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Critical care

Pediatric Critical Care is committed to cutting edge research to improve the care of our patients. Our unit participates in multi-center, National of Institutes of Health (NIH) funded projects and have original research to investigate novel approaches to care.

Current Research

Eliminating Catheter-Associated Bloodstream Infections in Pediatric ICUs (NACHRI-CLABSI)
Site Principle Investigator: Mary G. Gaspers, MD, MPH

The NACHRI-CLABSI project is a national collaborative effort of pediatric intensive care units that are members of The National Association of Children’s Hospital and Related Institutions.A quality improvement project focused on eliminating central line-associated blood stream infections (CLABSI), the project improves clinical care and maintains rigorous standards for central-line management.CLABSIs can prolong hospitalization and complicate the course of care.While some previous work has produced results in PICUs to reduce infections associated with central-line insertion, data from a number of children’s hospitals suggest that even after reliable implementation of sterile insertion practices, PICU patients may continue to experience infection. Despite these experiences, there are no pediatric specific evidence-based strategies related to catheter maintenance practices which focus upon reducing CLABSI.

Genetic Epidemiology and Immune Response of Life-Threatening Influenza Infection in Children and Young Adults (PICFlu)

Site Principle Investigator: Katri V. Typpo, MD, MPH

Seasonal influenza annually infects 5 to 20% of the population, leading to 200,000 hospitalizations and approximately 36,000 deaths. This study of life-threatening influenza in children, actively enrolling at over 30 sites across the United States, evaluates how the patient’s immune response is associated with disease susceptibility, severity and outcome. By better understanding why some children experience severe illness or fatality from influenza, we can identify potential novel treatment strategies. We believe that the genetic makeup of the patient strongly influences susceptibility to life-threatening influenza infection and survival. As the first very large multicenter study characterizing the role of innate immunity in life-threatening influenza in children, we are focusing on answering questions that can assist us in designing future clinical trials to prevent and ameliorate life-threatening influenza in children.

Hypertonic Fluid Selection in the Treatment of Pediatric Patients with Traumatic Brain Injury

Principle Investigators: Michele M. Munkwitz, MD and Britany Shutes, MD

At Diamond Children’s, we strive to use cutting edge technology to create the best possible patient outcomes in pediatric traumatic brain injury.  Currently, therapeutic use of either hypertonic saline or mannitol to treat high intracranial pressure is at the discretion of the physician. Using standard of care methods to measure pressure and oxygen in the injured patient’s brain we seek to determine if there are patient and clinical factors to predict which of the two fluids recommended by the most recent clinical guidelines is better for the initial management in our patient population.

Sepsis Prevalence, Outcomes, and Therapy (SPROUT)
Site Principle Investigator: Katri V. Typpo, MD, MPH

Pediatric sepsis is a major source of morbidity, mortality, and expenditures in pediatric intensive care units (PICUs) worldwide. As part of an international collaborative with over 100 participating sites on all inhabited continents, this project’s primary objective is to determine the prevalence, outcomes, and therapeutic variability of pediatric severe sepsis and septic shock. Secondary objectives are to understand the generalizability of criteria used to identify pediatric sepsis and determine the feasibility of clinical trials in this population.

Supplemental Parenteral Nutrition in Pediatric Respiratory Failure (SuPPeR)
Principle Investigator: Katri V. Typpo, MD, MPH

Acute hypoxemic respiratory failure (AHRF) accounts for 10% of all PICU admissions. Nutritional support is central to appropriate PICU management of AHRF, and yet fundamental gaps in knowledge exist regarding best practice for timing, route, dose, and type of nutrition. Optimized nutritional support during pediatric critical illness is important because even brief periods of malnutrition in infancy result in permanent negative effects on neurocognitive development, an outcome with lifelong impact. Parenteral nutrition, nutrition provided through an IV, supplementation in combination with normal feeding practices could improve long-term neurocognitive outcome for pediatric AHRF by preventing acute malnutrition, but has unknown effects on intestinal barrier function; a proposed mechanism for late sepsis and infectious complications during critical illness.   

Past Research

Epithelial Permeability in Children after Cardiopulmonary Bypass (EPIC-Cardiac)
Principle Investigator: Katri V. Typpo, MD, MPH

Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE)
Site Principle Investigator: Marc D. Berg, MD
Co-Investigators: Brent Hall, PharmD, Michele Munkwitz, MD, Claire Wells, CNP

RESTORE Ancillary Studies:

Genetic Variations and Biomarkers in Acute Lung Injury (BALI)
Pharmacologic Impact on Sedation Assessments (PISA)

Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA)
Site Principle Investigator: Andreas A. Theodorou, MD
Co-Investigator: Katri V. Typpo, MD, MPH

THAPCA Ancillary Study:

Hypothermia’s Impact on Pharmacology (HIP)

Other projects and research interests:

  • Clinical nutrition
  • CPR performance and ventricular fibrillation
  • Medication safety and error reduction
  • Patient safety and quality of patient care
  • Traumatic brain injury

If you have any questions about any of our research projects, please contact our Program Coordinator.


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