A5018054391- Cardiac Arrest and Resuscitation
- Respiratory Support and Mechanisms
- Mechanical Circulatory Support Devices
- Hemodynamic Monitoring and Therapy
- Ultrasound in Clinical Applications
- Sepsis Diagnosis and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Central Venous Catheters and Hemodialysis
- Intensive Care Unit Cognitive Disorders
- Antibiotics Pharmacokinetics and Efficacy
- Family and Patient Care in Intensive Care Units
- Transplantation: Methods and Outcomes
- Pulmonary Hypertension Research and Treatments
- Airway Management and Intubation Techniques
- Vascular Procedures and Complications
- Heart Failure Treatment and Management
- Cardiovascular Function and Risk Factors
- Hematological disorders and diagnostics
- Traumatic Brain Injury and Neurovascular Disturbances
- Pneumocystis jirovecii pneumonia detection and treatment
- Neonatal Respiratory Health Research
- Venous Thromboembolism Diagnosis and Management
- Infant Development and Preterm Care
- Cardiac Structural Anomalies and Repair
- Orthopedic Infections and Treatments
University of Pennsylvania
2015-2025
Children's Hospital of Philadelphia
2016-2025
Philadelphia University
2019-2023
Society of Critical Care Medicine
2016-2019
University of Delaware
2005
Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm children acute respiratory failure.Prospective, observational study.Single-center tertiary noncardiac PICU a children's hospital.Invasively ventilated failure.Diaphragm thickness at end-expiration end-inspiration were serially measured by ultrasound 56 patients (median age, 17 mo; interquartile range, 5.5-52), first...
Objectives: We aimed to determine the frequency and variables associated with low femoral central venous catheter (fCVC) tip position. also examined association between position symptomatic thromboembolism (VTE). Design: Retrospective cohort from two PICUs. Setting: Quaternary academic children’s hospitals, 2016–2021. Patients: Children (age <18 yr) in PICU who underwent temporary fCVC placement. Interventions: None. Measurements Main Results: Low occurs when is inferior fifth lumbar...
Objectives: To determine the feasibility and describe process of implementing a pediatric critical care bedside ultrasound program in large academic PICU to evaluate impact on clinical management. Design: Retrospective case series, description implementation. Setting: Single-center quaternary noncardiac children’s hospital. Patients: Consecutive patients from January 22, 2012, July with ultrasounds performed interpreted by practitioners. Interventions: A consisting 2-day immersive course...
The cellular and molecular mechanisms responsible for lipoprotein [a] (Lp[a]) catabolism are unknown. We examined the plasma clearance of Lp[a] LDL in mice using lipoproteins isolated from human coupled to radiolabeled tyramine cellobiose. Lipoproteins were injected into wild-type, receptor-deficient (Ldlr−/−), apolipoprotein E-deficient (Apoe−/−) mice. fractional catabolic rate was greatly slowed Ldlr−/− accelerated Apoe−/− compared with wild-type In contrast, similar that only slightly...
Objectives: To assess focused cardiac ultrasound impact on clinician hemodynamic characterization of patients with suspected septic shock as well expert-generated algorithm performance. Design: Retrospective, observational study. Setting: Single-center, noncardiac PICU. Patients: Less than 18 years old receiving study within 72 hours sepsis pathway initiation from January 2014 to December 2016. Interventions: Hemodynamics were characterized fluid responsive, myocardial dysfunction,...
Bedside ultrasound for hemodynamic evaluation in critically ill children is increasingly recognized as an important skill pediatric critical care medicine providers. Our institution implemented a training curriculum leading to institutional credentialing providers nonprocedural bedside core applications. We hypothesized that studies performed or supervised by credentialed (credentialed group) have better image quality and greater accuracy interpretation than non-credentialed without...
Objectives: Diaphragm atrophy is evident during invasive ventilation for pediatric acute respiratory failure, but with unknown significance. We hypothesized that diaphragm in failure associated prolonged noninvasive positive pressure following extubation. Design: Prospective observational study. Setting: Single-center academic PICU. Patients: Invasively ventilated children failure. Interventions: ultrasound was performed within 36 hours after intubation and repeated 48 preceding Rapid...
Background: Critically ill children are at risk for subtherapeutic antibiotic concentrations. The frequency of target attainment and factors concentrations cefepime in have not been extensively studied. Methods: We performed an observational study critically receiving a new prescription standard dosing suspected sepsis (≥2 systemic inflammatory response syndrome criteria within 48 hours start). Three plasma were measured steady state and, urine sample was collected prior to pharmacokinetics...
IMPORTANCE: Right atrial (RA) dysfunction is associated with worse outcomes in some populations pulmonary hypertension or respiratory failure but the prevalence and correlates of RA pediatric acute distress syndrome (PARDS) are unknown. OBJECTIVES: The aim this study was to evaluate function by characterizing pattern within first 24 hours PARDS onset. We hypothesized that would be common correlate presence right ventricular (RV) systolic dysfunction. DESIGN, SETTING, AND PARTICIPANTS:...
Key Points Success of hematopoietic stem cell transplantation for MIRAGE syndrome may be limited by syndrome-specific comorbidities. SAMD9 mutations associated with are a newly described cause congenital amegakaryocytic thrombocytopenia.
Objectives: The prevalence and importance of early right ventricular dysfunction pulmonary hypertension in pediatric acute respiratory distress syndrome are unknown. We aimed to describe the within 24 hours diagnosis their associations with outcomes. Design: Retrospective, single-center cohort study. Setting: Tertiary care, university-affiliated PICU. Patients: Children who had echocardiograms performed diagnosis. Interventions: None. Measurements Main Results: Between July 1, 2012, June 30,...
OBJECTIVES: To evaluate the impact of point-of-care ultrasound (POCUS) use on clinicians within a PICU and to assess infrastructural elements our POCUS program development. DESIGN: Retrospective observational study. SETTING: Large academic, noncardiac in United States. SUBJECTS: Patients who had diagnostic performed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Between January 1, 2017, December 31, 2022, 7201 studies were ordered; 1930 (26.8%) quality assurance (QA) record generated...
Traumatic brain injury (TBI) is one of the leading causes morbidity and mortality in children. While left ventricular systolic dysfunction (LVSD) has been observed following TBI adults, very little known regarding it pediatric population. The aim this study was to evaluate frequency admission risk factors for TBI. authors hypothesized that cardiac would be associated with mortality. This a single-center retrospective observational from quaternary children's hospital. Pediatric patients who...
The trajectory and importance of right ventricular systolic function pulmonary hypertension during the course pediatric acute respiratory distress syndrome are unknown. We hypothesized that new or persistent dysfunction would be associated with worse patient outcomes.