The aim of this application is for Children's Hospital of Michigan (CHM), Wayne State University (WSU) to continue in the Collaborative Pediatric Critical Care Research Network (CPCCRN). During its first cycle, the CPCCRN initiated a wide range of research including epidemiologic studies of life-threatening illnesses;descriptive studies of inflammation and sepsis;randomized trials of nutrients, drugs, and resuscitation interventions;informatics-based decision-making;genetic studies;and behavioral studies of the effects of critical illness on the family. Kathleen Meert, MD, PI for the CPCCRN at WSU during its first cycle and for the proposed cycle, is a pediatric intensivist with a wealth of clinical and translational research experience. The PICU at CHM is a 30 bed, multidisciplinary unit that cares for 1,500 patients/year with diverse racial and ethnic backgrounds. Strengths of WSU include its experience in the Neonatal Network, the Maternal-Fetal Network, the Pediatric Emergency Care Applied Research Network, the Pediatric Pharmacology Research Unit and the Children's Oncology Group, and its success with long-term follow-up of patients in clinical trials. Survival of children with disabling residuals of critical illness is increasing;thus long-term follow-up has become a top research priority. Disabling residuals include chronic psychological conditions such as post- traumatic stress symptoms (PTSS) and disorder (PTSD). The concept proposal for this application will determine the prevalence of and risk and resilience factors for PTSS and PTSD in children exposed to the PICU for treatment of critical illness;and develop a PICU screening tool to identify children at high risk for PTSS and PTSD. The central hypothesis is that children often experience their PICU stay as a traumatic event that can lead to PTSS and PTSD, and that risk and resilience factors can be identified during the PICU stay. The hypothesis will be tested by pursuing 3 specific aims: (1) Determine the prevalence of PTSS and PTSD after critical illness in children;(2) Identify predictors of PTSS and PTSD in critically ill children;and (3) Develop a PICU screening tool for PTSS and PTSD. The concept proposal is significant because it will lay a foundation for definitive studies of preventive interventions for critically ill children at risk of PTSS and PTSD.
The research is relevant to public health because it will allow screening for PTSS and PTSD to become a regular part of PICU care, and provide a basis for developing effective preventive interventions. Identifying and preventing psychological problems that result from critical illness will facilitate children's development, education, reintegration into family, school and community, and future productivity within society at large.
|Holubkov, Richard; Clark, Amy E; Moler, Frank W et al. (2015) Efficacy outcome selection in the therapeutic hypothermia after pediatric cardiac arrest trials. Pediatr Crit Care Med 16:10-Jan|
|Pollack, Murray M; Holubkov, Richard; Funai, Tomohiko et al. (2014) Relationship between the functional status scale and the pediatric overall performance category and pediatric cerebral performance category scales. JAMA Pediatr 168:671-6|
|Jardine, David; Emond, Mary; Meert, Kathleen L et al. (2014) A single nucleotide polymorphism in the corticotropin receptor gene is associated with a blunted cortisol response during pediatric critical illness. Pediatr Crit Care Med 15:698-705|
|Meert, Kathleen L; Eggly, Susan; Berg, Robert A et al. (2014) Feasibility and perceived benefits of a framework for physician-parent follow-up meetings after a child's death in the PICU. Crit Care Med 42:148-57|
|Berg, Robert A; Sutton, Robert M; Holubkov, Richard et al. (2013) Ratio of PICU versus ward cardiopulmonary resuscitation events is increasing. Crit Care Med 41:2292-7|
|Moler, Frank W; Silverstein, Faye S; Meert, Kathleen L et al. (2013) Rationale, timeline, study design, and protocol overview of the therapeutic hypothermia after pediatric cardiac arrest trials. Pediatr Crit Care Med 14:e304-15|
|Heidemann, Sabrina M; Holubkov, Richard; Meert, Kathleen L et al. (2013) Baseline serum concentrations of zinc, selenium, and prolactin in critically ill children. Pediatr Crit Care Med 14:e202-6|
|Holubkov, Richard; Casper, T Charles; Dean, J Michael et al. (2013) The role of the Data and Safety Monitoring Board in a clinical trial: the CRISIS study. Pediatr Crit Care Med 14:374-83|
|Berger, John T; Carcillo, Joseph A; Shanley, Thomas P et al. (2013) Critical pertussis illness in children: a multicenter prospective cohort study. Pediatr Crit Care Med 14:356-65|
|Anand, Kanwaljeet J S; Clark, Amy E; Willson, Douglas F et al. (2013) Opioid analgesia in mechanically ventilated children: results from the multicenter Measuring Opioid Tolerance Induced by Fentanyl study. Pediatr Crit Care Med 14:27-36|
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