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.

Public Health Relevance

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.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Cooperative Clinical Research--Cooperative Agreements (U10)
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Special Emphasis Panel (ZHD1-DSR-A (25))
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Maholmes, Valerie
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Wayne State University
Schools of Medicine
United States
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Carcillo, Joseph A; Dean, J Michael; Holubkov, Richard et al. (2016) Inherent Risk Factors for Nosocomial Infection in the Long Stay Critically Ill Child Without Known Baseline Immunocompromise: A Post Hoc Analysis of the CRISIS Trial. Pediatr Infect Dis J 35:1182-1186
Silverstein, Faye S; Slomine, Beth S; Christensen, James et al. (2016) Functional Outcome Trajectories After Out-of-Hospital Pediatric Cardiac Arrest. Crit Care Med 44:e1165-e1174
Meert, Kathleen L; Telford, Russell; Holubkov, Richard et al. (2016) Pediatric Out-of-Hospital Cardiac Arrest Characteristics and Their Association With Survival and Neurobehavioral Outcome. Pediatr Crit Care Med 17:e543-e550
Carcillo, Joseph A; Sward, Katherine; Halstead, E Scott et al. (2016) A Systemic Inflammation Mortality Risk Assessment Contingency Table for Severe Sepsis. Pediatr Crit Care Med :
Keele, Linda; Meert, Kathleen L; Berg, Robert A et al. (2016) Limiting and Withdrawing Life Support in the PICU: For Whom Are These Options Discussed? Pediatr Crit Care Med 17:110-20
Meert, Kathleen; Telford, Russell; Holubkov, Richard et al. (2016) Exploring the safety and efficacy of targeted temperature management amongst infants with out-of-hospital cardiac arrest due to apparent life threatening events. Resuscitation 109:40-48
Meert, Kathleen L; Slomine, Beth S; Christensen, James R et al. (2016) Family Burden After Out-of-Hospital Cardiac Arrest in Children. Pediatr Crit Care Med 17:498-507
Moler, Frank W; Hutchison, Jamie S; Nadkarni, Vinay M et al. (2016) Targeted Temperature Management After Pediatric Cardiac Arrest Due To Drowning: Outcomes and Complications. Pediatr Crit Care Med 17:712-20
Sward, Katherine A; Rubin, Sarah; Jenkins, Tammara L et al. (2016) Case Study: Semantic Annotation of a Pediatric Critical Care Research Study. Comput Inform Nurs 34:101-4
Willson, Douglas F; Webster, Angela; Heidemann, Sabrina et al. (2016) Diagnosis and Treatment of Ventilator-Associated Infection: Review of the Critical Illness Stress-Induced Immune Suppression Prevention Trial Data. Pediatr Crit Care Med 17:287-93

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