By: NCS Research Operations Subcommittee: Caitlin Brown PharmD, Michelle Schober MD, Shraddha Mainali MD, Cassia Righy MD, Minjee Kim MD, Tom Lawson CNP, Jennifer Kim MD, PhD, Ruchi Jha MD
Can you tell me a little about yourself and how you got involved in the Neurocritical Care Society?
I am a Pediatric Neurointensivist and Associate Professor of Pediatric Critical Care Medicine at Primary Children’s Hospital. I grew up in the United States and Colombia and completed all my medical training in both countries. During my pediatric critical care fellowship at the University of Miami I became interested in bench research. Since that time, I have developed a basic research program in pediatric traumatic brain injury (TBI) using rat pup and piglet models to generate preclinical data. I obtained a Master’s degree in Clinical Investigation with an emphasis on basic science research and Neuroscience during my early years at the University of Utah. I focus on cognitive outcomes and neuro-inflammation in the field of pediatric TBI. I am the immediate past chair of the Pediatric Neurocritical Care Network (PNCRG) and helped develop the Pediatric Subsection of NCS. My favorite part about NCS has been their welcoming attitude towards pediatric specialists partnering in neuroscience. I am excited to continue helping to create collaborations between PNCRG and NCS.
What is the mission of the Pediatric Neurocritical Care Research Group (PNCRG)?
The PNCRG started approximately 10 years ago. Their mission statement reads, “the PNCRG is dedicated to advancing knowledge to optimize neurologic outcomes for critically-ill children by performing clinical and preclinical studies, supporting education, developing and promoting best practices for pediatric neurocritical care and fostering advocacy.” The current membership represents over 60 institutions from 9 countries. The PNCRG meets formally twice a year to foster research ideas, present results and provide research proposal feedback.
How did the pediatric section of NCS start and what is the section currently working on?
Dr. Mark Wainwright sparked the idea of expanding Pediatric Neurocritical Care within NCS. The pediatric section within NCS currently has 67 members and continues to grow! We have built pediatric components of ENLS, created pediatric elements of “On-Call,” and gained pediatric representation in many committees. NCS has given us tremendous support and a platform to broaden our network. This has aided us in expanding our research network.
What type of research is the Pediatric Section of NCS and PNCRG currently working on?
Wow – where to start! We have a long history of completed and ongoing projects. To name a few..
- This is the pediatric arm of an adult study initiated by Dr. Molly Mcnett, PhD, RN, CNRN, FNCS, FAAN and Dr. Sherry Chou, MD, MMSC, FNCS. GCS-NeuroCOVIDpeds enrolls hospitalized pediatric patients (<18 years old) with a diagnosis of COVID or a COVID-related condition to collect granular data on the neurologic signs and symptoms during hospitalization, discharge outcomes and post-discharge condition. This study is ongoing and has been funded by an NCS Incline grant (Ericka Fink, PI, U of Pittsburgh).
- Transcranial Dopplers(TCD) Interest Group
- A subgroup within PNCRG is actively preparing to increase education and clinical availability of TCD within pediatric neurocritical care. They conducted a survey regarding TCD use and have published regarding current status and recommendations for standardizing practice in pediatric patients. This effort is ongoing.
- ADAPT (Approaches and Decisions in Acute Pediatric TBI)
- Michael Bell, MD completed the largest pediatric TBI study to date, 1000 patients in national and international sites. This was an NIH-funded, comparative effectiveness study to address TBI guidelines in pediatric patients with TBI.
- MRI Markers of Functional Outcomes After Severe Pediatric TBI
- Peter Ferrazzano, MD is the current Chair of PNCRG. He conducted an NIH funded ancillary study on MRIs from patients enrolled in ADAPT. This study is ongoing, but enrollment is closed.
- POCCA – Personalizing Outcomes after Child Cardiac Arrest
- The PI, Dr. Ericka Fink, MD, MS seeks to explore outcomes and biomarkers in pediatric cardiac arrest patient. This NIH funded, multicenter study is ongoing.
- BEAM– Biomarkers of Brain Injury in Critically Ill Children on ECMO
- Melanie Bembeae, MD, MPH, PhD is the PI of this NIH funded multicenter study of brain injury biomarkers in children who require extracorporeal membrane oxygenation. This study is ongoing.
- Park-PICU: Prevalence of Acute Rehab for Kids in the PICU
- Sapna Kudchadkar, MD, PhD is the PI of this NIH funded multicenter study evaluating early use of rehabilitation for PICU patients. This study is ongoing.
What are the biggest areas you hope to see NCS and PNCRG research in the future?
We have so much to learn! TBI is a common and devastating disease in children. I hope we can find non-invasive global measures of supply and demand in the brain. Additionally, with the increase in genetic testing I hope we can increase mechanistic understanding and diagnostics in neuroinflammatory conditions such as NORSE/FIRES. I believe that the commonalities and differences between the developing, mature and aging brain will strengthen the quality and impact of neurocritical care research when we partner to study patients across the age span.
What are ways NCS members can get involved in Pediatric Research within NCS?
- Join the Pediatric Section of NCS! Reach out on the NCS Pediatric Section Discussion Board!
- Also, visit our PNCRG website for more ways to collaborate. NCS and non-NCS members are welcome.
- Spread the word to your pediatric colleagues at your institutions! More information can be found at: http://www.pncrg.org/