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2. Brief report: incidence and outcomes of pediatric tracheal intubation-associated cardiac arrests in the ICU-RESUS clinical trial

Author

Nishisaki, Akira, Reeder, Ron W., McGovern, Elizabeth Laverriere, Ahmed, Tageldin, Bell, Michael J., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Diddle, Wesley, Federman, Myke, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick, Meert, Kathleen L., Morgan, Ryan W., Mourani, Peter M., Nadkarni, Vinay M., Naim, Maryam Y., Notterman, Daniel, Palmer, Chella A., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., Sutton, Robert M., and Berg, Robert A.

Published
2024
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3. Early bolus epinephrine administration during pediatric cardiopulmonary resuscitation for bradycardia with poor perfusion: an ICU-resuscitation study

Author

O’Halloran, Amanda J., Reeder, Ron W., Berg, Robert A., Ahmed, Tageldin, Bell, Michael J., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Dean, J. Michael, Diddle, J. Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Kienzle, Martha F., Kilbaugh, Todd J., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Meert, Kathleen L., Mourani, Peter M., Nadkarni, Vinay M., Naim, Maryam Y., Notterman, Daniel, Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Tilford, Bradley, Topjian, Alexis A., Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., Sutton, Robert M., and Morgan, Ryan W.

Published
2024
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6. Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study

Author

Kienzle, Martha F., Morgan, Ryan W., Reeder, Ron W., Ahmed, Tageldin, Berg, Robert A., Bishop, Robert, Bochkoris, Matthew, Carcillo, Joseph A., Carpenter, Todd C., Cooper, Kellimarie K., Diddle, J. Wesley, Federman, Myke, Fernandez, Richard, Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Frizzola, Meg, Graham, Kathryn, Hall, Mark, Horvat, Christopher, Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Meert, Kathleen L., Mourani, Peter M., Nadkarni, Vinay M., Naim, Maryam Y., Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Tabbutt, Sarah, Viteri, Shirley, Wolfe, Heather A., Sutton, Robert M., Bell, Michael J., Burns, Candice, Dean, J. Michael, Fink, Ericka L., Hehir, David, Landis, William P., Notterman, Daniel, Palmer, Chella A., Siems, Ashley, Srivastava, Neeraj, Tilford, Bradley, Wessel, David, Yates, Andrew R., and Zuppa, Athena F.

Published
2024
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7. The Temporal Association of the COVID-19 Pandemic and Pediatric Cardiopulmonary Resuscitation Quality and Outcomes.

Author

Morgan, Ryan W, Wolfe, Heather A, Reeder, Ron W, Alvey, Jessica S, Frazier, Aisha H, Friess, Stuart H, Maa, Tensing, McQuillen, Patrick S, Meert, Kathleen L, Nadkarni, Vinay M, Sharron, Matthew P, Siems, Ashley, Yates, Andrew R, Ahmed, Tageldin, Bell, Michael J, Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A, Carpenter, Todd C, Dean, J Michael, Diddle, J Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L, Franzon, Deborah, Hall, Mark, Hehir, David, Horvat, Christopher M, Huard, Leanna L, Manga, Arushi, Mourani, Peter M, Naim, Maryam Y, Notterman, Daniel, Pollack, Murray M, Sapru, Anil, Schneiter, Carleen, Srivastava, Nerraj, Tabbutt, Sarah, Tilford, Bradley, Viteri, Shirley, Wessel, David, Zuppa, Athena F, Berg, Robert A, and Sutton, Robert M

Subjects
Humans, Heart Arrest, Cardiopulmonary Resuscitation, Retrospective Studies, Prospective Studies, Child, Pandemics, COVID-19, Cardiovascular, Clinical Research, Pediatric, Rehabilitation, Good Health and Well Being, cardiac arrest, cardiopulmonary resuscitation, pediatrics, Nursing, Paediatrics and Reproductive Medicine, Pediatrics
Abstract

ObjectivesThe COVID-19 pandemic resulted in adaptations to pediatric resuscitation systems of care. The objective of this study was to determine the temporal association between the pandemic and pediatric in-hospital cardiac arrest (IHCA) process of care metrics, cardiopulmonary resuscitation (cardiopulmonary resuscitation) quality, and patient outcomes.DesignMulticenter retrospective analysis of a dataset comprising observations of IHCA outcomes pre pandemic (March 1, 2019 to February 29, 2020) versus pandemic (March 1, 2020 to February 28, 2021).SettingData source was the ICU-RESUScitation Project ("ICU-RESUS;" NCT028374497), a prospective, multicenter, cluster randomized interventional trial.PatientsChildren (≤ 18 yr) who received cardiopulmonary resuscitation while admitted to the ICU and were enrolled in ICU-RESUS.InterventionsNone.Measurements and main resultsAmong 429 IHCAs meeting inclusion criteria, occurrence during the pandemic period was associated with higher frequency of hypotension as the immediate cause of arrest. Cardiac arrest physiology, cardiopulmonary resuscitation quality metrics, and postarrest physiologic and quality of care metrics were similar between the two periods. Survival with favorable neurologic outcome (Pediatric Cerebral Performance Category score 1-3 or unchanged from baseline) occurred in 102 of 195 subjects (52%) during the pandemic compared with 140 of 234 (60%) pre pandemic ( p = 0.12). Among survivors, occurrence of IHCA during the pandemic period was associated with a greater increase in Functional Status Scale (FSS) (i.e., worsening) from baseline (1 [0-3] vs 0 [0-2]; p = 0.01). After adjustment for confounders, IHCA survival during the pandemic period was associated with a greater increase in FSS from baseline (+1.19 [95% CI, 0.35-2.04] FSS points; p = 0.006) and higher odds of a new FSS-defined morbidity (adjusted odds ratio, 1.88 [95% CI, 1.03-3.46]; p = 0.04).ConclusionsUsing the ICU-RESUS dataset, we found that relative to the year prior, pediatric IHCA during the first year of the COVID-19 pandemic was associated with greater worsening of functional status and higher odds of new functional morbidity among survivors.

Published
2022

9. Identification of post-cardiac arrest blood pressure thresholds associated with outcomes in children: an ICU-Resuscitation study

Author

Gardner, Monique M., Hehir, David A., Reeder, Ron W., Ahmed, Tageldin, Bell, Michael J., Berg, Robert A., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Dean, J. Michael, Diddle, J. Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Harding, Monica L., Horvat, Christopher M., Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Meert, Kathleen L., Morgan, Ryan W., Mourani, Peter M., Nadkarni, Vinay M., Naim, Maryam Y., Notterman, Daniel, Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Tilford, Bradley, Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., Sutton, Robert M., and Topjian, Alexis A.

