Collaborative Pediatric Critical Care Research Network

描述（由申请人提供）：本提案的总体目标是让韦恩州立大学（WSU）成为NICHD协作儿科重症监护研究网络的一部分。该网络将汇集具有研究专业知识和临床技能的儿科重症监护医师核心，以调查危重和受伤儿童的新型治疗和管理策略的安全性，有效性和风险/效益/成本比。该网络将进行广泛的跨学科研究，包括危及生命的疾病的流行病学研究，炎症和器官衰竭的病理生理学的描述性和转化性研究，药物，程序和其他干预措施的随机试验，特别是评估其对长期结果的影响，以及危重疾病对儿童及其家庭影响的行为研究。WSU的儿科重症监护医学（PCCM）学院负责最先进的多学科20床PICU，每年有1，400名医疗和手术入院。PCCM教师在PICU进行了许多随机试验和观察性研究，并参加了其他多中心研究网络。该学院与儿科外科医生有着悠久的合作历史。WSU的优势包括NICHD儿科药理学研究网络，新生儿研究网络，产妇胎儿网络，儿童肿瘤学小组的成员资格，以及其在临床试验中长期随访患者的能力。该概念提案将测试一个假设，即在儿童在PICU死亡3个月后，医生-父母验尸会议可以减少病理性悲伤和随后的家庭破裂的可能性。目标1将把验尸会议发展为一种战略性的沟通交流。目的二探讨死后会议对丧亲父母病理性悲伤、心理困扰及婚姻障碍之纵向影响。目的三将评估病理性悲伤、心理困扰和婚姻障碍的危险因素，以及死后会议在确定的高危人群中的作用。

DESCRIPTION (provided by applicant): The overall aim of this proposal is for Wayne State University (WSU) to be a part of the NICHD Collaborative Pediatric Critical Care Research Network. The Network will bring together a core of pediatric intensivists with the research expertise and clinical skill to investigate the safety, efficacy, and risk/benefit/cost ratios of novel treatments and management strategies for critically ill and injured children. The Network will conduct a wide range of transdisciplinary research including epidemiologic studies of life-threatening diseases, descriptive and translational studies of the pathophysiology of inflammation and organ failure, randomized trials of drugs, procedures and other interventions specifically evaluating their effect on long-term outcomes, and behavioral studies of the effect of critical illness on the child and his/her family. The Pediatric Critical Care Medicine (PCCM) faculty at WSU is responsible for the state-of-the-art, multidisciplinary 20-bed PICU that has 1,400 medical and surgical admissions annually. The PCCM faculty has conducted many randomized trials and observational studies in the PICU, and participated in other multicenter research networks. The faculty has a long history of collaboration with pediatric surgeons. Strengths of WSU include membership in the NICHD Pediatric Pharmacology Research Network, the Neonatal Research Network, the Maternal Fetal Network, the Children's Oncology Group, and its capability for long-term follow-up of patients in clinical trials. The concept proposal will test the hypothesis that a physician-parent postmortem conference 3 months after a child's death in the PICU can reduce the likelihood of pathological grief and subsequent family break-up. Aim 1 will develop the postmortem conference as a strategic communication encounter. Aim 2 will evaluate the longitudinal effect of the postmortem conference on pathological grief, psychological distress and marital dysfunction in bereaved parents. Aim 3 will evaluate risk factors for pathological grief, psychological distress and marital dysfunction, and the effect of the postmortem conference in the identified high-risk groups.