A5061785145- Sepsis Diagnosis and Treatment
- Respiratory Support and Mechanisms
- Immune Response and Inflammation
- Hemodynamic Monitoring and Therapy
- Acute Kidney Injury Research
- Adrenal Hormones and Disorders
- S100 Proteins and Annexins
- Clusterin in disease pathology
- Machine Learning in Healthcare
- Cardiac Arrest and Resuscitation
- Lipoproteins and Cardiovascular Health
- Cardiac, Anesthesia and Surgical Outcomes
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Heart Failure Treatment and Management
- Neonatal Respiratory Health Research
- Pneumonia and Respiratory Infections
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Lipid metabolism and disorders
- Electrolyte and hormonal disorders
- Renal function and acid-base balance
- Inflammation biomarkers and pathways
- Pregnancy and preeclampsia studies
- Biomarkers in Disease Mechanisms
- Trauma, Hemostasis, Coagulopathy, Resuscitation
- Methemoglobinemia and Tumor Lysis Syndrome
Cincinnati Children's Hospital Medical Center
2016-2025
University of Cincinnati
2022-2025
University of Cincinnati Medical Center
2022-2024
Children's Mercy Hospital
2023
Hospital Research Foundation
2022-2023
The Royal Children's Hospital Foundation
2022-2023
Indian Institute of Technology Madras
2022
Nationwide Children's Hospital
2022
Emory University
2022
Columbia University
2018
OBJECTIVES: Untangling the heterogeneity of sepsis in children and identifying clinically relevant phenotypes could lead to development targeted therapies. Our aim was analyze organ dysfunction trajectories with sepsis-associated multiple syndrome (MODS) identify reproducible determine if they are associated treatment effect (HTE) common DESIGN: Multicenter observational cohort study. SETTING: Thirteen PICUs United States. PATIENTS: Patients admitted suspected infections PICU between 2012...
Abstract Background Sepsis-associated acute kidney injury (SA-AKI) is associated with high morbidity, no current therapies available beyond continuous renal replacement therapy (CRRT). Systemic inflammation and endothelial dysfunction are key drivers of SA-AKI. We sought to measure differences between markers among children without SA-AKI, test whether this association varied across inflammatory biomarker-based risk strata, develop prediction models identify those at highest Methods...
Objectives: To perform: 1) external validation of the Phoenix Sepsis Score and sepsis criteria in a multicenter cohort critically ill children with infection comparison 2005 International Pediatric Consensus Conference (IPSCC) criteria; 2) study performance patient subgroups based on age comorbidities; 3) an assessment microbiological profile sepsis; 4) Phoenix-8 score. Design: Secondary, retrospective analysis from 2012 to 2018. Setting: Nine PICUs United States. Patients: PICU admissions...
Abstract Background Multiple organ dysfunction syndrome (MODS) is a critical driver of sepsis morbidity and mortality in children. Early identification those at risk death persistent dysfunctions necessary to enrich patients for future trials therapeutics. Here, we sought integrate endothelial PERSEVERE biomarkers estimate the composite or on day 7 septic shock. Methods We measured markers from 1 serum among with existing data. TreeNet® classification model was derived incorporating 22...
OBJECTIVES: Identification of children with sepsis-associated multiple organ dysfunction syndrome (MODS) at risk for poor outcomes remains a challenge. We sought to the determine reproducibility data-driven “persistent hypoxemia, encephalopathy, and shock” (PHES) phenotype its association inflammatory endothelial biomarkers, as well biomarker-based pediatric strata. DESIGN: retrained validated random forest classifier using subscores in 2012–2018 electronic health record (EHR) dataset used...
Multiple organ dysfunction syndrome (MODS) disproportionately drives morbidity and mortality among critically ill patients. However, we lack a comprehensive understanding of its pathobiology. Identification genes associated with persistent MODS trajectory may shed light on underlying biology allow for accurate prediction those at-risk.
Abstract Critical illness syndromes including sepsis, acute respiratory distress syndrome, and kidney injury (AKI) are associated with high in-hospital mortality long-term adverse health outcomes among survivors. Despite advancements in care, clinical biological heterogeneity patients continues to hamper identification of efficacious therapies. Precision medicine offers hope by identifying patient subclasses based on clinical, laboratory, biomarker ‘omic’ data potentially facilitating better...
