A5045874151- Mechanical Circulatory Support Devices
- Cardiac Arrest and Resuscitation
- Congenital Heart Disease Studies
- Antibiotics Pharmacokinetics and Efficacy
- Respiratory Support and Mechanisms
- Family and Patient Care in Intensive Care Units
- Pneumonia and Respiratory Infections
- Cardiac, Anesthesia and Surgical Outcomes
- Platelet Disorders and Treatments
- Disaster Response and Management
- Blood disorders and treatments
- Antimicrobial Resistance in Staphylococcus
- Congenital heart defects research
- Viral Infections and Outbreaks Research
- Central Venous Catheters and Hemodialysis
- Simulation-Based Education in Healthcare
- Anesthesia and Neurotoxicity Research
- Neonatal Respiratory Health Research
- Anesthesia and Sedative Agents
- Cardiac Structural Anomalies and Repair
- Airway Management and Intubation Techniques
- Blood Coagulation and Thrombosis Mechanisms
- Connective tissue disorders research
- Cardiac Ischemia and Reperfusion
- Sepsis Diagnosis and Treatment
University of Pennsylvania
1995-2023
Children's Hospital of Philadelphia
2020-2023
Philadelphia University
2023
Children's National
2012-2017
Hartford Hospital
2012
St. Christopher's Hospital for Children
2012
National Medical Center
2012
Drexel University
2008
Doctors Hospital
2007
Monroe Carell Jr. Children's Hospital
2005-2006
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,...
Piperacillin/tazobactam is a frequently prescribed antibiotic in pediatric intensive care units, but pharmacokinetic data to justify the optimal piperacillin/tazobactam dosing regimen are sparse critically ill children.Blood samples (2-4 per child) were collected from 13 children ages 9 months 6 years admitted unit who receiving standard regimens treat infections. Piperacillin concentrations measured by bioassay, and population pharmacokinetics of piperacillin component was conducted using...
To report a case of late presentation alveolar capillary dysplasia and misalignment pulmonary veins.Descriptive report.Pediatric intensive care unit tertiary children's hospital.Seven-week-old female infant with severe hypoxemic respiratory failure.Alveolar veins is cause primary hypertension in newborns that can rarely present past the newborn period. Early lung biopsy be helpful establishing diagnosis avoiding ineffective, futile, expensive therapeutic interventions.
To determine if a higher serum vancomycin (Vt) target trough concentration of 15-20 μg/ml or greater is associated with an increased rate vancomycin-induced nephrotoxicity in children admitted to pediatric intensive care unit (PICU), and risk factors for developing nephrotoxicity.Retrospective cohort study.A PICU within freestanding tertiary hospital.A total 113 patients received at least 48 hours The high-trough (H group [57 patients]) therapy between November 2008 June 2009 pneumonia,...
It has been previously observed that hypoxia increases cerebrospinal fluid (CSF) methionine enkephalin and leucine levels, these opioids contribute to hypoxia-induced pial artery vasodilation. The present study was designed investigate whether the activation of ATP-sensitive K+ channels (KATP) mediates contribution dilation. closed-cranial window technique used measure diameter in newborn pigs. Glibenclamide (10(-6) M), a KATP inhibitor, attenuated dilation resulting from moderate severe [23...
Background: Acquired von Willebrand syndrome (AvWS) in the setting of congenital heart disease is an under-recognized cause bleeding pediatric cardiac critical care unit. Methods: Fourteen patients diagnosed with AvWS admitted to intensive unit at Children’s National Health System between December 2009 and September 2015 were identified subsequent chart review case analysis. Results: Of 14 included this study, 4 on ventricular-assist devices, 6 extracorporeal membrane oxygenation, not...
MYH7, encoding the myosin heavy chain sarcomeric β-myosin chain, is a common cause of both hypertrophic and dilated cardiomyopathy. Additionally, families with left ventricular noncompaction cardiomyopathy (LVNC) congenital heart disease (CHD), typically septal defects or Ebstein anomaly, have been identified to heterozygous pathogenic variants in MHY7. One previous case single ventricle CHD failure due MYH7 variant has identified. Herein, we present center's experience complex variants....
Subcutaneous enoxaparin is the mainstay anticoagulant in critically ill pediatric patients although it poses several challenges this patient population. Enoxaparin infused IV over 30 minutes represents an attractive alternative, but there limited experience with route of administration children. In study, we assess dosing, anticoagulation quality, safety, and clinical efficacy compared to subcutaneous infants children.Retrospective single-center study comparing two different routes (IV vs...
Background Shunt or conduit thrombosis in a single ventricle circuit is life-threatening complication that requires prompt treatment to rapidly restore shunt/conduit patency. Transcatheter interventions represent an attractive alternative systemic thrombolysis open surgical procedures. We report our center's experience with catheter-based approaches patients palliated who present thrombosis. Methods A retrospective review was performed of all physiology were diagnosed over 5-year period and...
To elicit the perceptions of bedside critical care nurses toward continual in-house attending coverage and its effect on patient safety, communication, nursing education.A 5-point Likert-type questionnaire was designed to evaluate perception in pediatric cardiac intensive unit (PCICU) presence a 24 hour physician.Single tertiary referral PCICU Washington, DC SUBJECTS: The 46 who participated study were separated into two groups based exposure recent implementation at our institution. Group...
The use of extracorporeal membrane oxygenation (ECMO) in terminally ill pediatric patients who are not candidates for long-term mechanical circulatory support or heart transplantation requires careful deliberation. We present the case a 16-year-old female with relapse acute lymphoid leukemia and acute-on-chronic cardiomyopathy received short-term ECMO therapy. In addition, we highlight several ethical considerations that were crucial to this patient’s family-centered care demonstrate therapy...
Gastrointestinal mucormycosis involving ileum is a very rare phenomenon. We present case of 52-year-old male, known diabetes mellitus requiring extracorporeal membrane oxygenation (ECMO) for H1N1 pneumonia with severe acute respiratory distress syndrome (ARDS). The patient had small bowel obstruction impending perforation emergency resection and ileostomy. resected segment histopathology showed mucormycosis. He was treated conventional Amphotericin-B later changed to Posaconazole. responded...
Vancomycin trough (Vt) concentrations of 15–20 mcg/mL have been associated with an increased rate renal injury in adults. Current data pediatrics suggests Vts do not increase the risk children admitted to a pediatric intensive care unit (PICU). The primary objective was determine if difference exists incidence PICU patients receiving β-lactam as compared vancomycin therapy mcg/mL. This retrospective cohort study conducted within freestanding tertiary hospital. records between 10/2008–6/2009...
Critical Care Medicine: December 2015 - Volume 43 Issue 12 p 170 doi: 10.1097/01.ccm.0000474503.59980.d6