ABOUT THE RESEARCHER

OVERVIEW

Dr. Monica Kleinman has a strong clinical and academic interest in pediatric resuscitation, including the development of evidence-based treatment guidelines. Dr. Kleinman has been a volunteer for the American Heart Association (AHA) for more than 30 years. In 2003 she was appointed to the AHA’s National Emergency Cardiovascular Care Committee's Pediatric Subcommittee and subsequently served as its chair from 2007 through 2009. Dr. Kleinman's contributions include serving as an editor of the 2006 version of the Provider and Instructor Textbooks for Pediatric Advanced Life Support (PALS), and writing group chair for the 2010 AHA PALS Guidelines and 2015 AHA Basic Life Support Guidelines. From 2011 through 2015 she served as co-chair of the Pediatric Task Force for the International Liaison Committee on Resuscitation (ILCOR), the international consortium that develops consensus statements on resuscitation science and treatment recommendations. Currently Dr. Kleinman serves as a Domain Lead for the ILCOR continuous evidence evaluation process.

Dr. Kleinman is also passionate about patient safety and harm prevention, including the early identification of patient deterioration outside of the critical care setting. She developed the early warning score system used at Boston Children’s Hospital and has published several reports on its use as a predictor of deterioration in specific patient populations as well as in resource-limited settings. She is also interested in in-hospital emergency response systems in Children’s Hospitals, the use of checklists for improving patient safety, and inter-facility transport for critically ill children.

Dr. Kleinman has served as principal investigator for several clinical trials for children suffering from a rare disease, progeria. Affected children appear to age prematurely with poor growth, hair loss, skin tightness and joint contractures and, most importantly, accelerated atherosclerosis. Children die from cardiovascular events (heart attacks, heart failure and stroke) at an average age of 14. The genetic cause of progeria is a single base pair mutation in the Lamin A gene which results in the production of a mutant Lamin A protein. This protein, known as progerin, permanently intercalates into the nuclear membrane resulting in tissue and organ dysfunction. Clinical trials are aimed at reducing the production of progerin as well as hastening its elimination from affected cells. Three interventional trials at Boston Children’s Hospital have demonstrated that one drug, Lonafarnib, improves vascular distensibility and extends lifespan of children with the disease.

BACKGROUND

Dr. Monica Kleinman earned her MD from Brown University, then completed a residency in pediatrics at Rhode Island Hospital. She subsequently completed fellowship training in neonatology (Women & Infants’ Hospital) and pediatric critical care medicine (Yale-New Haven Hospital and Massachusetts General Hospital). She is currently a senior associate in Critical Care Medicine at Boston Children’s Hospital and serves as the Medical Director for the Medical-Surgical Intensive Care Unit and Critical Care Transport Service. She is responsible for the hospital’s emergency medical response system and is the senior medical advisor for the Program in Patient Safety and Quality.

