Acute life-threatening insults in children such as traumatic brain injury and cardiac arrest (CA) are leading causes of morbidity and mortality. Injury to the central nervous system from these insults is the key determinant of unfavorable outcome. These neurological and multi-system insults require a multidisciplinary and multi-departmental response that must be coordinated from the field through to rehabilitation. Research training in pediatric neurointensive care and resuscitation is thus best served by a parallel multidisciplinary and multi-departmental program. Our unique postdoctoral program at the Safar Center for Resuscitation Research, supported by a T32 since 2000 establishes important links across the continuum of care of brain injury in infants and children and facilitate rigorous scientific investigation across the key disciplines including pediatric critical care medicine, child neurology, pediatric neurological surgery, pediatric emergency medicine, neonatology, pediatric radiology, and pediatric rehabilitation medicine. We train fellows in these pediatric disciplines in both basic and clinical research in neurointensive care and resuscitation linking them to senior scientists. Our T32 program has had success in diversity recruitment specifically in recruiting applicants with disabilities. In this re-submitted competitive renewal application, funds are requested to support 4 positions each year (generally two new trainees each year). Since its inception, the program has filled every position with high-quality fellows who have published numerous peer-reviewed papers and abstracts, and have won many research awards. Since our last renewal 4 years ago, 3 of the graduates have gone on to major national funding including 2 receiving their first R01 awards and one receiving as PI a $1.87M multi-center Patient Centered Outcomes Research Institute (PCORI) grant. In the past 10 years, a total of 10 fellows funded by or clearly associated with our T32 have received 11 K awards. In the past 10 years our trainees have published 61 peer-reviewed papers (45 as first author), and many have received advanced degrees. They are highly sought after as faculty. The research focus is on cellular, molecular and biochemical mechanisms of secondary injury, novel therapies, and outcomes along with several new areas of study such as precision medicine and comparative effectiveness research, among others. We use a bench to bedside approach supported by federally funded studies by our faculty. We capitalize on the unique interaction between the Safar Center and the training programs at the Children's Hospital of Pittsburgh and the University of Pittsburgh School of Medicine and take advantage of unique resources and a Clinical and Translational Science Institute. The research areas of each mentor ask important questions suitable for career development and hypothesis testing. We integrate a curriculum in neurointensive care and involvement on a state-of-the-art pediatric neurocritical care clinical service. Graduates can formulate, execute, analyze, present, and publish experiments designed to answer key questions and are trained in grantsmanship and responsible conduct of research.
This program provides support for research training of physician-scientists specializing in the care of critically ill children with neurological crises sch as severe traumatic brain injury or anoxia from processes such as drowning or asphyxia. New therapies are desperately needed for these conditions from the field through the emergency department, intensive care unit, and rehabilitation. Our program thus attracts and trains young clinician scientists from each of these disciplines and offers training opportunities that range from basic science to clinical trials.
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