Published
2023
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10. Hyperferritinemic sepsis, macrophage activation syndrome, and mortality in a pediatric research network: a causal inference analysis

Author

Fan, Zhenziang, Kernan, Kate F., Qin, Yidi, Canna, Scott, Berg, Robert A., Wessel, David, Pollack, Murray M., Meert, Kathleen, Hall, Mark, Newth, Christopher, Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Zuppa, Athena F., Sward, Katherine, Dean, J. Michael, Park, H. J., and Carcillo, Joseph A.

Published
2023
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11. Lower respiratory tract infections in children requiring mechanical ventilation: a multicentre prospective surveillance study incorporating airway metagenomics

Author

Tsitsiklis, Alexandra, Osborne, Christina M, Kamm, Jack, Williamson, Kayla, Kalantar, Katrina, Dudas, Gytis, Caldera, Saharai, Lyden, Amy, Tan, Michelle, Neff, Norma, Soesanto, Victoria, Harris, J Kirk, Ambroggio, Lilliam, Maddux, Aline B, Carpenter, Todd C, Reeder, Ron W, Locandro, Chris, Simões, Eric AF, Leroue, Matthew K, Hall, Mark W, Zuppa, Athena F, Carcillo, Joseph, Meert, Kathleen L, Sapru, Anil, Pollack, Murray M, McQuillen, Patrick S, Notterman, Daniel A, Dean, J Michael, Zinter, Matt S, Wagner, Brandie D, DeRisi, Joseph L, Mourani, Peter M, and Langelier, Charles R

Subjects
Medical Microbiology, Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Immunization, Clinical Research, Lung, Infectious Diseases, 2.2 Factors relating to the physical environment, Aetiology, Infection, Good Health and Well Being, Bacteria, Child, Cohort Studies, Critical Illness, Haemophilus influenzae, Humans, Metagenomics, Moraxella catarrhalis, Prospective Studies, Respiration, Artificial, Respiratory Syncytial Virus, Human, Respiratory Tract Infections, United States, Microbiology, Immunology, Medical microbiology
Abstract

BackgroundLower respiratory tract infections (LRTI) are a leading cause of critical illness and mortality in mechanically ventilated children; however, the pathogenic microbes frequently remain unknown. We combined traditional diagnostics with metagenomic next generation sequencing (mNGS) to evaluate the cause of LRTI in critically ill children.MethodsWe conducted a prospective, multicentre cohort study of critically ill children aged 31 days to 17 years with respiratory failure requiring mechanical ventilation (>72 h) in the USA. By combining bacterial culture and upper respiratory viral PCR testing with mNGS of tracheal aspirate collected from all patients within 24 h of intubation, we determined the prevalence, age distribution, and seasonal variation of viral and bacterial respiratory pathogens detected by either method in children with or without LRTI.FindingsBetween Feb 26, 2015, and Dec 31, 2017, of the 514 enrolled patients, 397 were eligible and included in the study (276 children with LRTI and 121 with no evidence of LRTI). A presumptive microbiological cause was identified in 255 (92%) children with LRTI, with respiratory syncytial virus (127 [46%]), Haemophilus influenzae (70 [25%]), and Moraxella catarrhalis (65 [24%]) being most prevalent. mNGS identified uncommon pathogens including Ureaplasma parvum and Bocavirus. Co-detection of viral and bacterial pathogens occurred in 144 (52%) patients. Incidental carriage of potentially pathogenic microbes occurred in 82 (68%) children without LRTI, with rhinovirus (30 [25%]) being most prevalent. Respiratory syncytial virus (p

Published
2022

12. Identification of phenotypes in paediatric patients with acute respiratory distress syndrome: a latent class analysis

Author

Dahmer, Mary K, Yang, Guangyu, Zhang, Min, Quasney, Michael W, Sapru, Anil, Weeks, Heidi M, Sinha, Pratik, Curley, Martha AQ, Delucchi, Kevin L, Calfee, Carolyn S, Flori, Heidi, investigators, RESTORE and BALI study, Matthay, Michael A, Bateman, Scot T, Berg, Marc D, Borasino, Santiago, Bysani, Gokul K, Cowl, Allison S, Bowens, Cindy D, Faustino, Vincent S, Fineman, Lori D, Godshall, Aaron J, Hirshberg, Eliotte L, Kirby, Aileen L, McLaughlin, Gwenn E, Medar, Shivanand S, Oren, Phineas P, Schneider, James B, Schwarz, Adam J, Shanley, Thomas P, Source, Lauren R, Truemper, Edward J, Heyden, Michele A Vender, Wittmayer, Kimberly, Zuppa, Athena F, Wypij, David, and Network, Pediatric Acute Lung Injury and Sepsis Investigators

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Orphan Drug, Clinical Research, Rare Diseases, Acute Respiratory Distress Syndrome, Lung, 2.1 Biological and endogenous factors, Aetiology, Respiratory, Area Under Curve, Child, Humans, Latent Class Analysis, Phenotype, Respiration, Artificial, Respiratory Distress Syndrome, RESTORE and BALI study investigators, Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network, Public Health and Health Services, Other Medical and Health Sciences, Cardiovascular medicine and haematology, Clinical sciences
Abstract

BackgroundPrevious latent class analysis of adults with acute respiratory distress syndrome (ARDS) identified two phenotypes, distinguished by the degree of inflammation. We aimed to identify phenotypes in children with ARDS in whom developmental differences might be important, using a latent class analysis approach similar to that used in adults.MethodsThis study was a secondary analysis of data aggregated from the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial and the Genetic Variation and Biomarkers in Children with Acute Lung Injury (BALI) ancillary study. We used latent class analysis, which included demographic, clinical, and plasma biomarker variables, to identify paediatric ARDS (PARDS) phenotypes within a cohort of children included in the RESTORE and BALI studies. The association of phenotypes with clinically relevant outcomes and the performance of paediatric data in adult ARDS classification algorithms were also assessed.Findings304 children with PARDS were included in this secondary analysis. Using latent class analysis, a two-class model was a better fit for the cohort than a one-class model (p

Published
2022

13. Early Cardiac Arrest Hemodynamics, End-Tidal CO2, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016–2021)*

Author

Yates, Andrew R., Naim, Maryam Y., Reeder, Ron W., Ahmed, Tageldin, Banks, Russell K., Bell, Michael J., Berg, Robert A., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Dean, J. Michael, Diddle, J. Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Morgan, Ryan W., Mourani, Peter M., Nadkarni, Vinay M., Notterman, Daniel, Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Tilford, Bradley, Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yeh, Justin, Zuppa, Athena F., Sutton, Robert M., and Meert, Kathleen L.