PUBLICATIONS

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  1. Pediatric timing of epinephrine doses: A systematic review. Resuscitation. 2021 Mar; 160:106-117. View abstract
  2. Trends over time in drug administration during pediatric in-hospital cardiac arrest in the United States. Resuscitation. 2021 Jan; 158:243-252. View abstract
  3. eStablish And Formalize Expert Criteria for Avoidable Resuscitation Review (SAFECARR) Electronic Delphi: Development of a Consensus Framework for Classifying and Reviewing Cardiac Arrests Within the PICU. Pediatr Crit Care Med. 2020 11; 21(11):992-999. View abstract
  4. Adult Advanced Life Support: International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2020 Sep 21. View abstract
  5. The Impact of Videolaryngoscopy on Endotracheal Intubation Success by a Pediatric/Neonatal Critical Care Transport Team. Prehosp Emerg Care. 2020 May 15; 1-8. View abstract
  6. Interim Guidance for Basic and Advanced Life Support in Children and Neonates With Suspected or Confirmed COVID-19. Pediatrics. 2020 May 04. View abstract
  7. Intravenous vs. intraosseous administration of drugs during cardiac arrest: A systematic review. Resuscitation. 2020 04; 149:150-157. View abstract
  8. Skeletal maturation and long-bone growth patterns of patients with progeria: a retrospective study. Lancet Child Adolesc Health. 2020 04; 4(4):281-289. View abstract
  9. Pediatric Massive and Submassive Pulmonary Embolism: A Single-Center Experience. Hosp Pediatr. 2020 03; 10(3):272-276. View abstract
  10. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations: Summary From the Basic Life Support; Advanced Life Support; Pediatric Life Support; Neonatal Life Support; Education, Implementation, and Teams; and First Aid Task Forces. Circulation. 2019 12 10; 140(24):e826-e880. View abstract
  11. 2019 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2019 12; 145:95-150. View abstract
  12. A Stroke Alert Protocol Decreases the Time to Diagnosis of Brain Attack Symptoms in a Pediatric Emergency Department. J Pediatr. 2020 01; 216:136-141.e6. View abstract
  13. Multidisciplinary Quality Improvement Intervention to Achieve Sustained Improvement in Hand Hygiene Reliability in a Pediatric Intensive Care Unit. Pediatr Qual Saf. 2019 Nov-Dec; 4(6):e227. View abstract
  14. Cardiopulmonary Resuscitation in the Pediatric Cardiac Catheterization Laboratory: A Report From the American Heart Association's Get With the Guidelines-Resuscitation Registry. Pediatr Crit Care Med. 2019 11; 20(11):1040-1047. View abstract
  15. Trends in Survival After Pediatric In-Hospital Cardiac Arrest in the United States. Circulation. 2019 10 22; 140(17):1398-1408. View abstract
  16. Microbiome at sites of gingival recession in children with Hutchinson-Gilford progeria syndrome. J Periodontol. 2018 06; 89(6):635-644. View abstract
  17. ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement. Circulation. 2018 05 29; 137(22):e802-e819. View abstract
  18. ILCOR Scientific Knowledge Gaps and Clinical Research Priorities for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care: A Consensus Statement. Resuscitation. 2018 06; 127:132-146. View abstract
  19. Association of Lonafarnib Treatment vs No Treatment With Mortality Rate in Patients With Hutchinson-Gilford Progeria Syndrome. JAMA. 2018 04 24; 319(16):1687-1695. View abstract
  20. Cardiopulmonary Resuscitation in Infants and Children With Cardiac Disease: A Scientific Statement From the American Heart Association. Circulation. 2018 05 29; 137(22):e691-e782. View abstract
  21. Cardiac Abnormalities in Patients With Hutchinson-Gilford Progeria Syndrome. JAMA Cardiol. 2018 04 01; 3(4):326-334. View abstract
  22. Physiologic response to pre-arrest bolus dilute epinephrine in the pediatric intensive care unit. Resuscitation. 2018 05; 126:137-142. View abstract
  23. Survey of plasma proteins in children with progeria pre-therapy and on-therapy with lonafarnib. Pediatr Res. 2018 05; 83(5):982-992. View abstract
  24. Out-of-Hospital Cardiac Arrest Resuscitation Systems of Care: A Scientific Statement From the American Heart Association. Circulation. 2018 05 22; 137(21):e645-e660. View abstract
  25. Extracorporeal Cardiopulmonary Resuscitation in Pediatric Cardiac Arrest: Same Principles, Different Practices. Pediatr Crit Care Med. 2018 02; 19(2):165-167. View abstract
  26. Pubertal Progression in Female Adolescents with Progeria. J Pediatr Adolesc Gynecol. 2018 Jun; 31(3):238-241. View abstract
  27. Predicting Unplanned Transfers to the Intensive Care Unit: A Machine Learning Approach Leveraging Diverse Clinical Elements. JMIR Med Inform. 2017 Nov 22; 5(4):e45. View abstract
