PTCIB Research Programs

PTCIB supports research opportunities to inform the practice of healthcare providers who stabilize, diagnose, and manage the care of critically ill and injured children of all ages. Such research focuses on investigating the safety and effectiveness of treatment and management strategies for all sorts of pediatric critical illness and injury, including sepsis (blood infection), multiple organ dysfunction syndrome (MODS), acute lung injury, and severe traumatic brain injury (TBI). In addition, we will support research focused on the care of critically ill children and on the toll that such illness takes on the family.

Pediatric Critical Care Medicine, Pathophysiology, and Management of Critical Illness

Program Official: Tessie October

This program includes projects on the following topics related to critical illness:

• Physiology/pathophysiology of critical illness
• Biomarkers
• Medical and pharmacological management of critical illness
• Pediatric surgery and surgical intervention
• Anesthesia
• Remote monitoring/telemedicine for critically ill children
• Statistical modeling studies of critical illness
• Medical devices
• Decision-making for families of children with critical illness
• Social determinants of health
• Conditions of particular interest include:
  • MODS
  • Sepsis (but not neonatal sepsis)
  • Severe TBI
  • Serious life-threatening injury (includes studies that may investigate initial treatment in the emergency department [ED] but that ultimately manages the injury in the pediatric intensive care unit [PICU])
  • Acute lung injury
  • Critical status asthmaticus
  • Critical illness in children with complex, chronic conditions

Ethical, Translational, and Applied Research in Pediatric Critical Care Practice

Program Official: Tammara Jenkins

This program includes projects on:

• Nursing and non-pharmacological management of critical illness: Includes studies that may investigate general clinical care in the PICU (e.g., sleep, nutrition, music therapy, circadian rhythm, pet therapy, etc.), and non-pharmacological management of pain in the critically ill or injured child
• Grief and loss in PICU populations: Includes grief/loss/bereavement with parents, siblings, and pediatric patients
• Bereavement/palliative care/end-of-life: Includes end-of-life care and palliative care in the hospitalized child (PICU/acute care)  
• Ethical issues related to pediatric critical illness and pediatric critical care research
• Functional outcomes of critical illness: Includes acute rehabilitation after critical illness
• Environment of care
  • Healthcare systems: Includes PICU organization, structure, function
  • Interdisciplinary health care team dynamics and family communications: Includes family-centered care in the PICU, family conferences, interdisciplinary care conferences, PICU staff burnout, stress, and moral distress
  • Clinical education and training in the PICU
  • Patient safety: Includes medical errors in the PICU, quality indicators, development of care guidelines
• Psychosocial aspects of critical care (child, family, and health care provider): Includes family-centered care in the PICU, posttraumatic stress disorder in patients and families, post-ICU syndrome in patients and families, stress and coping, family presence, resiliency
• Care-based implementation science: Includes implementation and dissemination studies focused on care of the critically ill or injured child in the PICU
• Pediatric palliative care in the hospitalized child: Includes palliative care and end-of-life care in the hospitalized pediatric patient (ED, acute care, and ICU); basic science, clinical, and translational research; training and career development
• Acute care of the hospitalized child: Includes epidemiology, prevention, diagnosis, treatment/care /outcomes of acute inpatient medical care; basic science, clinical, and translational research; training and career development

In addition to investigator-initiated research, the program also supports research training within this research area, including the Pediatric Critical Care and Trauma Scientist Development Program, a national faculty training and career development program that helps pediatric critical care and trauma physician-scientists enhance their scientific understanding, clinical management, and rehabilitation of pediatric trauma and critical illness.

The program also supports the Collaborative Pediatric Critical Care Research Network, which serves as a national resource for studying the scientific bases of pediatric critical care medicine.

This program supports investigator-initiated research to advance the science of trauma and injury prevention and care for pediatric populations, with the goal of reducing the leading causes of morbidity and mortality in children. The overall program encourages projects to develop new methods, interventions, and measurement tools to improve clinical outcomes in children.