We previously derived the updated Pediatric Sepsis Biomarker Risk for Acute Kidney Injury (PERSEVERE-II AKI) prediction model, which had robust diagnostic test characteristics severe AKI on day 3 (D3 of septic shock. now sought to validate this model in an independent cohort children one was developed.
Abstract Background Sepsis poses a grave threat, especially among children, but treatments are limited owing to heterogeneity patients. We sought test the clinical and biological relevance of pediatric septic shock subclasses identified using reproducible approaches. Methods performed latent profile analyses clinical, laboratory, biomarker data from prospective multi-center observational cohort derive phenotypes trained support vector machine model assign in an internal validation set....
Objectives: Proprotein convertase subtilisin/kexin type 9 is a central regulator of lipid metabolism and has been implicated in regulating the host response to sepsis. loss-of-function associated with improved sepsis outcomes adult through increased hepatic bacterial clearance. Thus, there interest leveraging proprotein inhibitors as therapeutic strategy adults We sought validate this association children septic shock juvenile murine model Design: Prospectively enrolled cohort shock;...
Abstract Background Endothelial activation is a key driver of multiple organ dysfunction syndrome (MODS). Soluble endoglin (sENG) expressed by mature and progenitor endothelial cells thought to have angiogenic properties. We sought determine the association between sENG pediatric sepsis associated MODS. Methods Prospective observational study septic shock. Primary outcome interest was complicated course -a composite death (or) MODS on day 7 illness. Secondary outcomes included individual...
Abstract Sepsis is associated with significant mortality and morbidity among critically ill patients admitted to intensive care units (ICU) represents a major health challenge globally. Given the clinical biological heterogeneity dynamic nature of host immune response, identifying those at high risk poor outcomes remains critical challenge. Here, we performed secondary analysis publicly available time-series gene-expression datasets from peripheral blood ICU elucidate temporally stable gene...
Abstract Background Acute kidney injury (AKI) occurs commonly in pediatric septic shock and increases morbidity mortality. Early identification of high-risk patients can facilitate targeted intervention to improve outcomes. We previously modified the renal angina index (RAI), a validated AKI prediction tool, specificity this population (sRAI). Here, we prospectively assess sRAI performance separate cohort. Methods A secondary analysis prospective, multicenter, observational study children...
Progress in the management of critical care syndromes such as sepsis, Acute Respiratory Distress Syndrome (ARDS), and trauma has slowed over last two decades, limited by inherent heterogeneity within syndromic illnesses. Numerous immune endotypes have been proposed sepsis care, however overlap is unclear, limiting clinical translation. The SUBSPACE consortium an international that aims to advance precision medicine through sharing transcriptomic data. By evaluating existing across 6,000...
Bubble continuous positive airway pressure (bCPAP) is a simple, safe, and cost-effective strategy to provide respiratory support newborns with distress syndrome in resource-limited settings.To understand whether implementation of bCPAP, relative other modes the care syndrome, increases attitudes about its potential for consistent widespread use among providers neonatal intensive units (NICUs) lower middle-income countries.Semistructured qualitative interviews 14 healthcare providers,...
Abstract Background Sepsis is associated with significant mortality. Yet, there are no efficacious therapies beyond antibiotics. PCSK9 loss-of-function (LOF) and inhibition, through enhanced low-density lipoprotein receptor (LDLR) mediated endotoxin clearance, holds promise as a potential therapeutic approach among adults. In contrast, we have previously demonstrated higher mortality in the juvenile host. Given pleiotropic effects of on endothelium, canonical serum lipoproteins, both which...
Abstract Background Multiple organ dysfunction syndrome (MODS) is an important cause of post-operative morbidity and mortality for children undergoing cardiac surgery requiring cardiopulmonary bypass (CPB). Dysregulated inflammation widely regarded as a key contributor to bypass-related MODS pathobiology, with considerable overlap pathways associated septic shock. The pediatric sepsis biomarker risk model (PERSEVERE) comprised seven protein biomarkers reliably predicts baseline among...