A5071082225- Respiratory Support and Mechanisms
- Neonatal Respiratory Health Research
- Intensive Care Unit Cognitive Disorders
- Cardiac Arrest and Resuscitation
- Family and Patient Care in Intensive Care Units
- Pediatric Pain Management Techniques
- Mechanical Circulatory Support Devices
- Sepsis Diagnosis and Treatment
- Surgical Simulation and Training
- Emergency and Acute Care Studies
- Anesthesia and Neurotoxicity Research
- COVID-19 and healthcare impacts
- Palliative Care and End-of-Life Issues
- Infant Development and Preterm Care
- Ethics in Clinical Research
- Airway Management and Intubation Techniques
- Health disparities and outcomes
- Hemodynamic Monitoring and Therapy
- Retinal Diseases and Treatments
- Pneumonia and Respiratory Infections
- Sexual Assault and Victimization Studies
- Obstructive Sleep Apnea Research
- Childhood Cancer Survivors' Quality of Life
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Diabetes and associated disorders
Children's Hospital of Los Angeles
2018-2025
George Washington University
2024
Louisiana Cancer Research Center
2024
University of Southern California
2020-2023
Office of the Secretary of Defense
2018
Jaeb Center for Health Research
2017
Bayer (Germany)
2009
Schneider Children's Hospital
1996
<h3>Importance</h3> The inclusion of digital therapeutics (eg, virtual reality [VR] systems) for the management pain and anxiety associated with routine acutely painful medical procedures may have a substantial impact on treatment adherence improve long-term health outcomes among young patients. <h3>Objective</h3> To determine whether VR intervention decreases patients undergoing peripheral intravenous catheter (PIVC) placement compared standard care in pediatric setting. <h3>Design,...
OBJECTIVES: To describe mechanical ventilation management and factors associated with nonadherence to lung-protective principles in pediatric acute respiratory distress syndrome. DESIGN: A planned ancillary study a prospective international observational study. Mechanical (every 6 hr measurements) during syndrome days 0–3 was described compared Pediatric Acute Lung Injury Consensus Conference tidal volume recommendations (< 7 mL/kg children impaired system compliance, < 9 all other...
Objectives: Pediatric acute respiratory distress syndrome is heterogeneous, with a paucity of risk stratification tools to assist trial design. We aimed develop and validate mortality prediction models for patients pediatric syndrome. Design: Leveraging additional data collection from preplanned ancillary study (Version 1) the multinational Acute Respiratory Distress Incidence Epidemiology study, we identified predictors mortality. Separate were built entire Version 1 cohort, cohort...
Rationale: Few data exist to guide early adjunctive therapy use in pediatric acute respiratory distress syndrome (PARDS).Objectives: To describe contemporary of therapies for PARDS as a framework future investigations.Methods: This was preplanned substudy prospective, international, cross-sectional observational study children with from 100 centers over 10 weeks.Measurements and Main Results: We investigated six PARDS: continuous neuromuscular blockade, corticosteroids, inhaled nitric oxide...
Abstract Background Mechanical power is a composite variable for energy transmitted to the respiratory system over time that may better capture risk ventilator-induced lung injury than individual ventilator management components. We sought evaluate if mechanical ventilation with high associated fewer ventilator-free days (VFD) in children pediatric acute distress syndrome (PARDS). Methods Retrospective analysis of prospective observational international cohort study. Results There were 306...
Objectives: To assess the distribution, service delivery, and staffing of pediatric cardiac intensive care in United States. Design: Based on a 2016 national PICU survey, verified through online searching clinician networking, medical centers were identified with separate ICU or mixed ICU. These sent structured web-based survey up to four times, follow-up by mail phone for nonresponders. Setting: Cardiac ICUs defined as specialized units, specifically treatment children life-threatening...
We sought to evaluate the association between carbon dioxide ( co2 ) ventilatory equivalent (VEq = minute ventilation/volume of produced per min), a marker dead space that does not require blood gas measurement, and mortality risk. compared strength this physiologic fraction (V D /V t [Pa -mixed-expired P ]/Pa as well other commonly used markers (i.e., end-tidal alveolar [AVDSf (Pa -end-tidal )/Pa ], ratio [VR (minute ventilation × Pa )/(age-adjusted predicted 37.5)]).
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.
Mechanical ventilation strategies that balance lung and diaphragm protection have not been extensively tested in clinical trials. We conducted a single-center, phase II randomized controlled trial children with acute respiratory distress syndrome two time points of random assignment: the weaning phases ventilation. Patients intervention group were managed computerized decision support (CDS) tool, named REDvent, esophageal manometry to deliver protective The control received usual care. A...
Objectives: Mechanical ventilation of patients with acute respiratory distress syndrome should balance lung and diaphragm protective principles, which may be difficult to achieve in routine clinical practice. Through a Phase I trial, we sought determine whether computerized decision support–based protocol (real-time effort–driven ventilator management) is feasible implement, results improved acceptance for ventilation, improves outcomes over historical controls. Design: Interventional...
Interventional trials aimed at pediatric acute respiratory distress syndrome prevention require accurate identification of high-risk patients. In this study, we to characterize the frequency and outcomes children meeting "at risk for syndrome" criteria as defined by Pediatric Acute Lung Injury Consensus Conference.Planned substudy prospective multicenter, international Respiratory Distress Syndrome Incidence Epidemiology study conducted during 10 nonconsecutive weeks (May 2016-June...
Virtual reality (VR) is a well-researched digital intervention that has been used for managing acute pain and anxiety in pediatric patients undergoing various medical procedures. This study focuses on investigating the role of unique patient characteristics VR immersion level effectiveness during venipuncture.
The ventilatory ratio (VR) is a dead-space marker associated with mortality in mechanically ventilated adults ARDS. end-tidal alveolar dead space fraction (AVDSf) has been children. However, AVDSf requires capnography measurements, whereas VR does not. We sought to examine the prognostic value of VR, comparison AVDSf, children and young acute hypoxemic respiratory failure.We conducted retrospective study prospectively collected data from 180 failure. was calculated as (minute ventilation ×...
To determine the association between nationwide school closures and prevalence of common admission diagnoses in pediatric critical care unit.Retrospective cohort study.National database evaluation using Virtual Pediatric Systems LLC database.All patients admitted to PICU 81 contributing hospitals United States.Diagnosis categories were determined for all 110,418 during 20-week study period each year (2018, 2019, 2020). Admission data normalized relative statewide closure dates patient...
Background: Pediatric Critical Care Medicine Fellowship trainees need to acquire skills perform procedures. Over the last several years there have been advances that allowed for less invasive forms of interventions. Objective: Our hypothesis was over past decade rate procedures performed by decreased. Methods: Retrospective review at a single institution, tertiary, academic, children's hospital patients admitted from July 1, 2007-June 30, 2017 Intensive Unit and Cardiothoracic Unit. A...