2024
Assessing the Reliability of the Bleeding Assessment Scale in Critically Ill Children (BASIC) Definition: A Prospective Cohort Study.
Nellis M, Chegondi M, Willems A, Alqatani M, McMichael A, Aran A, Lerner R, Karam O. Assessing the Reliability of the Bleeding Assessment Scale in Critically Ill Children (BASIC) Definition: A Prospective Cohort Study. Pediatric Critical Care Medicine 2024 PMID: 39560732, DOI: 10.1097/pcc.0000000000003638.Peer-Reviewed Original ResearchCritically ill childrenAssessment ScaleIll ChildrenBleeding severityIntra-rater reliabilityInter-rater reliabilityCohort of critically ill childrenChildren aged 0Prospective cohort studyAssociated with increased 28-day mortalityEvaluation of bleedingActivated partial thromboplastin timeBedside nursesPatient demographic dataPartial thromboplastin timeTransfused blood componentsLonger hospital lengthParticipating PICUsCohort studyHemostatic medicationsDiverse cohortInotropic supportBleeding eventsSevere bleedingPlatelet countComprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study.
Hughes T, Treffalls R, Koek W, Dalton H, Karam O, Meyer A. Comprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study. Perfusion 2024, 2676591241289358. PMID: 39352407, DOI: 10.1177/02676591241289358.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationMultiple thrombotic eventsThrombotic eventsMembrane oxygenationPediatric extracorporeal membrane oxygenationMulti-center prospective studyEvaluate predictive factorsDays of therapyPlatelet transfusion volumeProspective cohort studyTransfusion volumeBinomial regressionPediatric patientsProlonged ECMOPlatelet volumePredictive factorsProspective studyUnivariate analysisAnti-XaCohort studySeverity scoreHigh riskPatientsAntithrombin IIIScoring tool
2023
Bleeding in Critically Ill Children With Malignancy or Hematopoietic Cell Transplant: A Single-Center Prospective Cohort Study
Levasseur J, Fikse L, Mauguen A, Killinger J, Karam O, Nellis M. Bleeding in Critically Ill Children With Malignancy or Hematopoietic Cell Transplant: A Single-Center Prospective Cohort Study. Pediatric Critical Care Medicine 2023, 24: e602-e610. PMID: 37678406, PMCID: PMC10843653, DOI: 10.1097/pcc.0000000000003374.Peer-Reviewed Original ResearchConceptsProspective cohort studyBleeding episodesSevere bleedingIll childrenCohort studyCell transplantIncidence rateLaboratory valuesMinimal bleedingRadiation therapySingle-center prospective cohort studyAssociated Patient CharacteristicsHigher PICU mortalityNew bleeding episodesOnly laboratory valueHematopoietic cell transplantCritically Ill ChildrenLow platelet countSevere bleeding episodesStem cell transplantPatient demographic dataSpecialized cancer hospitalModerate bleeding episodesYears of ageLonger PICUEpidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database study
Nellis M, An A, Mahmood H, Prishtina F, Hena Z, Karam O. Epidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database study. Perfusion 2023, 39: 536-542. PMID: 36606508, DOI: 10.1177/02676591221151027.Peer-Reviewed Original ResearchDirect thrombin inhibitorMembrane oxygenationPediatric Health Information System databaseThrombin inhibitorsHealth Information System databaseDifferent anticoagulant regimensRetrospective cohort studyUse of anticoagulationUse of bivalirudinPercent of encountersOccurrence of thrombosisRisk of thrombosisLarge administrative databaseMajority of childrenEligible encountersCardiac indicationsHeparin anticoagulationAnticoagulation regimensCohort studyMedian ageSystemic anticoagulationAnticoagulant regimensProspective studyPatient populationAdministrative databases
2021
Epidemiology of Bleeding in Critically Ill Children With an Underlying Oncologic Diagnosis
Romano J, Martinez M, Levasseur J, Killinger JS, Karam O, Nellis ME. Epidemiology of Bleeding in Critically Ill Children With an Underlying Oncologic Diagnosis. Critical Care Explorations 2021, 3: e0572. PMID: 34746797, PMCID: PMC8565795, DOI: 10.1097/cce.0000000000000572.Peer-Reviewed Original ResearchSevere bleedingOncologic diagnosisIll childrenEpidemiology of BleedingPICU-free daysSevere bleeding eventsVentilator-free daysIll pediatric patientsMedian platelet countRetrospective cohort studyInternational normalized ratioBlood component therapyVulnerable patient populationComprehensive cancer centerBleeding eventsHemostatic medicationsPICU admissionPercent patientsTransplant statusCohort studyMedian agePediatric patientsExact epidemiologySevere thrombocytopeniaPlatelet countEpidemiology of Bleeding in Critically Ill Children