  28. 2017 American Heart Association Focused Update on Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2018 01 02; 137(1):e7-e13. View abstract
  29. Validation of a pediatric early warning system for hospitalized pediatric oncology patients in a resource-limited setting. Cancer. 2017 Dec 15; 123(24):4903-4913. View abstract
  30. Ophthalmologic Features of Progeria. Am J Ophthalmol. 2017 Oct; 182:126-132. View abstract
  31. Improved outcomes after successful implementation of a pediatric early warning system (PEWS) in a resource-limited pediatric oncology hospital. Cancer. 2017 Aug 01; 123(15):2965-2974. View abstract
  32. 2016 AHA/ACC Clinical Performance and Quality Measures for Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. J Am Coll Cardiol. 2017 02 14; 69(6):712-744. View abstract
  33. 2016 AHA/ACC Clinical Performance and Quality Measures for Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force on Performance Measures. Circ Cardiovasc Qual Outcomes. 2017 01; 10(1):e000022. View abstract
  34. 292: LOW SURVIVAL AFTER EXTRACORPOREAL CARDIOPULMONARY RESUSCITATION IN NONCARDIAC PATIENTS. Crit Care Med. 2016 Dec; 44(12 Suppl 1):150. View abstract
  35. 1191: VALIDATION OF A PEDIATRIC EARLY WARNING SCORE IN A PEDIATRIC ONCOLOGY HOSPITAL IN GUATEMALA. Crit Care Med. 2016 Dec; 44(12 Suppl 1):373. View abstract
  36. Clinical Trial of the Protein Farnesylation Inhibitors Lonafarnib, Pravastatin, and Zoledronic Acid in Children With Hutchinson-Gilford Progeria Syndrome. Circulation. 2016 Jul 12; 134(2):114-25. View abstract
  37. The decision-making process and criteria in selecting candidate drugs for progeria clinical trials. EMBO Mol Med. 2016 07; 8(7):685-7. View abstract
  38. International Pediatric Otolaryngology Group (IPOG) consensus recommendations: Routine peri-operative pediatric tracheotomy care. Int J Pediatr Otorhinolaryngol. 2016 Jul; 86:250-5. View abstract
  39. Validation of a Pediatric Early Warning Score in Hospitalized Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients. Pediatr Crit Care Med. 2016 Apr; 17(4):e146-53. View abstract
  40. Part 5: Adult Basic Life Support and Cardiopulmonary Resuscitation Quality: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 03; 132(18 Suppl 2):S414-35. View abstract
  41. Part 1: Executive Summary: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 03; 132(18 Suppl 2):S315-67. View abstract
  42. Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2015 Oct 20; 132(16 Suppl 1):S177-203. View abstract
  43. Part 6: Pediatric basic life support and pediatric advanced life support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2015 Oct; 95:e147-68. View abstract
  44. Part 6: Pediatric Basic Life Support and Pediatric Advanced Life Support: 2015 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations (Reprint). Pediatrics. 2015 Nov; 136 Suppl 2:S88-119. View abstract
  45. American Heart Association Response to the 2015 Institute of Medicine Report on Strategies to Improve Cardiac Arrest Survival. Circulation. 2015 Sep 15; 132(11):1049-70. View abstract
  46. Parents' Experiences of Pediatric Palliative Transports: A Qualitative Case Series. J Pain Symptom Manage. 2015 Sep; 50(3):375-80. View abstract
  47. Enhancing the power of simulation for complex clinical care. Pediatr Crit Care Med. 2014 Nov; 15(9):904-6. View abstract
  48. Impact of farnesylation inhibitors on survival in Hutchinson-Gilford progeria syndrome. Circulation. 2014 Jul 01; 130(1):27-34. View abstract
  49. Assessment of hemoglobin threshold for packed RBC transfusion in a medical-surgical PICU. Pediatr Crit Care Med. 2014 Feb; 15(2):e89-94. View abstract
  50. Initial cutaneous manifestations of Hutchinson-Gilford progeria syndrome. Pediatr Dermatol. 2014 Mar-Apr; 31(2):196-202. View abstract
  51. Neurologic features of Hutchinson-Gilford progeria syndrome after lonafarnib treatment. Neurology. 2013 Jul 30; 81(5):427-30. View abstract
  52. Cardiopulmonary resuscitation quality: [corrected] improving cardiac resuscitation outcomes both inside and outside the hospital: a consensus statement from the American Heart Association. Circulation. 2013 Jul 23; 128(4):417-35. View abstract
  53. Examining pediatric resuscitation education using simulation and scripted debriefing: a multicenter randomized trial. JAMA Pediatr. 2013 Jun; 167(6):528-36. View abstract
  54. Early identification of children at risk for critical care: standardizing communication for inter-emergency department transfers. Pediatr Emerg Care. 2013 Apr; 29(4):419-24. View abstract
  55. Pediatric CPR quality targets--not just for 'grown-ups'. Resuscitation. 2013 Feb; 84(2):141-2. View abstract