Published
2024
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14. Chest compressions for pediatric organized rhythms: A hemodynamic and outcomes analysis

Author

Zinna, Shairbanu S., Morgan, Ryan W., Reeder, Ron W., Ahmed, Tageldin, Bell, Michael J., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Cooper, Kellimarie K., Michael Dean, J., Wesley Diddle, J., Federman, Myke, Fernandez, Richard, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Harding, Monica L., Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Landis, William P., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Meert, Kathleen L., Mourani, Peter M, Nadkarni, Vinay M., Naim, Maryam Y., Notterman, Daniel, Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Tilford, Bradley, Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., Berg, Robert A., and Sutton, Robert M.

Published
2024
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15. Temporal airway microbiome changes related to ventilator-associated pneumonia in children.

Author

Mourani, Peter M, Sontag, Marci K, Williamson, Kayla M, Harris, J Kirk, Reeder, Ron, Locandro, Chris, Carpenter, Todd C, Maddux, Aline B, Ziegler, Katherine, Simões, Eric AF, Osborne, Christina M, Ambroggio, Lilliam, Leroue, Matthew K, Robertson, Charles E, Langelier, Charles, DeRisi, Joseph L, Kamm, Jack, Hall, Mark W, Zuppa, Athena F, Carcillo, Joseph, Meert, Kathleen, Sapru, Anil, Pollack, Murray M, McQuillen, Patrick, Notterman, Daniel A, Dean, J Michael, Wagner, Brandie D, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN), and Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) members are as follows:

Subjects
Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) members are as follows:, Humans, RNA, Ribosomal, 16S, Prospective Studies, Child, Intensive Care Units, Pneumonia, Ventilator-Associated, Microbiota, Pneumonia & Influenza, Clinical Research, Infectious Diseases, Lung, Pneumonia, Assistive Technology, Bioengineering, Patient Safety, Infection, Respiratory, Medical and Health Sciences, Respiratory System
Abstract

We sought to determine whether temporal changes in the lower airway microbiome are associated with ventilator-associated pneumonia (VAP) in children.Using a multicentre prospective study of children aged 31 days to 18 years requiring mechanical ventilation support for >72 h, daily tracheal aspirates were collected and analysed by sequencing of the 16S rRNA gene. VAP was assessed using 2008 Centers for Disease Control and Prevention paediatric criteria. The association between microbial factors and VAP was evaluated using joint longitudinal time-to-event modelling, matched case-control comparisons and unsupervised clustering.Out of 366 eligible subjects, 66 (15%) developed VAP at a median of 5 (interquartile range 3-5) days post intubation. At intubation, there was no difference in total bacterial load (TBL), but Shannon diversity and the relative abundance of Streptococcus, Lactobacillales and Prevotella were lower for VAP subjects versus non-VAP subjects. However, higher TBL on each sequential day was associated with a lower hazard (hazard ratio 0.39, 95% CI 0.23-0.64) for developing VAP, but sequential values of diversity were not associated with VAP. Similar findings were observed from the matched analysis and unsupervised clustering. The most common dominant VAP pathogens included Prevotella species (19%), Pseudomonas aeruginosa (14%) and Streptococcus mitis/pneumoniae (10%). Mycoplasma and Ureaplasma were also identified as dominant organisms in several subjects.In mechanically ventilated children, changes over time in microbial factors were marginally associated with VAP risk, although these changes were not suitable for predicting VAP in individual patients. These findings suggest that focusing exclusively on pathogen burden may not adequately inform VAP diagnosis.

Published
2021

16. Associations Between End-Tidal Carbon Dioxide During Pediatric Cardiopulmonary Resuscitation, Cardiopulmonary Resuscitation Quality, and Survival

Author

Morgan, Ryan W., Reeder, Ron W., Bender, Dieter, Cooper, Kellimarie K., Friess, Stuart H., Graham, Kathryn, Meert, Kathleen L., Mourani, Peter M., Murray, Robert, Nadkarni, Vinay M., Nataraj, Chandrasekhar, Palmer, Chella A., Srivastava, Neeraj, Tilford, Bradley, Wolfe, Heather A., Yates, Andrew R., Berg, Robert A., Sutton, Robert M., Ahmed, Tageldin, Bell, Michael J., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carpenter, Todd C., Carcillo, Joseph A., Dean, J. Michael, Diddle, J. Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L, Franzon, Deborah, Frazier, Aisha H., Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Naim, Maryam Y., Notterman, Daniel, Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Tabbutt, Sarah, Viteri, Shirley, Wessel, David, and Zuppa, Athena F.

Published
2024
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17. Survival With Favorable Neurologic Outcome and Quality of Cardiopulmonary Resuscitation Following In-Hospital Cardiac Arrest in Children With Cardiac Disease Compared With Noncardiac Disease*

Author

Federman, Myke, Sutton, Robert M., Reeder, Ron W., Ahmed, Tageldin, Bell, Michael J., Berg, Robert A., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Dean, J. Michael, Diddle, J. Wesley, Fernandez, Richard, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Kirkpatrick, Theresa, Maa, Tensing, Maitoza, Laura A., Manga, Arushi, McQuillen, Patrick S., Meert, Kathleen L., Morgan, Ryan W., Mourani, Peter M., Nadkarni, Vinay M., Notterman, Daniel, Palmer, Chella A., Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Tilford, Bradley, Viteri, Shirley, Wessel, David, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., and Naim, Maryam Y.

Published
2024
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18. Viral Detection by Reverse Transcriptase Polymerase Chain Reaction in Upper Respiratory Tract and Metagenomic RNA Sequencing in Lower Respiratory Tract in Critically Ill Children With Suspected Lower Respiratory Tract Infection

Author

Osborne, Christina M., Langelier, Charles, Kamm, Jack, Williamson, Kayla, Ambroggio, Lilliam, Reeder, Ron W., Locandro, Christopher, Kirk Harris, J., Wagner, Brandie D., Maddux, Aline B., Caldera, Saharai, Lyden, Amy, Soesanto, Victoria, Simões, Eric A.F., Leroue, Matthew K., Carpenter, Todd C., Hall, Mark W., Zuppa, Athena F., Carcillo, Joseph A., Meert, Kathleen L., Pollack, Murray M., McQuillen, Patrick S., Notterman, Daniel A., DeRisi, Joseph, and Mourani, Peter M.

