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UCL Great Ormond Street Institute of Child Health

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Critical Care

Lead Contact: Dr Mark Peters (m.peters@ucl.ac.uk)

 

 

Introduction

Severe infection or injury requiring intensive care are the most common reasons for admission to Great Ormond Street Hospital and the most common causes of death in childhood. 

In the last 10 years, progress has been made in the care of these cases that has resulted in dramatic improvements in survival. 

Intensive care medicine is characterised by complex disease processes in which there is a dynamic interaction between an insult or injury and the subsequent host response. 

The Critical Care Group investigates these responses with international clinical studies and a basic science programme into cellular adhesion, cytokine balance, platelets and fibrinolysis in inflammation, ischaemia reperfusion injury and the role of the innate immune system in systemic inflammation.

Aims

  • To increase the understanding of the pathophysiology of the systemic inflammatory response to infection or injury in critically ill children
  • To develop new therapeutic strategies for the systemic inflammatory response to infection or injury in critically ill children

Current Projects

Resuscitation officer performing chest compressions for Cardiopulmonary resuscitation (CPR) on a manikin

  • Cardiac arrest causes severe brain damage and death within minutes.  Prompt, appropriate chest compressions (pressing on the front of the chest) undoubtedly increase the chance of successful resuscitation. However, optimal compressions remain poorly understood and are particularly challenging to estimate in children. Premature infants and teenagers differ 100 fold in size and in their chest stiffness.  Chest compressions remain the key element of life support but international guidelines give only subjective instructions:  "Push hard, push fast, minimise interruptions of chest compressions; allow full chest recoil".  We aim to measure and improve current practice to help save lives.
  • A multi-centre randomised controlled trial to determine the effectiveness of different central venous catheters in the prevention of blood stream infection in the paediatric intensive care unit
  • Haemodynamics and therapeutics of Shock in Children and Neonates
  • Novel therapies for Pulmonary Hypertension of the Newborn
  • Genetic control of platelet count during critical illness
  • A multi-centre randomised controlled study of glycaemic control in critically ill children
  • Mathematical model of intra-cranial pressure and therapeutics in severe paediatric head injury
  • Mechanisms of ischaemic-preconditioning in humans
  • Role of the protein C pathway in necrotising enterocolitis
  • Genetic risk factors for the systemic inflammatory response following infection or trauma
  • UK paediatric intensive care outcome study
  • Alteration in mitochondrial functions with age in critical illness
  • Hereditary surfactant protein B deficiency: genetic analysis for mutations in the SP-B gene
  • The effect of glutamine on liver metabolism during sepsis in infants and children 

Funders

For information on how to respond to a Pediatric Respiratory Emergency, please visit the ACLS Training Center website, which provides information on what to do in an emergency based on different causal factors.