  56. Clinical trial of a farnesyltransferase inhibitor in children with Hutchinson-Gilford progeria syndrome. Proc Natl Acad Sci U S A. 2012 Oct 09; 109(41):16666-71. View abstract
  57. A prospective study of radiographic manifestations in Hutchinson-Gilford progeria syndrome. Pediatr Radiol. 2012 Sep; 42(9):1089-98. View abstract
  58. Mechanisms of premature vascular aging in children with Hutchinson-Gilford progeria syndrome. Hypertension. 2012 Jan; 59(1):92-7. View abstract
  59. Hutchinson-Gilford progeria is a skeletal dysplasia. J Bone Miner Res. 2011 Jul; 26(7):1670-9. View abstract
  60. Part 14: pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 02; 122(18 Suppl 3):S876-908. View abstract
  61. Part 1: executive summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 02; 122(18 Suppl 3):S640-56. View abstract
  62. Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19; 122(16 Suppl 2):S250-75. View abstract
  63. Conventional cardiopulmonary resuscitation by bystanders improved outcomes in children with out-of-hospital cardiac arrest. Arch Dis Child Educ Pract Ed. 2011 Jun; 96(3):120. View abstract
  64. Part 10: Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19; 122(16 Suppl 2):S466-515. View abstract
  65. Part 7: CPR techniques and devices: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19; 122(16 Suppl 2):S338-44. View abstract
  66. Part 3: Evidence evaluation process: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19; 122(16 Suppl 2):S283-90. View abstract
  67. Part 4: Conflict of interest management before, during, and after the 2010 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010 Oct 19; 122(16 Suppl 2):S291-7. View abstract
  68. Pediatric advanced life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Pediatrics. 2010 Nov; 126(5):e1361-99. View abstract
  69. Pediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Pediatrics. 2010 Nov; 126(5):e1261-318. View abstract
  70. Risk factors for central line-associated bloodstream infection in pediatric intensive care units. Infect Control Hosp Epidemiol. 2010 Oct; 31(10):1049-56. View abstract
  71. Part 1: Executive summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Resuscitation. 2010 Oct; 81 Suppl 1:e1-25. View abstract
  72. Part 10: Paediatric basic and advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2010 Oct; 81 Suppl 1:e213-59. View abstract
  73. Part 4: Conflict of interest management before, during, and after the 2010 International Consensus Conference on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2010 Oct; 81 Suppl 1:e41-7. View abstract
  74. Part 3: Evidence evaluation process: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2010 Oct; 81 Suppl 1:e32-40. View abstract
  75. Part 7: CPR techniques and devices: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Resuscitation. 2010 Oct; 81 Suppl 1:e86-92. View abstract
  76. The use of vasoactive agents via peripheral intravenous access during transport of critically III infants and children. Pediatr Emerg Care. 2010 Aug; 26(8):563-6. View abstract
  77. Safety of surfactant administration before transport of premature infants. Air Med J. 2010 Jul-Aug; 29(4):170-7. View abstract
  78. Regional systems of care for out-of-hospital cardiac arrest: A policy statement from the American Heart Association. Circulation. 2010 Feb 09; 121(5):709-29. View abstract
  79. Regionalization of critical care: not just for kids. Crit Care Med. 2009 Jul; 37(7):2303-4. View abstract
  80. Postoperative pulmonary embolism in a three year old with Klippel-Trenaunay syndrome. Int Med Case Rep J. 2009; 2:1-5. View abstract
  81. Postresuscitation care. Pediatr Clin North Am. 2008 Aug; 55(4):943-67, xi. View abstract
  82. A simulator-based tool that assesses pediatric resident resuscitation competency. Pediatrics. 2008 Mar; 121(3):e597-603. View abstract
  83. New approaches to progeria. Pediatrics. 2007 Oct; 120(4):834-41. View abstract
  84. Toward a new paradigm in hospital-based pediatric education: the development of an onsite simulator program. Pediatr Crit Care Med. 2005 Nov; 6(6):635-41. View abstract
  85. Acute arsenic poisoning in two siblings. Pediatrics. 2005 Jul; 116(1):249-57. View abstract
  86. Clinical practice parameters for pediatric and neonatal septic shock: to have or to have not? Crit Care Med. 2002 Jun; 30(6):1400-1. View abstract
  87. Accuracy of a new low-flow sidestream capnography technology in newborns: a pilot study. J Perinatol. 2002 Apr-May; 22(3):219-25. View abstract
  88. Comparison of intravenous and endotracheal epinephrine during cardiopulmonary resuscitation in newborn piglets. Crit Care Med. 1999 Dec; 27(12):2748-54. View abstract