Published
2024
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19. Outcomes and characteristics of cardiac arrest in children with pulmonary hypertension: A secondary analysis of the ICU-RESUS clinical trial

Author

Morgan, Ryan W, Reeder, Ron W, Ahmed, Tageldin, Bell, Michael J, Berger, John T, Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A, Carpenter, Todd C, Dean, J Michael, Diddle, J Wesley, Federman, Myke, Fernandez, Richard, Fink, Ericka L, Franzon, Deborah, Frazier, Aisha H, Friess, Stuart H, Graham, Kathryn, Hall, Mark, Hehir, David A, Himebauch, Adam S, Horvat, Christopher M, Huard, Leanna L, Maa, Tensing, Manga, Arushi, McQuillen, Patrick S, Meert, Kathleen L, Mourani, Peter M, Nadkarni, Vinay M, Naim, Maryam Y, Notterman, Daniel, Page, Kent, Pollack, Murray M, Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P, Srivastava, Neeraj, Tabbutt, Sarah, Tilford, Bradley, Viteri, Shirley, Wessel, David, Wolfe, Heather A, Yates, Andrew R, Zuppa, Athena F, Berg, Robert A, and Sutton, Robert M

Published
2023
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20. Early, Persistent Lymphopenia Is Associated With Prolonged Multiple Organ Failure and Mortality in Septic Children

Author

Podd, Bradley S., Banks, Russell K., Reeder, Ron, Telford, Russell, Holubkov, Richard, Carcillo, Joseph, Berg, Robert A., Wessel, David, Pollack, Murray M., Meert, Kathleen, Hall, Mark, Newth, Christopher, Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Zuppa, Athena F., Sward, Katherine, Dean, J. Michael, and Randolph, Adrienne G.

Published
2023
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22. Association between time of day and CPR quality as measured by CPR hemodynamics during pediatric in-hospital CPR

Author

Wolfe, Heather A, Morgan, Ryan W, Sutton, Robert M, Reeder, Ron W, Meert, Kathleen L, Pollack, Murray M, Yates, Andrew R, Berger, John T, Newth, Christopher J, Carcillo, Joseph A, McQuillen, Patrick S, Harrison, Rick E, Moler, Frank W, Carpenter, Todd C, Notterman, Daniel A, Dean, J Michael, Nadkarni, Vinay M, Berg, Robert A, investigators, for the Eunice Kennedy Shriver National Institute of Child Health Human Development Collaborative Pediatric Critical Care Research Network Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation, Zuppa, Athena F, Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Holubkov, Richard, Telford, Russell, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, Heidemann, Sabrina, Pawluszka, Ann, Tomanio, Elyse, Bell, Michael J, Hall, Mark W, Steele, Lisa, Kwok, Jeni, Sapru, Anil, Abraham, Alan, Alkhouli, Mustafa F, Shanley, Thomas P, Weber, Monica, Dalton, Heidi J, La Bell, Aimee, Mourani, Peter M, Malone, Kathryn, and Doctor, Allan

Subjects
Biomedical and Clinical Sciences, Health Services and Systems, Cardiovascular Medicine and Haematology, Clinical Sciences, Health Sciences, Clinical Research, Cardiovascular, Heart Disease, Pediatric, Blood Pressure, Cardiopulmonary Resuscitation, Child, Heart Arrest, Hemodynamics, Hospitals, Pediatric, Humans, Infant, Cardiopulmonary resuscitation, Cardiac arrest, In-Hospital, Survival, Outcomes, Eunice Kennedy Shriver National Institute of Child Health Human Development Collaborative Pediatric Critical Care Research Network Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation (PICqCPR) investigators, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences, Public health
Abstract

IntroductionPatients who suffer in-hospital cardiac arrest (IHCA) are less likely to survive if the arrest occurs during nighttime versus daytime. Diastolic blood pressure (DBP) as a measure of chest compression quality was associated with survival from pediatric IHCA. We hypothesized that DBP during CPR for IHCA is lower during nighttime versus daytime.MethodsThis is a secondary analysis of data collected from the Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation Study. Pediatric or Pediatric Cardiac Intensive Care Unit patients who received chest compressions for ≥1 min and who had invasive arterial BP monitoring were enrolled. Nighttime was defined as 11:00PM to 6:59AM and daytime as 7:00AM until 10:59PM. Primary outcome was attainment of DBP ≥ 25 mmHg in infants

Published
2020

23. Acute Disorders of Consciousness in Pediatric Severe Sepsis and Organ Failure: Secondary Analysis of the Multicenter Phenotyping Sepsis-Induced Multiple Organ Failure Study*

Author

Cheung, Christina, Kernan, Kate F., Berg, Robert A., Zuppa, Athena F., Notterman, Daniel A., Pollack, Murray M., Wessel, David, Meert, Kathleen L., Hall, Mark W., Newth, Christopher, Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Banks, Russell K., Reeder, Ron W., Holubkov, Richard, Carcillo, Joseph A., and Fink, Ericka L.

Published
2023
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24. Association of CPR simulation program characteristics with simulated and actual performance during paediatric in-hospital cardiac arrest

Author

Cashen, Katherine, Sutton, Robert M., Reeder, Ron W., Ahmed, Tageldin, Bell, Michael J., Berg, Robert A., Bishop, Robert, Bochkoris, Matthew, Burns, Candice, Carcillo, Joseph A., Carpenter, Todd C., Wesley Diddle, J., Federman, Myke, Fink, Ericka L., Franzon, Deborah, Frazier, Aisha H., Friess, Stuart H., Graham, Kathryn, Hall, Mark, Hehir, David A., Horvat, Christopher M., Huard, Leanna L., Maa, Tensing, Manga, Arushi, McQuillen, Patrick S., Morgan, Ryan W., Mourani, Peter M., Nadkarni, Vinay M., Naim, Maryam Y., Notterman, Daniel, Palmer, Chella A., Pollack, Murray M., Sapru, Anil, Schneiter, Carleen, Sharron, Matthew P., Srivastava, Neeraj, Viteri, Shirley, Wolfe, Heather A., Yates, Andrew R., Zuppa, Athena F., and Meert, Kathleen L.

