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.
Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE)
RESTORE is an NIH sponsored study at 31 pediatric intensive care units across the United States. The purpose of the study is to evaluate if sedatives used in children with acute respiratory failure affects how long they need to be mechanically ventilated, how much it costs, and their quality of life and emotional health after hospital discharge.
Ensuring the safety and comfort of critically ill infants and children supported on mechanical ventilation is integral to the practice of pediatric critical care. Yet, the medications required to keep patients comfortable and safe can cause other complications. Over time, children can develop a tolerance to the sedation medications and may experience undesired side effects requiring them to remain on the ventilator longer.
This study is being done to learn more about the best ways to keep children comfortable and safe during mechanical ventilation, while limiting undesired short-term and long-term risks. Using a protocol or guideline to manage sedation may allow some pediatric patients to come off the ventilator faster with fewer side effects because less medication is used.
Associated ancillary projects with RESTORE are:
Pharmacologic Impact on Sedation Assessments (PISA)
Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA)
THAPCA is an NIH sponsored study with 38 participating pediatric intensive care units in the United States and Canada. Therapeutic hypothermia (lowering the body temperature) has been successfully used in adults after cardiac arrest to improve survival and outcome. Hypothermia has also been studied in newborn infants, but it has not been studied in infants or children who have had cardiac arrest.
When a person has a cardiac arrest, cells throughout body undergo severe stress which may result in cell injury or death. Brain cells are especially susceptible to lack of oxygen and blood supply that occur during a cardiac arrest. Fever commonly occurs after cardiac arrest and is associated with worse outcome. It is not known whether preventing elevated body temperature, by keeping it in a normal range (Normothermia) or a below normal range (Hypothermia), results in less brain injury and greater survival.
Associated ancillary projects with THAPCA:
Eliminating Catheter-Associated Bloodstream Infections in Pediatric ICUs (NACHRI-CLABSI)
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.
Epithelial Permeability in Children after Cardiopulmonary Bypass (EPIC-Cardiac)
The EPIC-Cardiac project is original research started here at the University of Arizona. In children who undergo cardiac bypass for repair of their congenital heart disease, the lungs and intestines may be injured from the surgery and predispose the patient to necrotizing enterocolitis (NEC). NEC is a serious intestinal infection and can prolong hospitalization and delay the post operative healing process. If we have a better understanding of mucosal injury after bypass, we may be able to find medications or therapies to prevent or protect patients from these types of complications before they go onto bypass and reduce their likelihood of developing NEC. This study measures intestinal and lung permeability, as well as other markers for mucosal injury, with the ultimate goal of improving post operative care in our cardiac bypass patients.
Other projects and research interests:
If you have any questions about any of our research projects, please contact our Program Coordinator.