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The initial clinical trial that initiated the network was a randomized trial that assigned critically ill children to one of three mechanical ventilator weaning strategies to determine the best way to wean them from the mechanical ventilator support. This study was initiated at Boston Children's Hospital by Drs. Adrienne Randolph and John Arnold in the Medical-Surgical ICU with the assistance of the Respiratory Care Department in protocol development and testing. The study was funded by Ronald McDonald House Charities. The results of this trial were published in JAMA in 2002 (abstract). The trial results led to widespread use of the extubation readiness test to determine if children could be safely extubated from mechanical ventilator support.
One of the other three major studies that founded the PALISI Network was also initiated at Boston Children's Hospital and led by Drs. Martha Curley and John Arnold. This study of prone positioning for children with acute lung injury was funded by the National Institutes of Health. Results of this randomized trial revealed that prone positioning was an ineffective intervention in children with acute lung injury (abstract). The other two trials that initiated the network included a trial showing that intratracheal Calfactant to be beneficial for children with respiratory failure and acute lung injury (abstract), and a randomized trial comparing a high versus low target hemoglobin threshold that has been submitted for publication.
The PALISI Network's goal is to perform multi-center research studies to better describe disease processes and outcomes in pediatric patients and to evaluate interventions in this population. Since 1999, PALISI Network investigators have successfully conducted and published 4 large multicenter randomized controlled clinical trials including:
A randomized clinical trial comparing two protocols (pressure support and volume support) to no protocol for weaning infants and children from mechanical ventilator support. Principal Investigator: Adrienne Randolph, MD, MSc, Children's Hospital, Boston. Published in JAMA 2002 Nov 27;288(20):2561-8. [abstract]
A randomized clinical trial of prone positioning for acute lung injury in children. Principal Investigator: Martha Curley, RN, PhD, Children's Hospital, Boston. Published in JAMA. 2005 Jul 13;294(2):229-37. [abstract]
A randomized clinical trial of calf-lung surfactant for acute lung injury. Principal Investigator: Doug Willson, MD, University of Virginia Children's Medical Center Published in JAMA. 2005 Jan 26;293(4):470-6. [abstract].
A randomized trial of liberal versus restrictive hemoglobin target for stable critically ill children. Principal Investigator: Jacques Lacroix, MD, Hospital St. Justine, Montreal, Quebec, Canada. Published in New Engl J Med 2007; 356:1609-1619. [abstract]
The PALISI Network has also recently performed the largest multicenter observational study in pediatric critical care to date on anemia, blood loss and transfusion practices across 30 PICUs. The PALISI Network holds meetings twice per year in the winter and fall. For more information about the PALISI Network, visit the PALISI website.
The Critical Care, Anesthesia, and Perioperative Extension (CAPE) Program is a comprehensive and longitudinal care practice group for children with significant special health care needs, technology dependence and medical complexities. Services include consultation and support to families and institutions who are considering homecare of ventilator assisted children, long-term coordination of care including home visits, and perioperative consultation and planning around critical care recovery and rehabilitation. Transitional care, coordination with community services, and education out-reach are also offered to improve the quality of life for these children and their families.
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”