Geoffrey L. Allen
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View article: Variations in Alarm Burden, Source, and Cause Across Inpatient Units at a Children’s Hospital
Variations in Alarm Burden, Source, and Cause Across Inpatient Units at a Children’s Hospital Open
BACKGROUND AND OBJECTIVES Alarms at hospitals are frequent and can lead to alarm fatigue posing patient safety risks. We aimed to describe alarm burden over a 1-year period and explored variations in alarm rates stratified by unit type, al…
View article: Machine learning-driven identification of the gene-expression signature associated with a persistent multiple organ dysfunction trajectory in critical illness
Machine learning-driven identification of the gene-expression signature associated with a persistent multiple organ dysfunction trajectory in critical illness Open
H.R.W.'s NIHR35GM126943 award supported the work detailed in this manuscript. Upon his death, the award was transferred to M.N.A. M.R.A., N.S.P, and R.K were supported by NIHR21GM151703. R.K. was supported by R01GM139967.
View article: Prognostic and predictive value of endothelial dysfunction biomarkers in sepsis-associated acute kidney injury: risk-stratified analysis from a prospective observational cohort of pediatric septic shock
Prognostic and predictive value of endothelial dysfunction biomarkers in sepsis-associated acute kidney injury: risk-stratified analysis from a prospective observational cohort of pediatric septic shock Open
View article: Detrimental effects of PCSK9 loss-of-function in the pediatric host response to sepsis are mediated through independent influence on Angiopoietin-1
Detrimental effects of PCSK9 loss-of-function in the pediatric host response to sepsis are mediated through independent influence on Angiopoietin-1 Open
View article: Prognostic and Predictive Value of Endothelial Dysfunction Biomarkers in Sepsis-Associated Acute Kidney Injury: Risk Stratified Analysis from a Prospective Observational Cohort of Pediatric Septic Shock
Prognostic and Predictive Value of Endothelial Dysfunction Biomarkers in Sepsis-Associated Acute Kidney Injury: Risk Stratified Analysis from a Prospective Observational Cohort of Pediatric Septic Shock Open
Background Sepsis Associated Acute Kidney Injury (SA-AKI) is associated with high morbidity, with no current therapies available beyond continuous renal replacement therapy (CRRT). Systemic inflammation and endothelial dysfunction are key …
View article: Serum renin and prorenin concentrations predict severe persistent acute kidney injury and mortality in pediatric septic shock
Serum renin and prorenin concentrations predict severe persistent acute kidney injury and mortality in pediatric septic shock Open
View article: Detrimental effects of PCSK9 loss-of-function in the pediatric host response to sepsis are mediated through independent influence on Angiopoietin-1
Detrimental effects of PCSK9 loss-of-function in the pediatric host response to sepsis are mediated through independent influence on Angiopoietin-1 Open
Background: Sepsis is associated with significant mortality, yet there are no efficacious therapies beyond antibiotics and supportive care. In adult sepsis studies, PCSK9 loss-of-function (LOF) and inhibition has shown therapeutic promise,…
View article: Integrated PERSEVERE and endothelial biomarker risk model predicts death and persistent MODS in pediatric septic shock: a secondary analysis of a prospective observational study
Integrated PERSEVERE and endothelial biomarker risk model predicts death and persistent MODS in pediatric septic shock: a secondary analysis of a prospective observational study Open
View article: Integrated PERSEVERE and endothelial biomarker risk model predicts MODS in pediatric septic shock: A retrospective observational study
Integrated PERSEVERE and endothelial biomarker risk model predicts MODS in pediatric septic shock: A retrospective observational study Open
Background: Multiple organ dysfunction syndrome (MODS) is a critical driver of sepsis morbidity and mortality in children. Early identification of those at risk of persistent organ dysfunctions is necessary to enrich patients for future tr…
View article: School and Work Absences After Critical Care Hospitalization for Pediatric Acute Respiratory Failure
School and Work Absences After Critical Care Hospitalization for Pediatric Acute Respiratory Failure Open
In this secondary analysis of a cluster randomized trial, 2 in 3 children hospitalized for acute respiratory failure missed school after discharge, for a median duration of nearly 2 weeks. In addition, more than half of primary caregivers …
View article: A Continuous Metric to Measure Endotype and Corticosteroid Interaction in Septic Shock
A Continuous Metric to Measure Endotype and Corticosteroid Interaction in Septic Shock Open
The benefit of corticosteroids for septic shock remains unclear, reflecting heterogeneity of treatment effect. We previously reported a binary septic shock endotype classification based on expression of 100 genes. This binary classificatio…
View article: Recalibration of the Renal Angina Index for Pediatric Septic Shock
Recalibration of the Renal Angina Index for Pediatric Septic Shock Open
View article: Variability in Serum Sodium Concentration and Prognostic Significance in Severe Traumatic Brain Injury: A Multicenter Observational Study
Variability in Serum Sodium Concentration and Prognostic Significance in Severe Traumatic Brain Injury: A Multicenter Observational Study Open
View article: Association of Race and Ethnicity with Sedation Management in Pediatric Intensive Care
Association of Race and Ethnicity with Sedation Management in Pediatric Intensive Care Open
Rationale: Racial disparities in pain management have been previously reported for children receiving emergency care.Objectives: To determine whether patient race or ethnicity is associated with the broader goal of pain manag…
View article: Proprotein Convertase Subtilisin/Kexin Type 9 Loss-of-Function Is Detrimental to the Juvenile Host With Septic Shock*
Proprotein Convertase Subtilisin/Kexin Type 9 Loss-of-Function Is Detrimental to the Juvenile Host With Septic Shock* Open
Objectives: Proprotein convertase subtilisin/kexin type 9 is a central regulator of lipid metabolism and has been implicated in regulating the host response to sepsis. Proprotein convertase subtilisin/kexin type 9 loss-of-function is assoc…
View article: PERSEVERE Biomarkers Predict Severe Acute Kidney Injury and Renal Recovery in Pediatric Septic Shock
PERSEVERE Biomarkers Predict Severe Acute Kidney Injury and Renal Recovery in Pediatric Septic Shock Open
Rationale: Acute kidney injury (AKI), a common complication of sepsis, is associated with substantial morbidity and mortality and lacks definitive disease-modifying therapy. Early, reliable identification of at-risk patients is impo…
View article: Prospective clinical testing and experimental validation of the Pediatric Sepsis Biomarker Risk Model
Prospective clinical testing and experimental validation of the Pediatric Sepsis Biomarker Risk Model Open
Prognostic biomarkers for pediatric septic shock are conserved in a murine model of sepsis and accelerate testing of precision medicine strategies.
