Collaborative Pediatric Critical Care Research Network

描述(由申请人提供)：本申请的目的是为了让密歇根儿童医院(CHM)、韦恩州立大学(WSU)继续参与合作的儿科重症监护研究网络(CPCCRN)。在第一个周期中，CPCCRN启动了广泛的研究，包括威胁生命的疾病的流行病学研究；炎症和败血症的描述性研究；营养素、药物和复苏干预的随机试验；基于信息学的决策；基因研究；以及危重疾病对家庭影响的行为研究。凯瑟琳·梅尔特，医学博士，西苏里州立大学CPCCRN第一周期和拟议周期的PI，是一名拥有丰富临床和转化性研究经验的儿科强化医生。CHM的PICU是一个有30个床位的多学科单位，每年照顾1500名具有不同种族和民族背景的患者。WSU的优势包括其在新生儿网络、母婴网络、儿科急救应用研究网络、儿科药理研究单位和儿童肿瘤学小组方面的经验，以及在临床试验中成功地对患者进行长期跟踪。危重疾病残留物致残儿童的存活率正在增加；因此，长期随访已成为研究的重中之重。残留物包括慢性心理疾病，如创伤后应激症状(PTSS)和精神障碍(PTSD)。这一应用的概念提案将确定暴露在PICU治疗危重疾病的儿童中PTSS和PTSD的患病率以及PTSS和PTSD的风险和复原力因素；并开发PICU筛查工具，以确定PTSS和PTSD的高危儿童。中心假设是，儿童在PICU的停留通常是一种创伤性事件，可能导致创伤后应激障碍和创伤后应激障碍，风险和弹性因素可以在PICU停留期间确定。这一假设将通过追求三个具体目标来检验：(1)确定儿童危重疾病后PTSS和PTSD的患病率；(2)确定危重儿童PTSS和PTSD的预测因素；(3)开发用于PTSS和PTSD的PICU筛查工具。这一概念提案意义重大，因为它将为对有创伤后应激障碍和创伤后应激障碍风险的危重儿童进行预防性干预的最终研究奠定基础。

DESCRIPTION (provided by applicant): The aim of this application is for Children's Hospital of Michigan (CHM), Wayne State University (WSU) to continue in the Collaborative Pediatric Critical Care Research Network (CPCCRN). During its first cycle, the CPCCRN initiated a wide range of research including epidemiologic studies of life-threatening illnesses; descriptive studies of inflammation and sepsis; randomized trials of nutrients, drugs, and resuscitation interventions; informatics-based decision-making; genetic studies; and behavioral studies of the effects of critical illness on the family. Kathleen Meert, MD, PI for the CPCCRN at WSU during its first cycle and for the proposed cycle, is a pediatric intensivist with a wealth of clinical and translational research experience. The PICU at CHM is a 30 bed, multidisciplinary unit that cares for 1,500 patients/year with diverse racial and ethnic backgrounds. Strengths of WSU include its experience in the Neonatal Network, the Maternal-Fetal Network, the Pediatric Emergency Care Applied Research Network, the Pediatric Pharmacology Research Unit and the Children's Oncology Group, and its success with long-term follow-up of patients in clinical trials. Survival of children with disabling residuals of critical illness is increasing; thus long-term follow-up has become a top research priority. Disabling residuals include chronic psychological conditions such as post- traumatic stress symptoms (PTSS) and disorder (PTSD). The concept proposal for this application will determine the prevalence of and risk and resilience factors for PTSS and PTSD in children exposed to the PICU for treatment of critical illness; and develop a PICU screening tool to identify children at high risk for PTSS and PTSD. The central hypothesis is that children often experience their PICU stay as a traumatic event that can lead to PTSS and PTSD, and that risk and resilience factors can be identified during the PICU stay. The hypothesis will be tested by pursuing 3 specific aims: (1) Determine the prevalence of PTSS and PTSD after critical illness in children; (2) Identify predictors of PTSS and PTSD in critically ill children; and (3) Develop a PICU screening tool for PTSS and PTSD. The concept proposal is significant because it will lay a foundation for definitive studies of preventive interventions for critically ill children at risk of PTSS and PTSD.