I am heavily involved in a bi-campus initiative on pediatric ventilator associated pneumonia (pVAP). Although primarily a quality improvement initiative, we recently presented an abstract describing our process for developing a case definition tool for the diagnosis of pVAP and implementing a pediatric VAP bundle that was presented at the Society for Critical Care Medicine Annual Congress.
Near-4-Kids is a mulit-institutional national emergency airway registry for children; it is another quality improvement initiative, with a research component, that I participate in. This collaborative seeks to identify factors associated with adverse events surrounding tracheal intubation with an ultimate goal of compiling ‘best practices' surrounding to tracheal intubation associated with a reduced risk of adverse events.
As fellowship program director, I am supervising several of the Pediatric Critical Care Medicine fellows as they develop, conduct and complete their research projects. These include a recently completed pilot study evaluating the relationship between severity of illness and interleukin-12 (IL-12) levels and an ongoing study to assess the utility of a vancomycin dosing protocol to improve efficiency and reduce toxicity associated with vancomycin dosing. Planned studies involving or led by fellows include: a prospective study evaluating the utility of noninvasive cardiac output monitoring in the pediatric population; a prospective study utilizing urine cortisol levels to assess the appropriateness of empiric stress hydrocortisone dosing in patients with a clinical assessment of adrenal insufficiency; a prospective study assessing the use of simulation of unsuccessful resuscitations in improving resident communication and comfort around end-of-life care.