independent variables, it can compute expected mortality risk morbidity risk. Although the ranges for variables not changed, recent data collection improvements made adapt new practice patterns, minimize bias, reduce potential sources error. These include changing outcome hospital survival/death...
Objective: Changes in technology and increased reports of successful extracorporeal life support use patient populations, such as influenza, cardiac arrest, adults, are leading to expansion support. Major limitations remain bleeding thrombosis. These complications the most frequent causes death morbidity. As a pilot project provide baseline data for detailed evaluation thrombosis current era, patients were analyzed from eight centers Eunice Kennedy Shriver National Institute Child Health...
To determine the incidence of cardiopulmonary resuscitation in PICUs and subsequent outcomes.Multicenter prospective observational study children younger than 18 years old randomly selected intensively followed from PICU admission to hospital discharge Collaborative Pediatric Critical Care Research Network December 2011 April 2013.Among 10,078 enrolled, 139 (1.4%) received for more or equal 1 minute and/or defibrillation. Of these children, 78% attained return circulation, 45% survived...
Functional status assessment methods are important as outcome measures for pediatric critical care studies.To investigate the relationships between 2 functional appropriate large-sample studies, Status Scale (FSS) and Pediatric Overall Performance Category Cerebral (POPC/PCPC) scales.Prospective cohort study with random patient selection at 7 sites 8 children's hospitals general/medical cardiac/cardiovascular intensive units (PICUs) in Collaborative Critical Care Research Network....
Assessments of care including quality assessments adjusted for physiological status should include the development new morbidities as well mortalities. We hypothesized that morbidity, like mortality, is associated with dysfunction and could be predicted simultaneously mortality.Prospective cohort study from December 4, 2011, to April 7, 2013.General cardiac/cardiovascular PICUs at seven sites.Randomly selected PICU patients their first admission.None.Among 10,078 admissions, unadjusted...
On the basis of laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, American Heart Association recommends using to guide pediatric CPR. However, evidence-based targets CPR remain an important knowledge gap for guidelines.
The aim of this study was to evaluate the relative frequency pediatric in-hospital cardiopulmonary resuscitation events occurring in ICUs compared general wards. We hypothesized that proportion provided versus wards has increased over past decade, and shift is associated with improved outcomes.Prospective observational study.Total 315 hospitals American Heart Association's Get With Guidelines-Resuscitation database.Total 5,870 between January 1, 2000 September 14, 2010. Cardiopulmonary were...
Pertussis persists in the United States despite high immunization rates. This report characterizes presentation and acute course of critical pertussis by quantifying demographic data, laboratory findings, clinical complications, care therapies among children requiring admission to PICU.Prospective cohort study.Eight PICUs comprising Eunice Kennedy Shriver National Institute for Child Health Human Development Collaborative Pediatric Critical Care Research Network 17 additional across...
Introduction: Cardiac resynchronization therapy (CRT) has been demonstrated to result in clinical improvement older adult patients with dilated cardiomyopathy (DCM), specifically those left bundle branch block and prolonged QRS duration. We sought demonstrate the benefits of CRT on cardiac function outcome young that developed congestive heart failure (CHF) DCM following pacing for AV block. Methods Results: reviewed charts six who CHF or low output symptoms implantation right ventricular...
We previously demonstrated that parents whose children die in a pediatric intensive care unit (PICU) have high level of complicated grief symptoms 6 months after the death. In this study, we investigate change extent among these between and 18 postdeath identify factors predicting improvement.One hundred thirty-eight 106 completed surveys at months. Surveys included Inventory Complicated Grief (ICG), measures avoidance, attachment, caregiving social support, demographics. Multivariable...
To describe pediatric severe asthma care, complications, and outcomes to plan for future prospective studies by the Collaborative Pediatric Critical Care Research Network.Retrospective cohort study.: intensive care units in United States that submit administrative data Health Information System.Children 1-18 yrs old treated a System unit during 2004-2008.None.Thirteen-thousand five-hundred fifty-two children were studied; 2,812 (21%) Network 10,740 (79%) non-Collaborative unit. Medication...
Sepsis is common in children and often results cardiac dysfunction. Assessment of patients with sepsis-associated myocardial depression using ejection fraction fractional shortening conventional echocardiography load dependent reveals dysfunction only after clinical deterioration has occurred. Speckle tracking imaging a novel technology that can assess deformation strain by displacement acoustic markers the myocardium. We hypothesize speckle will detect impairments during sepsis are not...
Nosocomial infection/sepsis occurs in up to 40% of children requiring long-term intensive care. Zinc, selenium, glutamine, metoclopramide (a prolactin secretalogue), and/or whey protein supplementation have been effective reducing infection and sepsis other populations. We evaluated whether daily nutriceutical with zinc, metoclopramide, compared protein, would reduce the occurrence nosocomial this at-risk population.Randomized, double-blinded, comparative effectiveness trial.Eight pediatric...
To determine if development of an extracorporeal cardiopulmonary resuscitation simulation program reduced times in real patients: Before-after study.Twenty-six bed pediatric cardiac ICU a tertiary urban hospital.Forty-three patients (aged 1 d to 16 yr) who received resuscitation.An interdisciplinary team collaborated define the roles and clarify responsibilities each individual involved resuscitation. An "ideal rapid deployment" was defined tested using sessions. This included task analysis,...
To examine the clinical factors associated with increased opioid dose among mechanically ventilated children in pediatric intensive care unit.Prospective, observational study 100% accrual of eligible patients.Seven units from tertiary-care children's hospitals Collaborative Pediatric Critical Care Research Network.Four hundred nineteen treated morphine or fentanyl infusions.None.Data on use, concomitant therapy, demographic and explanatory variables were collected. Significant variability...