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合作儿科重症护理研究网络的一部分。该网络将汇集具有研究专长和临床技能的核心儿科重症医师，调查危重和受伤儿童的新治疗和管理策略的安全性、有效性和风险/效益/成本比。该网络将开展广泛的跨学科研究，包括对危及生命的疾病进行流行病学研究，对炎症和器官衰竭的病理生理学进行描述性和转译性研究，对药物、程序和其他干预措施进行随机试验，具体评估它们对长期结果的影响，以及对危重疾病对儿童及其家庭的影响进行行为研究。华盛顿州立大学的儿科重症监护医学（PCCM）教师负责最先进的，多学科的20张病床的PICU，每年有1400名内科和外科病人入院。PCCM教师在PICU进行了许多随机试验和观察性研究，并参与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。华盛顿州立大学的优势包括NICHD儿童药理学研究网络、新生儿研究网络、母胎网络、儿童肿瘤组的成员资格，以及对临床试验患者的长期随访能力。这一概念提案将验证一个假设，即在儿童死于重症监护病房3个月后召开医生-父母尸检会议，可以减少病理性悲伤和随后的家庭破裂的可能性。目标1将把事后会议发展为战略沟通会议。目的2将评估死后会议对丧亲父母病理性悲伤、心理困扰和婚姻功能障碍的纵向影响。目的3将评估病理性悲伤、心理困扰和婚姻功能障碍的危险因素，以及在确定的高危人群中进行死后会议的效果。

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.