View article: Early Osmotherapy in Severe Traumatic Brain Injury: An International Multicenter Study
Early Osmotherapy in Severe Traumatic Brain Injury: An International Multicenter Study Open
The optimal osmotic agent to treat intracranial hypertension in patients with severe traumatic brain injury (TBI) remains uncertain. We aimed to test whether the choice of mannitol or hypertonic saline (HTS) as early (first 96 h) osmothera…
View article: Hyperchloremia Is Associated With Complicated Course and Mortality in Pediatric Patients With Septic Shock*
Hyperchloremia Is Associated With Complicated Course and Mortality in Pediatric Patients With Septic Shock* Open
Objective: Hyperchloremia is associated with poor outcome among critically ill adults, but it is unknown if a similar association exists among critically ill children. We determined if hyperchloremia is associated with poor outcomes in chi…
View article: Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response
Endotype Transitions During the Acute Phase of Pediatric Septic Shock Reflect Changing Risk and Treatment Response Open
Objective: We previously identified septic shock endotypes A and B based on 100 genes reflecting adaptive immunity and glucocorticoid receptor signaling. The endotypes differ with respect to outcome and corticosteroid responsiveness. We de…
View article: Improved Risk Stratification in Pediatric Septic Shock Using Both Protein and mRNA Biomarkers. PERSEVERE-XP
Improved Risk Stratification in Pediatric Septic Shock Using Both Protein and mRNA Biomarkers. PERSEVERE-XP Open
PERSEVERE-XP combines protein and mRNA biomarkers to provide mortality risk stratification with possible clinical utility. PERSEVERE-XP significantly improves on PERSEVERE and suggests a role for TP53-related cellular division, repair, and…
View article: Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial
Racial and Ethnic Disparities in Parental Refusal of Consent in a Large, Multisite Pediatric Critical Care Clinical Trial Open
View article: Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure*
Multiple Organ Dysfunction in Children Mechanically Ventilated for Acute Respiratory Failure* Open
Objectives: The impact of extrapulmonary organ dysfunction, independent from sepsis and lung injury severity, on outcomes in pediatric acute respiratory failure is unclear. We sought to determine the frequency, timing, and risk factors for…
View article: Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock*
Glucocorticoid Receptor Polymorphisms and Outcomes in Pediatric Septic Shock* Open
Objective: Polymorphisms of the glucocorticoid receptor gene are associated with outcome and corticosteroid responsiveness among patients with inflammatory disorders. We conducted a candidate gene association study to test the hypothesis t…
View article: Pediatric Sepsis Biomarker Risk Model-II: Redefining the Pediatric Sepsis Biomarker Risk Model With Septic Shock Phenotype
Pediatric Sepsis Biomarker Risk Model-II: Redefining the Pediatric Sepsis Biomarker Risk Model With Septic Shock Phenotype Open
Objective: The Pediatric Sepsis Biomarker Risk Model (PERSEVERE), a pediatric sepsis risk model, uses biomarkers to estimate baseline mortality risk for pediatric septic shock. It is unknown how PERSEVERE performs within distinct septic sh…
View article: Combining Prognostic and Predictive Enrichment Strategies to Identify Children With Septic Shock Responsive to Corticosteroids*
Combining Prognostic and Predictive Enrichment Strategies to Identify Children With Septic Shock Responsive to Corticosteroids* Open
Objectives: Prognostic and predictive enrichment strategies are fundamental tools of precision medicine. Identifying children with septic shock who may benefit from corticosteroids remains a challenge. We combined prognostic and predictive…
View article: Prospective Testing and Redesign of a Temporal Biomarker Based Risk Model for Patients With Septic Shock: Implications for Septic Shock Biology
Prospective Testing and Redesign of a Temporal Biomarker Based Risk Model for Patients With Septic Shock: Implications for Septic Shock Biology Open
The temporal version of the pediatric sepsis biomarker risk model (tPERSEVERE) estimates the risk of a complicated course in children with septic shock based on biomarker changes from days 1 to 3 of septic shock. We validated tPERSEVERE pe…
View article: Differential expression of the Nrf2-linked genes in pediatric septic shock
Differential expression of the Nrf2-linked genes in pediatric septic shock Open
View article: A Multibiomarker-Based Model for Estimating the Risk of Septic Acute Kidney Injury
A Multibiomarker-Based Model for Estimating the Risk of Septic Acute Kidney Injury Open
We have derived and tested a model to estimate the risk of septic acute kidney injury on day 3 of septic shock using a novel panel of biomarkers. The model had very good performance in a test cohort and has test characteristics supporting …
View article: Additional file 6: Table S6. of Differential expression of the Nrf2-linked genes in pediatric septic shock
Additional file 6: Table S6. of Differential expression of the Nrf2-linked genes in pediatric septic shock Open
List of network genes shown in Fig. 4. (XLSX 10 kb)