Sequeira J, Nellis ME, Karam O. Epidemiology of Bleeding in Critically Ill Children. Frontiers In Pediatrics 2021, 9: 699991. PMID: 34422724, PMCID: PMC8371326, DOI: 10.3389/fped.2021.699991.Peer-Reviewed Original ResearchPediatric critical care unitRisk of mortalityCritical care unitsIll childrenCare unitClinical outcomesProspective observational cohort studyEpidemiology of BleedingPICU-free daysPercent of patientsVentilator-free daysDuration of surgeryObservational cohort studyCritically Ill ChildrenWorse clinical outcomesType of surgeryFurther multicenter studiesHigher severityCohort studyCritical illnessPediatric IndexSevere complicationsConsecutive patientsIll patientsMedian ageCompliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study*
Karsies T, Tarquinio K, Shein SL, Beardsley AL, Prentice E, Karam O, Fontela P, Moore-Clingenpeel M, Willson DF. Compliance With an Antibiotic Guideline for Suspected Ventilator-Associated Infection: The Ventilator-Associated INfection (VAIN2) Study*. Pediatric Critical Care Medicine 2021, 22: 859-869. PMID: 33965989, DOI: 10.1097/pcc.0000000000002761.Peer-Reviewed Original ResearchConceptsVentilator-associated infectionPositive respiratory culturesRespiratory culturesAntibiotic continuationPhase 3 subjectsRespiratory culture resultsVentilator-Associated InfectionsObservational cohort studyOverall study populationBaseline data collectionPhase 1Antibiotic discontinuationAntibiotic recommendationsAntibiotic guidelinesAntibiotic decisionsCohort studyGuideline adherenceMicrobiologic dataIllness severityMechanical ventilationAntibiotic managementRespiratory secretionsAntibiotic utilizationConsensus guidelinesAntibiotic treatmentVariation in Neonatal Transfusion Practice
Patel RM, Hendrickson JE, Nellis ME, Birch R, Goel R, Karam O, Karafin MS, Hanson SJ, Sachais BS, Hauser RG, Luban NLC, Gottschall J, Josephson CD, Sola-Visner M, National Heart L, Mast A, Hod E, Custer B, Vichinsky E, Spencer B, Mathew S, Harris D, Busch M, Norris P, Ness P, Kleinman S, Tamburro R, Glynn S, Malkin K. Variation in Neonatal Transfusion Practice. The Journal Of Pediatrics 2021, 235: 92-99.e4. PMID: 33836184, PMCID: PMC8316298, DOI: 10.1016/j.jpeds.2021.04.002.Peer-Reviewed Original ResearchConceptsWeeks of gestationEntire cohortPretransfusion hemoglobinPlatelet countNeonatal transfusionBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIIInternational normalized ratio (INR) valuesHematologic valuesNeonatal transfusion practicesPretransfusion platelet countRetrospective cohort studyBlood product transfusionGestational age groupsPatient blood managementNational Heart LungRecipient EpidemiologyInitial hospitalizationProduct transfusionCohort studyRed blood cellsGestational ageTransfusion practiceHeart LungBlood management
2020
Brighter Days May Be Ahead: Continuous Measurement of Pediatric Intensive Care Unit Light and Sound
Greenfield KD, Karam O, O'Meara A. Brighter Days May Be Ahead: Continuous Measurement of Pediatric Intensive Care Unit Light and Sound. Frontiers In Pediatrics 2020, 8: 590715. PMID: 33194924, PMCID: PMC7649178, DOI: 10.3389/fped.2020.590715.Peer-Reviewed Original ResearchPediatric intensive care unitCourse of admissionIll childrenTertiary care pediatric intensive care unitProspective observational cohort studyPost-intensive care syndromeObservational cohort studyIntensive care unitModifiable environmental factorsMedian illuminancePatients 0Cardiovascular supportCohort studyCare unitClinical effectsPatientsMedian light levelsSleep/AdmissionSound levelsMedian sound levelChildrenUnit lightHoursLevelsAssociation Between Lactates, Blood Glucose, and Systemic Oxygen Delivery in Children After Cardiopulmonary Bypass
Klee P, Rimensberger PC, Karam O. Association Between Lactates, Blood Glucose, and Systemic Oxygen Delivery in Children After Cardiopulmonary Bypass. Frontiers In Pediatrics 2020, 8: 332. PMID: 32656170, PMCID: PMC7325592, DOI: 10.3389/fped.2020.00332.Peer-Reviewed Original ResearchPediatric critical care unitPICU admissionSystemic oxygen deliveryCardiopulmonary bypassCritical care unitsOxygen extractionBlood glucoseOxygen deliveryCardiac surgeryCare unitLow systemic oxygen deliveryObservational cohort studyDuration of bypassWorse clinical outcomesHigher oxygen extractionLogistic regression modelsCohort studyCardiac lesionsClinical outcomesSurrogate markerPyruvate ratioAdmissionHyperlactatemiaSame timepointsBypassEpidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation.
