ON-GOING CLINICAL STUDIES
Pediatric Cervical Spine Clearance: A Multicenter Prospective Observational Study
A prospective multicenter observational study, led by Dr. Katie Russell of Intermountain Primary Children’s Healthcare, that will examine the sensitivity, specificity, negative, and positive predictive values of CT scan and plain films in diagnosing cervical spine injury that requires treatment.
Cervical Spine Clearance in Obtunded Pediatric Trauma Patients
A multicenter retrospective cohort study, led by Dr. Aaron Jensen of UCSF-Benioff Children’s Hospital, that examines the rate of occult ligamentous injury on MRI in the context of a normal cervical spine CT in injured children. Additional subgroup analyses of imaging characteristics, timing and long-term outcomes will also be reported.
Evaluation of Outcomes of Extracorporeal Life Support On Pediatric Patients with SARS-CoV-2
Since the SARS-CoV-2 pandemic began in 2020, it has been noted that the effects of SARS-CoV-2 vary with severity and age, but a large proportion has affected the elderly and those with chronic medical conditions in particular. Given the vulnerbility of those on ECMO, it was decided to evaluate the effects of SARS-CoV-2 on the outcomes of pediatric patients requiring ECMO.
Use of a Water Soluble Contrast-Based protocol to Assist in the Management of Pediatric Adhesive Small Bowel Obstruction
Adhesive small bowel obstruction (ASBO) is a common problem following abdominal surgery. The use of water-soluble enteral contrast protocols in adults have been shown to reduce unnecessary operations and identify those patients that need an operation earlier. Little is known about the utility of water-soluble enteral contrast protocols is children with ASBO. The goal of this study is to determine if water-soluble enteral contrast protocols are safe and effective in the non-operative management of ASBO in children and are successful earlier identification of patients that will fail non-operative management. This study prospective observational study leverages the variations in the management ASBO across the 10 WPSRC sites to answer these important clinical questions.
A Multi-Center Randomized Trial of Transanastomotic Tube for Proximal Esophageal Atresia and Distal Tracheoesophageal Fistula Repair
The use of trans-anastomotic nasogastric tubes following esophageal reconstruction in esophageal atresia is controversial. Advocates of trans-anastomotic tubes argue that the tubes allow for earlier enteral feedings and function as a stent to maintain patency of the anastomosis. However, retrospective studies suggest that trans-anastomotic tubes increase the risk of anastomotic strictures. This prospective trial randomizes patients into tube vs no-tube treatment groups, with the primary endpoint of anastomotic stricture formation at 1-year post-operatively.
The Utility of MRCP in the Surgical Management of Choledocholithiasis in Pediatric Patients
Existing guidelines for the management of choledocholithiasis in adults may not be applicable in children, given anatomic differences and the limited availability of ERCP in many pediatric centers. This retrospective study seeks to develop a diagnostic and treatment algorithm for choledocholithiasis in children that minims unnecessary interventions and optimized clinical outcomes. In addition, the study aims to determine the role of MRCP and ERCP in the diagnosis and management of gallstone disease in children.
Colon Bundle Protocol for Improving Care in Pediatric General Surgery Patients
Building on research from the Oregon Health and Science University that demonstrated improved clinical outcomes following the institution of a colon bundle protocol, similar colon bundle protocols were implemented across WPSRC member organizations. Using the NSQIP data set, this study seeks to understand the effects of such protocols on postoperative recovery and infection complications following colon surgery.