Published
2023
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25. Functional outcomes among survivors of pediatric in-hospital cardiac arrest are associated with baseline neurologic and functional status, but not with diastolic blood pressure during CPR

Author

Wolfe, Heather A, Sutton, Robert M, Reeder, Ron W, Meert, Kathleen L, Pollack, Murray M, Yates, Andrew R, Berger, John T, Newth, Christopher J, Carcillo, Joseph A, McQuillen, Patrick S, Harrison, Rick E, Moler, Frank W, Carpenter, Todd C, Notterman, Daniel A, Holubkov, Richard, Dean, J Michael, Nadkarni, Vinay M, Berg, Robert A, Health, for the Eunice Kennedy Shriver National Institute of Child, Network, Human Development Collaborative Pediatric Critical Care Research, Investigators, Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation, Zuppa, Athena F, Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Tomanio, Elyse, Kwok, Jeni, Bell, Michael J, Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F, Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W, Steele, Lisa, Shanley, Thomas P, Weber, Monica, Dalton, Heidi J, La Bell, Aimee, Mourani, Peter M, Malone, Kathryn, Telford, Russell, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, and Doctor, Allan

Subjects
Biomedical and Clinical Sciences, Health Services and Systems, Cardiovascular Medicine and Haematology, Clinical Sciences, Health Sciences, Heart Disease, Clinical Research, Cardiovascular, Pediatric, Adolescent, Blood Pressure, Cardiopulmonary Resuscitation, Child, Child, Preschool, Diastole, Female, Follow-Up Studies, Heart Arrest, Hospital Mortality, Hospitals, Pediatric, Humans, Infant, Infant, Newborn, Male, Prognosis, Prospective Studies, Survival Rate, United States, Young Adult, Cardiopulmonary resuscitation, Cardiac arrest, In-hospital, Survival, Outcomes, Eunice Kennedy Shriver National Institute of Child Health, Human Development Collaborative Pediatric Critical Care Research Network, Pediatric Intensive Care Quality of Cardiopulmonary Resuscitation Investigators, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences, Public health
Abstract

AimDiastolic blood pressure (DBP) during cardiopulmonary resuscitation (CPR) is associated with survival following pediatric in-hospital cardiac arrest. The relationship between intra-arrest haemodynamics and neurological status among survivors of pediatric cardiac arrest is unknown.MethodsThis study represents analysis of data from the prospective multicenter Pediatric Intensive Care Quality of cardiopulmonary resuscitation (PICqCPR) Study. Primary predictor variables were median DBP and median systolic blood pressure (SBP) over the first 10min of CPR. The primary outcome measure was "new substantive morbidity" determined by Functional Status Scale (FSS) and defined as an increase in the FSS of at least 3 points or increase of 2 in a single FSS domain. Univariable analyses were completed to investigate the relationship between new substantive morbidity and BPs during CPR.Results244 index CPR events occurred during the study period, 77 (32%) CPR events met all inclusion criteria as well as having both DBP and FSS data available. Among 77 survivors, 32 (42%) had new substantive morbidity as measured by the FSS score. No significant differences were identified in DBP (median 30.5mmHg vs. 30.9mmHg, p=0.5) or SBP (median 76.3mmHg vs. 63.0mmHg, p=0.2) between patients with and without new substantive morbidity. Children who developed new substantive morbidity were more likely to have lower pre-arrest FSS than those that did not (median [IQR]: 7.5 [6.0-9.0] versus 9.0 [7.0-13.0], p=0.01).ConclusionNew substantive morbidity determined by FSS after a pediatric IHCA was associated with baseline functional status, but not DBP during CPR.

Published
2019

26. The association of immediate post cardiac arrest diastolic hypertension and survival following pediatric cardiac arrest

Author

Topjian, Alexis A, Sutton, Robert M, Reeder, Ron W, Telford, Russell, Meert, Kathleen L, Yates, Andrew R, Morgan, Ryan W, Berger, John T, Newth, Christopher J, Carcillo, Joseph A, McQuillen, Patrick S, Harrison, Rick E, Moler, Frank W, Pollack, Murray M, Carpenter, Todd C, Notterman, Daniel A, Holubkov, Richard, Dean, J Michael, Nadkarni, Vinay M, Berg, Robert A, Investigators, for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network, Zuppa, Athena F, Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Landis, William P, Tomanio, Elyse, Kwok, Jeni, Bell, Michael J, Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F, Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W, Steele, Lisa, Shanley, Thomas P, Weber, Monica, Dalton, Heidi J, La Bell, Aimee, Mourani, Peter M, Malone, Kathryn, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, and Doctor, Allan

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Hypertension, Cardiovascular, Heart Disease, Aetiology, 2.1 Biological and endogenous factors, Diastole, Female, Heart Arrest, Humans, Infant, Male, Prospective Studies, Survival Rate, Time Factors, Cardiac arrest, Child, Hypotension, Hemodynamics, Post cardiac arrest care, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators, Clinical Sciences, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences, Public health
Abstract

AimIn-hospital cardiac arrest occurs in >5000 children each year in the US and almost half will not survive to discharge. Animal data demonstrate that an immediate post-resuscitation burst of hypertension is associated with improved survival. We aimed to determine if systolic and diastolic invasive arterial blood pressures immediately (0-20 min) after return of spontaneous circulation (ROSC) are associated with survival and neurologic outcomes at hospital discharge.MethodsThis is a secondary analysis of the Pediatric Intensive Care Quality of CPR (PICqCPR) study of invasively measured blood pressures during intensive care unit CPR. Patients were eligible if they achieved ROSC and had at least one invasively measured blood pressure within the first 20 min following ROSC. Post-ROSC blood pressures were normalized for age, sex and height. "Immediate hypertension" was defined as at least one systolic or diastolic blood pressure >90th percentile. The primary outcome was survival to hospital discharge.ResultsOf 102 children, 70 (68.6%) had at least one episode of immediate post-CPR diastolic hypertension. After controlling for pre-existing hypotension, duration of CPR, calcium administration, and first documented rhythm, patients with immediate post-CPR diastolic hypertension were more likely to survive to hospital discharge (79.3% vs. 54.5%; adjusted OR = 2.93; 95%CI, 1.16-7.69).ConclusionsIn this post hoc secondary analysis of the PICqCPR study, 68.6% of subjects had diastolic hypertension within 20 min of ROSC. Immediate post-ROSC hypertension was associated with increased odds of survival to discharge, even after adjusting for covariates of interest.

