Critical Care

Research Activities

Vasopressin clearance in pediatric hemofiltration
Calculate sieving coefficient and clearance of vasopressin during hemofiltration of critically-ill children. John Scott Baird, MD

Calfactant Therapy for Direct Acute Respiratory Distress Syndrome & Direct Acute Lung Injury in Children (CARDS Study)
Dr. Biagas is the site director of a two-year multi-insitutional controlled trial of the use of surfactant in acute, direct lung injury.
Sponsor: Pneuma Partners Limited, Amherst, NY under IND 38,482; CRO: AHRM, Inc. Katherine Biagas, MD

Expression of Nutrient Transporters and Hypoxia Ischemia Factor (HIF1a) at the Developing Mammalian Blood Brain Barrier
Dr. Biagas has studied the expression of genes and proteins key in functioning and development of the blood brain barrier. Katherine Biagas, MD

The incidence of hyperglycemia and volatility of serum glucose levels in critical pediatric illness.
Dr. Biagas serves as mentor for on-going studies in this area and is the site coordinator for a planned multi-institutional study of glucose control. Katherine Biagas, MD

Assessing the Feasibility of using Natural Language Processing at Extracting Asthma Severity and Quality of Treatment from the Electronic Patient Record
Working with Dr. Carol Friedman (Department of Biomedical Informatics), Dr. Hum plans to use Natural Language Processing techniques to extract and codify the free text of inpatient medical records who have been diagnosed with asthma with respect to asthma severity and management. This information will be evaluated against the objectives of the Children’s Asthma Care performance measurement set as required by the Joint Commission. Our objective is to use Natural Language Processing as the first step in a clinical decision support process for inpatient asthma management. R. Stanley Hum, MD

Ventilation performance monitoring in the pediatric intensive care unit
With Dr. David Vawdrey (Department of Biomedical Informatics) The ventilation strategy of low tidal volume ventilation has been shown in critically ill adults to reduce mortality, duration of mechanical ventilation and duration of intensive care stay. While no equivalent pediatric studies have been undertaken, lower tidal volume ventilation has been generally accepted to be beneficial. Because consistency and accuracy of manually collected ventilation parameters is variable, actual adherence to low tidal volume ventilation strategies for pediatric patients is unknown. Since modern ventilators are able to send ventilation data electronically, we propose to collect this data on a minute-by-minute basis via our research computers. We will use automatically acquired data to evaluate adherence to tidal volume goals and correlate delivered tidal volume with patient outcome. We also expect the association between lower tidal volume and improved patient outcome to remain important after patient characteristics and illness severity have been considered. R. Stanley Hum, MD

OpenMDC: an open-source framework for medical device communication
Working with Dr. David Vawdrey (Department of Biomedical Informatics), Dr. Hum has developed an extensible, open-source framework for collecting real-time data from bedside medical devices that support RS-232 serial output. A prototype systems has been created and tested with our ventilators with plans to expand to other devices in the pediatric intensive care unit. R. Stanley Hum, MD

Optimizing the consent process for minimal risk research with children Impact of parental presence on PICU rounds
NICHD K23 (2004 - 2008) Irving Center for Clinical Research Pilot Award (2008 - 2009) Marilyn Morris, MD, MPH

Glycemic Status in the PICU, Krisin Ognibene, MD, MSc

Aldose Reductase (AR)- Receptor for Advanced Glycation Endproducts (RAGE) axis in septic mice heart
Systemic Inflammation is induced by using cecal ligation and puncture that results in polymicrobial sepsis in mice. We are utilizing this model to study the role of an enzyme AR that is implicated in glucose metabolism and RAGE in cardiac dysfunction that follows sepsis. Thyyar M. Ravindranath, MD

Neutrophil-pulmonary endothelial aberration in septic peritonitis
Sepsis induced Systemic Inflammatory Response Syndrome (SIRS) leads to multiple organ failure. We are studying innate immune response by characterizing neutrophil functional and morphological alterations in bone marrow and lung as well as pulmonary endothelial signaling following polymicrobial septic peritonitis induced SIRS in transgenic and wild type mice. Thyyar M. Ravindranath, MD

Neutrophil function in acute respiratory failure in children
Neutrophils play a central role in acute respiratory failure. We are defining the role of AR in neutrophils and neutrophil functions following pediatric acute respiratory failure. Thyyar M. Ravindranath, MD

Matrix metalloproteinase-13 and acute lung injury
Working in the laboratory of Jeanine D’Armiento MD, PhD, Dr. Sen is investigating the role of matrix metalloproteinase-13 (MMP-13) in a murine model of acute lung injury. We have characterized the injured mice in terms of fibrosis, protein leak, and inflammation, and are seeking to explain the mechanistic role of MMP-13 in inflammation after injury. Anita I. Sen, MD

Hypothermia for Pediatric Cardiac Arrest Planning Grant
This 2-year research grant is designed as a pilot project to collect data on all patients suffering a cardiac arrest in preparation for a prospective study in hypothermia following cardiac arrest. Dr. Schleien is chair of the planning committee for the hypothermia protocol.
NICHD RFA HD-02-026 Charles L. Schleien, MD, MBA

Hypothermia After Cardiac Arrest
A randomized prospective, multi-institutional study of therapeutic hypothermia after cardiac arrest in infants and children. Dr. Schleien, chaired the Protocol Committee and is a Co-investigator as well as site P.I. Charles L. Schleien, MD, MBA

Laboratory predictors of postoperative outcomes
Correlating specific laboratory parameters to length of stay, morbidity and mortality Arthur Smerling, MD

Near infrared spectroscopy monitoring in the ICU
Arthur Smerling, MD

Calfactant Therapy for Direct Acute Respiratory Distress Syndrome & Direct Acute Lung Injury in Children (CARDS Study)
Dr. Talathoti is the research study coordinator for the Division. Naresh Talathoti, MBBS

The National Registry of Cardio-Pulmonary Resuscitation (NRCPR)
Naresh Talathoti, MBBS

Pediatric Diabetic Ketoacidosis (DKA) Fluid Therapy Randomized Controlled Trial (RCT)
Naresh Talathoti, MBBS