Program priorities address the full continuum of care, from prevention through treatment, and then through acute rehabilitation. It supports research on both inflicted and unintentional injuries, and on the diagnosis and treatment of all forms of child abuse and neglect. The program also includes violence and violence-related injuries and the prevention, treatment, and biomedical outcomes of violence.

This program also supports research and training opportunities aimed at advancing emergency medical services for children (EMSC) science. Such research focuses on investigating optimal (safe and quality) EMSC from prehospital settings through ED care. The branch also encourages research that evaluates effective health care delivery practices, interventions, and treatments of critically and non-critically ill/injured children within the EMSC system. In addition, complementary and ground-breaking research is encouraged to inform the field of disaster management involving children, including emergency preparedness for and mitigation of disasters and public health emergencies, and the acute response and recovery of children in these events.

Unintentional Injury Prevention and Trauma Care

Program Official: Cinnamon Dixon

This program includes projects on:

• Injury/trauma resulting from unintentional causes such as motor vehicle or road traffic-related (vehicle, bicycle, pedestrian), drowning, falls, poisoning, fire/burns, animals
• Unintentional injury/trauma patterns such as penetrating, blunt, blast, hemorrhagic, fracture, laceration, wound, TBI, concussion, spinal, or intra-abdominal injuries
• Epidemiology, pathophysiology, and prevention of unintentional injury/trauma
• Diagnostics, interventions, and treatments related to injury/trauma care
• Communication, patient/family/healthcare team dynamics in trauma care
• Telemedicine and simulation in trauma care
• Unintentional injury and trauma outcomes including morbidity/mortality, pain, and cost
• Health disparities in unintentional injury/trauma
• Dissemination and implementation of unintentional injury/trauma care best-practices

EMSC and Disaster Management

Program Official: Cinnamon Dixon

This program includes projects on:

• EMSC research in prehospital (first-responders, clinics, EMS/transport) and emergency department settings
• Epidemiology, pathophysiology, and prevention of pediatric emergencies
• Health care preparedness for pediatric emergencies
• Delivery of EMSC care (quality, processes, safety)
• Use of EMSC systems and social determinants of health
• Triage, diagnostics, bio-analytics, and statistical modeling in EMSC
• Sedation/anesthesia, analgesia, and pharmacologic management in EMSC
• Medical/surgical interventions and treatments in EMSC
• mHealth, eHealth, telemedicine, simulation in EMSC
• EMSC outcomes including morbidity/mortality, use, length of stay, experience, and cost
• Patient/family/health care team dynamics, decision-making and care coordination in EMSC
• Epidemiology of disasters and public health emergencies involving children
• Pathophysiology of conditions affecting children involved in disasters
• Preparedness for and mitigation of disasters involving children
• Disaster response and acute recovery for children
• Dissemination and implementation of EMSC and disaster management science and best practices

Trauma, Violence, and Child Maltreatment

Program Official: Leah Gilbert

This program includes projects on:

• Epidemiology of violence and violence-related injury, including understanding means and types of violence and their inter-relationships, the spread of violence in domestic and international contexts, victimization, prevention, and treatment
• Diagnosis, treatment, and prevention of child maltreatment, including sexual assault, abusive head trauma, medical abuse/neglect, adverse childhood experiences, sudden unexplained death in children, treatment and care of abuse, and screening, prevention, and medical and physical health outcomes
• Neurobiology of violence, traumatic stress, and abuse, including basic, clinical, and translational studies on the biological embedding of trauma exposure

Psychological Trauma, Resilience, and Wellbeing

Program Official: Valerie Maholmes

This program includes projects on:

• Psychological processes that co-occur with physical trauma and that affect treatment, recovery, and well-being 
• Trauma-informed care in child-serving systems, including disparities in systems of care
• Trauma-informed approaches for responding appropriately to child and adolescent psychological trauma and its effects 
• Acute and long-term psychological effects of adverse events on children/youth, and the development of appropriate responses to foster resilience and prevent further traumatization from these incidents
• Effects of intergenerational and historical trauma on community, family, and child health and well-being