Pediatric intensive care is a relatively young specialism that has gone through major developments in de the past decades. The introduction of milestones such as the endotracheal tube, mechanical ventilators, cardiopulmonary bypass and extra-corporal oxygenation has made modern pediatric intensive care possible. Yet, the efficacy of many intensive care interventions and therapies in the critically ill child lack scientific evidence underscoring the need for research.
Research of the PICU of the Emma Children’s Hospital focusses on three subjects:
a. Acute respiratory insufficiency
b. Long-term effects of critical diseases and treatments
c. Intensive care in resource poor settings.
Acute respiratory insufficiency
The respiratory tract is one of the most vulnerable vital systems in infants and children, due to age specific anatomy and physiology as well as the maturing character of individuals in this age group. Causes, morbidity and outcome of acute respiratory insufficiency in (young) children differ from adult patients. In addition, treatments modalities that are applied in adults may not be extrapolated to children.
The focus and subjects of the research line ‘Acute Respiratory Insufficiency’ of the PICU of the Emma Children’s Hospital are:
- Severe viral lower respiratory tract infections: pathogenesis, treatments and outcome
- Mechanical ventilation in children: modes, injurious effects
- Age: age specific characteristics of acute lung injury in children, including pathogenesis and outcome
- Respiratory complications after anesthesia for (cardio)surgery: improving preventive screening methods
Long term effects of critical illness and intensive care treatment
Critical illness and intensive care treatment may have both medical as well as psychological long-term deleterious effects in children and their caregivers. Knowledge and monitoring of these effects may have consequences for the treatment as well as preventive interventions during the acute phase.
The focus and subjects of the research line “Long term effects of critical illness and intensive care treatment” of the PICU in the Emma Children’s Hospital are:
- Medical effects: long-term medical effects of critical illness and intensive care treatment
- Psychological effects in patients: long term effects of intensive care treatment on psychiatric, psychological and neurocognitive functioning
- Psychological effects in parents and siblings: long-term effects of critical illness and intensive care admission of psychiatric and psychological functioning of parents and siblings
Intensive care and resource poor settings
Pediatric mortality due to circulatory and/or respiratory conditions in low and middle income countries is still unacceptably high. Reducing mortality requires improved knowledge on early recognition of life-threatening conditions and first line treatment of the critically ill children in these settings where other diseases and circumstances such as HIV, malaria, TB and malnutrition play a prominent role.
The focus and subjects of the research line “Intensive care and resource poor settings” of the PICU in the Emma Children’s Hospital are:
- Circulatory insufficiency: etiology, pathogenesis and consequences in resource poor settings
- Convulsions and Coma: etiology and outcome
Job BM van Woensel, MD PhD, principal investigator
Job C Calis, MD PhD, senior staff member PICU
Hennie Knoester, MD PhD, senior staff member PICU
Reinout A Bem, MD PhD, fellow PICU
Bart Cortjens, MD PhD student
Saranke Ingelse, MD PhD student
David van Meenen, MD, PhD student
Laura Schouten, MD, PhD student