Published
2019

27. A Population Pharmacokinetic Analysis to Study the Effect of Extracorporeal Membrane Oxygenation on Cefepime Disposition in Children

Author

Zuppa, Athena F, Zane, Nicole R, Moorthy, Ganesh, Dalton, Heidi J, Abraham, Alan, Reeder, Ron W, Carcillo, Joseph A, Yates, Andrew R, Meert, Kathleen L, Berg, Robert A, Sapru, Anil, Mourani, Peter, Notterman, Daniel A, Dean, J Michael, and Gastonguay, Marc R

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Pediatric Research Initiative, Clinical Research, Anti-Bacterial Agents, Body Weight, Cefepime, Critical Illness, Extracorporeal Membrane Oxygenation, Female, Humans, Infant, Intensive Care Units, Pediatric, Male, Metabolic Clearance Rate, Models, Biological, Protein Binding, cefepime, extracorporeal membrane oxygenation, pediatrics, population pharmacokinetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network, Nursing, Paediatrics and Reproductive Medicine, Pediatrics, Clinical sciences, Paediatrics
Abstract

ObjectivesLimited data exist on the effects of extracorporeal membrane oxygenation on pharmacokinetics of cefepime in critically ill pediatric patients. The objective was to describe cefepime disposition in children treated with extracorporeal membrane oxygenation using population pharmacokinetic modeling.DesignMulticenter, prospective observational study.SettingThe pediatric and cardiac ICUs of six sites of the Collaborative Pediatric Critical Care Research Network.PatientsSeventeen critically ill children (30 d to < 2 yr old) on extracorporeal membrane oxygenation who received cefepime as standard of care between January 4, 2014, and August 24, 2015, were enrolled.InterventionsNone.Measurements and main resultsA pharmacokinetic model was developed to evaluate cefepime disposition differences due to extracorporeal membrane oxygenation. A two-compartment model with linear elimination, weight effects on clearance, intercompartmental clearance (Q), central volume of distribution (V1), and peripheral volume of distribution (V2) adequately described the data. The typical value of clearance in this study was 7.1 mL/min (1.9 mL/min/kg) for a patient weighing 5.8 kg. This value decreased by approximately 40% with the addition of renal replacement therapy. The typical value for V1 was 1,170 mL. In the setting of blood transfusions, V1 increased by over two-fold but was reduced with increasing age of the extracorporeal membrane oxygenation circuit oxygenator.ConclusionsCefepime clearance was reduced in pediatric patients treated with extracorporeal membrane oxygenation compared with previously reported values in children not receiving extracorporeal membrane oxygenation. The model demonstrated that the age of the extracorporeal membrane oxygenation circuit oxygenator is inversely correlated to V1. For free cefepime, only 14 of the 19 doses (74%) demonstrated a fT_minimum inhibitory concentration of 16 mg/L, an appropriate target for the treatment of pseudomonal infections, for greater than 70% of the dosing interval. Pediatric patients on extracorporeal membrane oxygenation might benefit from the addition of therapeutic drug monitoring of cefepime to assure appropriate dosing.

Published
2019

30. Machine learning derivation of four computable 24-h pediatric sepsis phenotypes to facilitate enrollment in early personalized anti-inflammatory clinical trials

Author

Qin, Yidi, Kernan, Kate F., Fan, Zhenjiang, Park, Hyun-Jung, Kim, Soyeon, Canna, Scott W., Kellum, John A., Berg, Robert A., Wessel, David, Pollack, Murray M., Meert, Kathleen, Hall, Mark, Newth, Christopher, Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Zuppa, Athena F., Banks, Russell, Reeder, Ron W., Holubkov, Richard, Notterman, Daniel A., Michael Dean, J., and Carcillo, Joseph A.

Published
2022
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31. Identification of phenotypes in paediatric patients with acute respiratory distress syndrome: a latent class analysis

Author

Matthay, Michael A, Bateman, Scot T, Berg, Marc D, Borasino, Santiago, Bysani, Gokul K, Cowl, Allison S, Bowens, Cindy D, Faustino, Vincent S, Fineman, Lori D, Godshall, Aaron J, Hirshberg, Eliotte L, Kirby, Aileen L, McLaughlin, Gwenn E, Medar, Shivanand S, Oren, Phineas P, Schneider, James B, Schwarz, Adam J, Shanley, Thomas P, Source, Lauren R, Truemper, Edward J, Vender Heyden, Michele A, Wittmayer, Kimberly, Zuppa, Athena F, Wypij, David, Dahmer, Mary K, Yang, Guangyu, Zhang, Min, Quasney, Michael W, Sapru, Anil, Weeks, Heidi M, Sinha, Pratik, Curley, Martha A Q, Delucchi, Kevin L, Calfee, Carolyn S, and Flori, Heidi

Published
2022
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33. Prevalence of Pathogenic and Potentially Pathogenic Inborn Error of Immunity Associated Variants in Children with Severe Sepsis

Author

Kernan, Kate F., Ghaloul-Gonzalez, Lina, Vockley, Jerry, Lamb, Janette, Hollingshead, Deborah, Chandran, Uma, Sethi, Rahil, Park, Hyun-Jung, Berg, Robert A., Wessel, David, Pollack, Murray M., Meert, Kathleen L., Hall, Mark W., Newth, Christopher J. L., Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Zuppa, Athena F., Banks, Russel, Reeder, Ron W., Holubkov, Richard, Notterman, Daniel A., Dean, J. Michael, and Carcillo, Joseph A.

Published
2022
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34. Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes

Author

Sutton, Robert M, Reeder, Ron W, Landis, William, Meert, Kathleen L, Yates, Andrew R, Berger, John T, Newth, Christopher J, Carcillo, Joseph A, McQuillen, Patrick S, Harrison, Rick E, Moler, Frank W, Pollack, Murray M, Carpenter, Todd C, Notterman, Daniel A, Holubkov, Richard, Dean, J Michael, Nadkarni, Vinay M, Berg, Robert A, Investigators, the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network, Zuppa, Athena F, Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Tomanio, Elyse, Kwok, Jeni, Bell, Michael J, Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F, Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W, Steele, Lisa, Shanley, Thomas P, Weber, Monica, Dalton, Heidi J, La Bell, Aimee, Mourani, Peter M, Malone, Kathryn, Telford, Russell, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, and Doctor, Allan

