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.
|Dalton, Heidi J; Cashen, Katherine; Reeder, Ron W et al. (2018) Hemolysis During Pediatric Extracorporeal Membrane Oxygenation: Associations With Circuitry, Complications, and Mortality. Pediatr Crit Care Med 19:1067-1076|
|Berger, John T; Villalobos, Michele E; Clark, Amy E et al. (2018) Cognitive Development One Year After Infantile Critical Pertussis. Pediatr Crit Care Med 19:89-97|
|Basu, Sonali; Holubkov, Richard; Dean, J Michael et al. (2018) PICU Autopsies: Rates, Patient Characteristics, and the Role of the Medical Examiner. Pediatr Crit Care Med 19:1137-1145|
|Cornell, Timothy T; Selewski, David T; Alten, Jeffrey A et al. (2018) Acute kidney injury after out of hospital pediatric cardiac arrest. Resuscitation 131:63-68|
|Cashen, Katherine; Reeder, Ron; Dalton, Heidi J et al. (2018) Hyperoxia and Hypocapnia During Pediatric Extracorporeal Membrane Oxygenation: Associations With Complications, Mortality, and Functional Status Among Survivors. Pediatr Crit Care Med 19:245-253|
|Pollack, Murray M; Holubkov, Richard; Reeder, Ron et al. (2018) PICU Length of Stay: Factors Associated With Bed Utilization and Development of a Benchmarking Model. Pediatr Crit Care Med 19:196-203|
|Pollack, Murray M; Holubkov, Richard; Berg, Robert A et al. (2018) Predicting cardiac arrests in pediatric intensive care units. Resuscitation 133:25-32|
|Cashen, Katherine; Reeder, Ron; Dalton, Heidi J et al. (2018) Acquired infection during neonatal and pediatric extracorporeal membrane oxygenation. Perfusion 33:472-482|
|Berg, Robert A; Sutton, Robert M; Reeder, Ron W et al. (2018) Association Between Diastolic Blood Pressure During Pediatric In-Hospital Cardiopulmonary Resuscitation and Survival. Circulation 137:1784-1795|
|Meert, Kathleen; Telford, Russell; Holubkov, Richard et al. (2018) Paediatric in-hospital cardiac arrest: Factors associated with survival and neurobehavioural outcome one year later. Resuscitation 124:96-105|
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