John S Giuliano Jr MD

Associate Professor of Pediatrics (Critical Care); Medical Director, Pediatric Transport Service; Associate Medical Director, Pediatric Extracorporeal Membrane Oxygenation (ECMO) Service; Associate Medical Director, Pediatric Intensive Care Unit

Research Interests

Pediatric sepsis; Acute lung injury and the inflammatory response; Pediatric transport medicine

Current Projects

  • Describing the temporal kinetics of angiopoietin levels in children with varying degrees of sepsis.
  • Evaluating the biomarker profile of critically ill children with influenza infection
  • Understanding pediatric medication pharmacokinetics
  • Evaluating whether chlorhexidine-impregnated central line dressings in children reduce blood stream infections without causing skin breakdown

Research Summary

John Giuliano, M.D, has focused his research interests around inflammation and the host’s response to sepsis/acute lung injury. To this end, he is involved in a translational research project looking at the role angiopoietins play in capillary leak from pediatric sepsis. Additionally, he is looking at the incidence of morbidity and mortality in pediatric patients admitted to the ICU with influenza. Finally, he is investigating the use of an antiseptic-impregnated central line dressing to see if it reduces catheter associated blood stream infections.

Extensive Research Description

John Giuliano, M.D, research interest has centered around our body’s inflammatory response to infection. His main interest lies in the release of vascular growth factors called angiopoietins. He has shown that ang-2 is significantly elevated when children with septic shock are admitted to the PICU and that these levels peak around day 2 of illness. This growth factor may play a role in the capillary leak phenomena seen in these patients. Along similar lines, he is studying plasma biomarkers released when children have severe influenza infections. He will also be conducting a RTC comparing CHG-impregnated dressings to the current clear dressings used to cover central lines in children. Reports on the biopatch, a CHG disk, have demonstrated significant skin irritation in this population without clear reductions in infection.

Selected Publications

  • Giuliano Jr. JS, Tran K, Li FY, Northrup V, Tala JA, Bhandari V. The Temporal Kinetics of Circulating Angiopoietin Levels in Children with Sepsis. Accepted Pediatr Crit Care Med.
  • Thompson C, Shabanova V, Giuliano Jr. JS. The SNAP index does not correlate with the State Behavioral Scale in intubated and sedated children. Pediatric Anesthesia 2013; accepted August 9, doi: 10.1111/pan.12258.
  • Sanchez-Pinto N, Giuliano Jr. JS, Schwartz H, Garrett L, Gothard MD, Kantak A, Bigham MT. The Impact of Postintubation Chest Radiograph During Pediatric and Neonatal Critical Care Transport. Pediatr Crit Care Med 2013; 14(5):e213-e217.
  • Giuliano Jr. JS, Faustino EVS, Li S, Pinto MG, Canarie MF, Carroll CL for the Northeast Pediatric Critical Care Research Consortium (NEPCCRC). Corticosteroid Therapy in Critically Ill Pediatric Asthmatic Patients. Pediatr Crit Care Med 2013; 14(5):467-70.
  • Sanders Jr. RC, Giuliano Jr. JS, Sullivan J, Brown III CA, Walls RM, Nadkarni V, Nishisaki A. Level of Trainee and Tracheal Intubation Outcomes. Pediatrics 2013; 131(3): e821-8. Epub 2013 Feb 11.
  • Kline-Krammes S, Reed C, Giuliano Jr. JS, Schwartz HP, Forbes M, Pope J, Besunder J, Gothard MD, Russell K, Bigham MT. Heliox in Children with Croup: A Strategy to Hasten Improvement. Air Med J 2012; 31(3): 131-7.
  • Kandil S, Schmenk H, Northrup V, Bigham, MT, Giuliano Jr. JS. Pediatric Transport Triage Using the Transport Risk Assessment in Pediatrics (TRAP) Score. Prehospital Emergency Care 2012; 16(3):366-73. Epub 2012 Mar 23.
  • Randolph AG, Vaughn F, Sullivan R, Rubinson L, Thompson BT, Yoon G, Smoot E, Rice TW, Loftis LL, Helfaer M, Doctor A, Paden M, Flori H, Babbitt C, Graciano AL, Gedeit R, Sanders RC, Giuliano JS, Zimmerman J, Uyeki TM, and the Pediatric Acute Lung Injury and Sepsis Investigator’s Network and the National Heart, Lung and Blood Institute ARDS Clinical Trials Network. Critically Ill Children During the 2009-2010 Influenza Pandemic in the United States. Pediatrics 2011; 128(6):e1450-8. Epub 2011 Nov 7.
  • Wheeler DS, Giuliano JS Jr, Lahni PM, Denenberg A, Wong HR, Zingarelli B. The immunomodulatory effects of albumin in vitro and in vivo. Adv Pharmacol Sci 2011;2011:691928. Epub 2011 Apr 26.
  • Giuliano Jr. JS, Lahni PM, Bigham MT, Manning PB, Nelson DP, Wong HR, Wheeler DS. Plasma Angiopoietin-2 Levels Increase in Children Following Cardiopulmonary Bypass. Intensive Care Med 2008; 34(10):1851-7.


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