Minimizing Adverse Outcomes After Pediatric Open-Heart Surgery

Congenital heart anomalies are the most common birth defects in the United States. Each year, approximately 10,000 babies (1 in 115) born in the United States have a congenital heart defect that will require operative repair with the aid of cardiopulmonary bypass (CPB) during early childhood. Each year, approximately 24,000 children (newborn to age 5) undergo procedures that require CPB. When compared to adult CPB patients, the occurrence of adverse effects in the pediatric CPB population reflects an increased sensitivity to organ damage due to increased metabolic demands and exposure to severe decreases in temperature, hematocrit, and blood pressure. For these reasons, it is critical to seek ways to improve current techniques to minimize the deleterious effects of CPB in the pediatric population.

The pathophysiology of CPB procedures in pediatric patients is woefully under investigated. In addition, private companies have shown very little interest in developing new pediatric heart-lung machines, oxygenators, and cannulas because of the very small market when compared to adult patients (400,000 adults versus 20,000 children in 2006; 20:1 ratio). This deficit is further compounded by the small number of US pediatric centers that are conducting research on minimizing the adverse effects of CPB in the pediatric population. My passion is to develop novel technologies and methodologies to be used in minimizing the adverse effects of CPB in neonates, infants, and small children. In particular, I focus on research in minimizing cerebral, myocardial, pulmonary, and renal injury during and after pediatric CPB procedures and mechanical circulatory support. My research specialties include pediatric heart-lung machines, pulsatile versus non-pulsatile perfusion, pediatric mechanical circulatory support systems, complement, neutrophil, platelet, and cytokine inhibition during pediatric open-heart procedures,
microdevices for measuring systemic inflammation in real-time, detection and classification of microemboli, blood viscoelasticity, and plasma proteomics.

During the past five years at Penn State, we have established an outstanding multi-disciplinary research team whose goal is to improve the outcomes of pediatric cardiac patients nationally and internationally.

At the Penn State Hershey Children's Hospital, we founded the Penn State Hershey Center for Pediatric Cardiovascular Research. http://www.pennstatehershey.org/web/pedscardiacresearch/home/overview

Collaboration in multiple disciplinary teams (from the Departments of Pediatrics, Surgery, Bioengineering, Anesthesiology, Comparative Medicine, Health and Evaluation Sciences, and Pharmacology) combines basic science research, engineering, and clinical applications with a common focus on pediatric open-heart procedures and pediatric mechanical circulatory support systems.

I am also the founder and scientific chair of this International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion.
http://www.hmc.psu.edu/childrens/pedscpb/