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Pediatric, Clinical Research, Cardiovascular, Adolescent, Blood Pressure Determination, Child, Child, Preschool, Guideline Adherence, Heart Arrest, Heart Massage, Hospital Mortality, Hospitals, Pediatric, Humans, Infant, Intensive Care Units, Pediatric, Male, Nervous System Diseases, Outcome and Process Assessment, Health Care, Practice Guidelines as Topic, Pressure, Quality Improvement, United States, Cardiac arrest, Cardiopulmonary resuscitation, Intensive care unit, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) Investigators, Nursing, Public Health and Health Services, Emergency & Critical Care Medicine, Clinical sciences, Public health
Abstract

AimThe primary aim of this study was to evaluate the association between chest compression rates and 1) arterial blood pressure and 2) survival outcomes during pediatric in-hospital cardiopulmonary resuscitation (CPR).MethodsProspective observational study of children ≥37 weeks gestation and 120-140, >140) and outcomes.ResultsCompression rate data were available for 164 patients. More than half (98/164; 60%) were 120-140, p = 0.010; >140, p = 0.077), but not survival. A rate between 80-

Published
2018

35. Association Between Diastolic Blood Pressure During Pediatric In-Hospital Cardiopulmonary Resuscitation and Survival

Author

Berg, Robert A, Sutton, Robert M, Reeder, Ron W, Berger, John T, Newth, Christopher J, Carcillo, Joseph A, McQuillen, Patrick S, Meert, Kathleen L, Yates, Andrew R, Harrison, Rick E, Moler, Frank W, Pollack, Murray M, Carpenter, Todd C, Wessel, David L, Jenkins, Tammara L, Notterman, Daniel A, Holubkov, Richard, Tamburro, Robert F, Dean, J Michael, Nadkarni, Vinay M, Zuppa, Athena F, Graham, Katherine, Twelves, Carolann, Landis, William, DiLiberto, Mary Ann, Tomanio, Elyse, Kwok, Jeni, Bell, Michael J, Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F, Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W, Steele, Lisa, Shanley, Thomas P, Weber, Monica, Dalton, Heidi J, La Bell, Aimee, Mourani, Peter M, Malone, Kathryn, Telford, Russell, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, and Doctor, Allan

Subjects
Pediatric, Cardiovascular, Heart Disease, Lung, Clinical Research, Adolescent, Adolescent Development, Age Factors, Arterial Pressure, Brain, Cardiopulmonary Resuscitation, Cerebrovascular Circulation, Child, Child Development, Child, Preschool, Diastole, Disability Evaluation, Female, Heart Arrest, Hospital Mortality, Humans, Infant, Infant, Newborn, Inpatients, Male, Patient Discharge, Prospective Studies, Recovery of Function, Risk Factors, Time Factors, Treatment Outcome, United States, cardiopulmonary resuscitation, heart arrest, pediatrics, survival, treatment outcomes, Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN) PICqCPR (Pediatric Intensive Care Quality of Cardio-Pulmonary Resuscitation) Investigators, Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services, Cardiovascular System & Hematology
Abstract

BackgroundOn the basis of laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data demonstrating that survival depends on attaining adequate arterial diastolic blood pressure (DBP) during CPR, the American Heart Association recommends using blood pressure to guide pediatric CPR. However, evidence-based blood pressure targets during pediatric CPR remain an important knowledge gap for CPR guidelines.MethodsAll children ≥37 weeks' gestation and

Published
2018

37. Mortality Risk in Pediatric Sepsis Based on C-reactive Protein and Ferritin Levels

Author

Horvat, Christopher M., Fabio, Anthony, Nagin, Daniel S., Banks, Russell K., Qin, Yidi, Park, Hyun-Jung, Kernan, Kate F., Canna, Scott W., Berg, Robert A., Wessel, David, Pollack, Murray M., Meert, Kathleen, Hall, Mark, Newth, Christopher, Lin, John C., Doctor, Allan, Shanley, Tom, Cornell, Tim, Harrison, Rick E., Zuppa, Athena F., Reeder, Ron W., Sward, Kathy, Holubkov, Richard, Notterman, Daniel A., Dean, J. Michael, and Carcillo, Joseph A.

Published
2022
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38. Population pharmacokinetic modelling and simulation of tranexamic acid in adult trauma patients.

Author

Stitt, Gideon, Spinella, Philip C., Bochicchio, Grant V., Roberts, Ian, Downes, Kevin J., and Zuppa, Athena F.

Subjects
BOLUS drug administration, OXYGEN saturation, TRANEXAMIC acid, PLATELET count, CLINICAL pharmacology
Abstract

Aims: The aim of this study is to describe the disposition of tranexamic acid (TXA) in adult trauma patients and derive a dosing regimen that optimizes exposure based on a predefined exposure target. Methods: We performed a population pharmacokinetic (popPK) analysis of participants enrolled in the Tranexamic Acid Mechanisms and Pharmacokinetics in Traumatic Injury (TAMPITI) trial (≥18 years with traumatic injury, given ≥1 blood product and/or requiring immediate transfer to the operating room) who were randomized to a single dose of either 2 or 4 g of TXA ≤2 h from time of injury. PopPK analysis was conducted using nonlinear mixed‐effects modelling (NONMEM). Simulations were then performed using the final model to generate estimated plasma TXA concentrations in 1000 simulated participants. Dosing schemes were evaluated to determine maintenance of TXA plasma concentrations >10 mg/L for ≥8 h after administration of the initial dose. Results: TXA PK was best described by a two‐compartment model with proportional residual error and allometric scaling on all parameters. Platelet count, skeletal muscle oxygen saturation measured by near‐infrared spectroscopy and interleukin‐8 concentration were significant covariates on TXA clearance. Based on simulations, a 2 g IV bolus dose, repeated 3 h later, best achieved the target exposure. Conclusions: According to simulations from a popPK model of TXA, a 2 g IV bolus with a repeated dose 3 h later would be most likely to maintain concentrations >10 mg/L for 8 h in >95% of adult trauma patients and should be considered for patients with ongoing haemorrhage. [ABSTRACT FROM AUTHOR]

Published
2024
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40. Early Cardiac Arrest Hemodynamics, End-Tidal Co 2, and Outcome in Pediatric Extracorporeal Cardiopulmonary Resuscitation: Secondary Analysis of the ICU-RESUScitation Project Dataset (2016–2021)*

