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Clinical Services (Critical Care Medicine):
PALISI: Pediatric Acute Lung Injury and Sepsis Investigators
The PALISI Network was founded in 2002 when pediatric critical care investigators participating in four multicenter trials in the US and Canada joined together to form one combined research network. 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 Children's Hospital, Boston 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 Children's Hospital Boston 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 also completed a 30-center observational study of anemia, blood loss and transfusion practices that was led by Drs. Scot Bateman and Adrienne Randolph from the MSICU.
Dr. Adrienne Randolph has been the Chair of the PALISI Network since its inception. There are currently investigators at 50 pediatric ICUs (45 US, 5 Canadian) participating in the PALISI Network. Participation in the network is voluntary. Investigators must raise money from government, foundation and industry sources to fund their research proposals.
The Center for the Critically Ill Child at Children's Hospital Boston funded the 1st International Sepsis Forum on Sepsis in Infants and Children that was a joint venture of the PALISI Network and the International Sepsis Forum. The purpose of the meeting was to create standard definitions for the types of common infections occurring in children in the ICU and to define populations with higher susceptibility to infection. These infections included pneumonia, urinary tract infections, central venous catheter-related infections, skin and soft tissue infections, and central nervous system infections, among others. The ultimate goal was to advance future research in infection treatment and prevention in critically ill children. Through the generous funding of our donors, we were able to make the entire proceeds of this 3-day consensus conference freely available worldwide through the Pediatric Critical Care Medicine website.