Karam O, Goel R, Dalton H, Nellis ME. Epidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation. Critical Care Medicine 2020, 48: e698-e705. PMID: 32697511, DOI: 10.1097/ccm.0000000000004417.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkChest tube outputMembrane oxygenationHemostatic transfusionsRBC transfusionTransfusion doseExtracorporeal membrane oxygenation daysLarge observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkTube outputPlatelet transfusion doseObservational cohort studyHuman Development Collaborative Pediatric Critical Care Research NetworkInternational normalized ratioTotal platelet countPartial thromboplastin timeAntithrombin levelsCohort studyConsecutive childrenTransfusion strategyChest tubePlatelet countHemostatic testing
2019
Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity.
Nellis ME, Tucci M, Lacroix J, Spinella PC, Haque KD, Stock A, Steiner ME, Faustino EVS, Zantek ND, Davis PJ, Stanworth SJ, Cholette JM, Parker RI, Demaret P, Kneyber MCJ, Russell RT, Stricker PA, Vogel AM, Willems A, Josephson CD, Luban NLC, Loftis LL, Leteurtre S, Stocker CF, Goobie SM, Karam O. Bleeding Assessment Scale in Critically Ill Children (BASIC): Physician-Driven Diagnostic Criteria for Bleeding Severity. Critical Care Medicine 2019, 47: 1766-1772. PMID: 31567407, PMCID: PMC6861687, DOI: 10.1097/ccm.0000000000004025.Peer-Reviewed Original ResearchConceptsIll childrenAssessment ScaleDiagnostic criteriaProspective cohort studyRed cell transfusionCritically Ill ChildrenFuture epidemiologic studiesDelphi consensus processInternational expert consensusRounds of votingBleeding severityRelevant bleedingSubstantial inter-rater reliabilityBleeding episodesCell transfusionCohort studyCritical illnessOrgan dysfunctionOnline Delphi processSurgical interventionPediatric intensivistsPatient outcomesInter-rater reliabilityEpidemiologic studiesExpert consensusQuantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome.
Nellis ME, Dalton H, Karam O. Quantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome. Critical Care Medicine 2019, 47: e886-e892. PMID: 31449061, PMCID: PMC8608374, DOI: 10.1097/ccm.0000000000003968.Peer-Reviewed Original ResearchConceptsChest tube bleedingExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkMembrane oxygenationChest tubeClinical outcomesPlatelet countML/Large observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkPICU-free daysPercent of patientsObservational cohort studyWorse clinical outcomesHuman Development Collaborative Pediatric Critical Care Research NetworkMembrane oxygenation specialistsHospital mortalityTransfusion volumeCohort studyHeparin doseConsecutive patientsThrombotic eventsPediatric institutionHemostatic testsAnemia at Discharge From the PICU: A Bicenter Descriptive Study.
Demaret P, Valla FV, Behal H, Mimouni Y, Baudelet JB, Karam O, Recher M, Duhamel A, Tucci M, Javouhey E, Leteurtre S. Anemia at Discharge From the PICU: A Bicenter Descriptive Study. Pediatric Critical Care Medicine 2019, 20: e400-e409. PMID: 31246740, DOI: 10.1097/pcc.0000000000002015.Peer-Reviewed Original ResearchConceptsPediatric critical illnessPICU admissionPICU dischargeRisk of anemiaCritical illnessRisk markersHigher C-reactive protein levelsInotropic/vasopressor supportC-reactive protein levelsWorld Health Organization criteriaMedian hemoglobin levelRetrospective cohort studyElectronic medical recordsVasopressor supportPlasma transfusionCohort studyCreatinine levelsMultivariate adjustmentAnemic childrenHemoglobin levelsMechanical ventilationAnemia statusOrganization criteriaMedical recordsIll children
2018
Platelet Transfusion Practices in Critically Ill Children
Nellis ME, Karam O, Mauer E, Cushing MM, Davis PJ, Steiner ME, Tucci M, Stanworth SJ, Spinella PC. Platelet Transfusion Practices in Critically Ill Children. Critical Care Medicine 2018, 46: 1309-1317. PMID: 29727368, PMCID: PMC6476545, DOI: 10.1097/ccm.0000000000003192.Peer-Reviewed Original ResearchConceptsPlatelet transfusionsCells/LMajor bleedingProphylactic transfusionICU mortalityMinor bleedingIll childrenOverall ICU mortalityPediatric critical illnessPlatelet transfusion practicesProspective cohort studyProphylactic platelet transfusionsCohort studyCritical illnessPost transfusionAdjusted analysisPlatelet countTransfusion practiceAppropriate indicationsMedian changePlatelet doseTransfusionBleedingCells/L.Prophylaxis