Author

Yates, Andrew R., primary, Naim, Maryam Y., additional, Reeder, Ron W., additional, Ahmed, Tageldin, additional, Banks, Russell K., additional, Bell, Michael J., additional, Berg, Robert A., additional, Bishop, Robert, additional, Bochkoris, Matthew, additional, Burns, Candice, additional, Carcillo, Joseph A., additional, Carpenter, Todd C., additional, Dean, J. Michael, additional, Diddle, J. Wesley, additional, Federman, Myke, additional, Fernandez, Richard, additional, Fink, Ericka L., additional, Franzon, Deborah, additional, Frazier, Aisha H., additional, Friess, Stuart H., additional, Graham, Kathryn, additional, Hall, Mark, additional, Hehir, David A., additional, Horvat, Christopher M., additional, Huard, Leanna L., additional, Maa, Tensing, additional, Manga, Arushi, additional, McQuillen, Patrick S., additional, Morgan, Ryan W., additional, Mourani, Peter M., additional, Nadkarni, Vinay M., additional, Notterman, Daniel, additional, Pollack, Murray M., additional, Sapru, Anil, additional, Schneiter, Carleen, additional, Sharron, Matthew P., additional, Srivastava, Neeraj, additional, Tilford, Bradley, additional, Viteri, Shirley, additional, Wessel, David, additional, Wolfe, Heather A., additional, Yeh, Justin, additional, Zuppa, Athena F., additional, Sutton, Robert M., additional, and Meert, Kathleen L., additional

Published
2023
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42. Special population considerations and regulatory affairs for clinical research

Author

Grimsrud, Kristin N, Sherwin, Catherine MT, Constance, Jonathan E, Tak, Casey, Zuppa, Athena F, Spigarelli, Michael G, and Mihalopoulos, Nicole L

Subjects
Pharmacology and Pharmaceutical Sciences, Biomedical and Clinical Sciences, Geriatrics, human subject research, pediatrics, pregnancy, regulations, Pharmacology & Pharmacy, Pharmacology and pharmaceutical sciences
Abstract

Special populations, including women (non-pregnant and pregnant), pediatrics, and the elderly, require additional consideration with regard to clinical research. There are very specific regulatory laws, which protect these special populations, that need to be understood and adhered to in order to perform clinical research. This review provides a broad overview of some of the physiological differences in special populations and discusses how these differences may affect study design and regulatory considerations. These various special populations, with respect to regulatory affairs, are clearly defined within the Code of Federal Regulations. The definition of "special population" exists to provide enhanced awareness of their vulnerabilities, thereby allowing the creation of regulatory guidance aimed to decrease injury or outright harm. Currently, progress is being made to be more inclusive of special populations in clinical trials. This reflects changing attitudes towards drug information, with it being more representative of those patients that will ultimately be prescribed or exposed to the therapy. However, all research undertaken in these populations should be performed in a manner that ensures all protections of each participant are upheld.

Published
2015

44. The association of immediate post cardiac arrest diastolic hypertension and survival following pediatric cardiac arrest

Author

Topjian, Alexis A., Sutton, Robert M., Reeder, Ron W., Telford, Russell, Meert, Kathleen L., Yates, Andrew R., Morgan, Ryan W., Berger, John T., Newth, Christopher J., Carcillo, Joseph A., McQuillen, Patrick S., Harrison, Rick E., Moler, Frank W., Pollack, Murray M., Carpenter, Todd C., Notterman, Daniel A., Holubkov, Richard, Dean, J. Michael, Nadkarni, Vinay M., Berg, Robert A., Zuppa, Athena F., Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Landis, William P., Tomanio, Elyse, Kwok, Jeni, Bell, Michael J., Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F., Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W., Steele, Lisa, Shanley, Thomas P., Weber, Monica, Dalton, Heidi J., Bell, Aimee La, Mourani, Peter M., Malone, Kathryn, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, and Doctor, Allan

Published
2019
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46. Survival With Favorable Neurologic Outcome and Quality of Cardiopulmonary Resuscitation Following In-Hospital Cardiac Arrest in Children With Cardiac Disease Compared With Noncardiac Disease*

Author

Federman, Myke, primary, Sutton, Robert M., additional, Reeder, Ron W., additional, Ahmed, Tageldin, additional, Bell, Michael J., additional, Berg, Robert A., additional, Bishop, Robert, additional, Bochkoris, Matthew, additional, Burns, Candice, additional, Carcillo, Joseph A., additional, Carpenter, Todd C., additional, Dean, J. Michael, additional, Diddle, J. Wesley, additional, Fernandez, Richard, additional, Fink, Ericka L., additional, Franzon, Deborah, additional, Frazier, Aisha H., additional, Friess, Stuart H., additional, Graham, Kathryn, additional, Hall, Mark, additional, Hehir, David A., additional, Horvat, Christopher M., additional, Huard, Leanna L., additional, Kirkpatrick, Theresa, additional, Maa, Tensing, additional, Maitoza, Laura A., additional, Manga, Arushi, additional, McQuillen, Patrick S., additional, Meert, Kathleen L., additional, Morgan, Ryan W., additional, Mourani, Peter M., additional, Nadkarni, Vinay M., additional, Notterman, Daniel, additional, Palmer, Chella A., additional, Pollack, Murray M., additional, Sapru, Anil, additional, Schneiter, Carleen, additional, Sharron, Matthew P., additional, Srivastava, Neeraj, additional, Tilford, Bradley, additional, Viteri, Shirley, additional, Wessel, David, additional, Wolfe, Heather A., additional, Yates, Andrew R., additional, Zuppa, Athena F., additional, and Naim, Maryam Y., additional

Published
2023
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48. Chest compression rates and pediatric in-hospital cardiac arrest survival outcomes

Author

Zuppa, Athena F., Graham, Katherine, Twelves, Carolann, Diliberto, Mary Ann, Tomanio, Elyse, Kwok, Jeni, Bell, Michael J., Abraham, Alan, Sapru, Anil, Alkhouli, Mustafa F., Heidemann, Sabrina, Pawluszka, Ann, Hall, Mark W., Steele, Lisa, Shanley, Thomas P., Weber, Monica, Dalton, Heidi J., Bell, Aimee La, Mourani, Peter M., Malone, Kathryn, Telford, Russell, Locandro, Christopher, Coleman, Whitney, Peterson, Alecia, Thelen, Julie, Doctor, Allan, Sutton, Robert M., Reeder, Ron W., Landis, William, Meert, Kathleen L., Yates, Andrew R., Berger, John T., Newth, Christopher J., Carcillo, Joseph A., McQuillen, Patrick S., Harrison, Rick E., Moler, Frank W., Pollack, Murray M., Carpenter, Todd C., Notterman, Daniel A., Holubkov, Richard, Dean, J. Michael, Nadkarni, Vinay M., and Berg, Robert A.

Published
2018
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