Collaborative Pediatric Critical Care Research Network

描述（由申请人提供）：本申请的目的是为密歇根儿童医院（CHM），韦恩州立大学（WSU）继续在合作儿科重症监护研究网络（CPCCRN）中工作。在第一个周期中，CPCCRN发起了广泛的研究，包括对危及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、药物和复苏干预的随机试验；informatics-based决策;基因研究;以及危重疾病对家庭影响的行为研究。Kathleen Meert，医学博士，华盛顿州立大学CPCCRN第一周期和拟议周期的PI，是一名儿科重症医师，拥有丰富的临床和转化研究经验。CHM的PICU是一个30张床位的多学科单位，每年照顾1500名不同种族和民族背景的患者。华盛顿州立大学的优势包括其在新生儿网络、母胎网络、儿科急诊护理应用研究网络、儿科药理学研究单位和儿童肿瘤小组方面的经验，以及在临床试验中对患者的长期随访方面的成功。患有严重疾病残废的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。残障后遗症包括慢性心理状况，如创伤后应激症状（PTSS）和精神障碍（PTSD）。本应用的概念提案将确定暴露于PICU治疗危重疾病的儿童PTSD和PTSD的患病率、风险和恢复因素；并开发PICU筛查工具，以识别患有PTSD和PTSD的高危儿童。核心假设是，儿童在PICU停留期间经常经历创伤性事件，可能导致创伤后应激障碍和创伤后应激障碍，并且在PICU停留期间可以确定风险和恢复力因素。该假设将通过追求3个具体目标来检验：(1)确定儿童危重疾病后PTSD和PTSD的患病率；(2)确定危重症患儿PTSD和PTSD的预测因素；(3)开发创伤后应激障碍和创伤后应激障碍的PICU筛查工具。这一概念提案意义重大，因为它将为有PTSD和PTSD风险的危重儿童的预防性干预措施的明确研究奠定基础。

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.