Developmental Neurobiology

Our mechanistic and translational oriented studies aim to understand how anesthesia and certain diseases alter brain function, induce pain states, modulate neuromuscular function and regulate seizure development, to identify therapies to promote recovery. Researchers are using both animal models and human induced pluripotent stem cells that simulate clinical situations and apply molecular, cellular, physiological and behavioral techniques to study mechanisms and develop treatments.

  • The Jankowski Lab is studying how multiple cellular systems such as the immune system, endocrine system and peripheral nerve glia all regulate sensory neuron function to influence nociceptive processing. Specific projects include analyses of ischemic muscle pain, neonatal sensory neuron sensitization and pain development in animal models of neurofibromatosis 1.
  • The Danzer Lab is researching how the hippocampus plays a role in the development of epilepsy and autism. The relationship between stress, aberrant granule cell integration, age and seizure development are major ongoing projects. The lab also studies how PTEN deletion in hippocampal dentate granule cells modulates the development of autism.
  • The McAuliffe Lab is developing an in-vitro system that utilizes a combination of human derived induced pluripotent stem cells, genetically engineered calcium reporters, and machine learning to develop a novel system to establish a malignant hyperthermia phenotype in patients without the need for an invasive muscle biopsy, and establish a platform for the study of other skeletal muscle disorders.

Pharmacology/Pharmacogenomics

Our researchers investigate the pharmacokinetics, pharmacodynamics and pharmacogenetics of anesthetic and analgesic drugs in infants, children and adolescents. These studies evaluate genetic and disease-related contributions to patient response to pediatric anesthesia and pain management drugs, with the long-term goal of personalizing drug dosing.

  • The Dr. Chidambaran and her Peds PAIN-PAL Lab (Personalized Analgesia Lab) is leading a large, multicenter clinical trial in children undergoing musculoskeletal surgery to study epigenetic determinants of chronic post-surgical pain (CSPS). Other ongoing projects also include assessments of inflammation in CSPS, pharmacogenetic and psychosocial predictors of CSPS and morphine pharmacogenomics.
  • Drs. Mahmoud, Ok, Amin, Paquin and Kandil of the Pediatric Imaging and Sleep Anesthesia (PISA) Lab are primary site investigators in a multicenter evaluation of dosing and efficacy of dexmedetomidine as an anesthetic in MRI and the influence of this agent on airway configuration. The lab also has a focus on the effects of sevoflurane vs. propofol on auditory brainstem responses during pediatric anesthesia.
  • Dr. Kenneth Goldschneider researches complex chronic pain conditions in infants, children and young adults, including those related to juvenile fibromyalgia, Ehlers-Danlos syndrome, vascular malformations, epidermolysis bullosa and pancreatitis.
  • The Furstein Lab is studying how peripheral nerve blocks modulate pain after surgery. Specific focus areas include efficacy of pre- or post-surgery nerve blocks for pain control, and assessment of adductor canal blockade for pain reduction after medial patellofemoral ligament reconstruction. The lab is also using fMRI to predict trajectory of recovery following adolescent anterior cruciate ligament (ACL) repair.
  • Dr. Charlotte Walter is researching opioid safety and use of opioid disposal packets in the pediatric surgical population. She is also performing studies in children to characterize near-infrared spectroscopy signals from the brain in response to nociceptive stimulation of varying intensity and duration, and after analgesic and neuromuscular paralytic administration.
  • Joan Beiersdorfer, MSN, APRN, CRNA is studying whether sevoflurane vs total intravenous anesthesia (TIVA) is a better strategy to reduce post-operative nausea/vomiting in children undergoing percutaneous radiofrequency ablation or cryoablation.

Behavioral/Procedural Interventions

Our researchers evaluate the effectiveness of new technologies in children receiving anesthesia, sedation and pain management services. Researchers are developing technologies to improve outcomes, reduce morbidity and enhance survival.

  • The Olbrecht Lab is studying the use of immersive virtual reality (VR) technologies to impact clinical outcomes and medication utilization in pediatric patients with acute and chronic pain. The goal is to create a series of immersive VR modules that will compliment other multimodal therapies to manage post-operative pain in pediatric patients. The lab is developing and testing a prototype for a universal attachment to VR headsets that integrates real-time, patient-generated feedback into gaming software to facilitate guided training of patients to manage their own pain.
  • Abby Hess, APRN, DNP is conducting clinical feasibility testing to commercialize a tablet-based breathing-controlled app & device that interfaces with anesthesia equipment. She developed an app and device designed to improve children’s anxiety during anesthesia induction to improve patient satisfaction.
  • Gretchen Rogers, APRN, CPNP is studying new ways to use telemedicine for delivering pre-anesthesia care to pediatric patients undergoing surgery. Her current focus is on the utility of these services with patients that have developmental disabilities or behavioral diagnoses.

Quality Improvement Research

We are examining best practices on an organizational basis for children receiving anesthesia and pain management to improve outcomes and enhance technical skill acquisition. Provider education and quality improvement are major focuses of Anesthesia Research.

  • The Thienprayoon Lab is designing a novel methods to improve communication in pediatric palliative care. The lab has a particular interest in identifying and defining domains of quality in pediatric hospice/palliative care along with generating electronic peer mentorship programs for pediatric palliative care physicians.
  • Dr. Jayant (Nick) Pratap is using novel strategies including machine learning to predict pediatric surgery cancellations. He is also analyzing preoperative interventions to reduce surgery cancellation in disadvantaged children.
  • Dr. Kenneth Goldschneider is involved in the Patient-Reported Outcome Measurement Information System (PROMIS), a cooperative network of researchers using rigorous, mixed-method development, testing and validation protocols to create streamlined, reliable and valid tools that assess different components (i.e. physical, mental, social) of adult and child self-reported health, including patient-reported experiences of pain. The PROMIS pediatric scales provide reliable, and valid measures for future research on pain behavior and its effects in school-aged children with chronic pain.
  • Dr. Lori Aronson is researching total pancreatectomy with islet autotransplantation (TPIAT). She is performing a review of TPIAT patients at a free-standing children's hospital to evaluate perioperative outcomes.
  • Dr. Edward Cooper is researching simulated tracheal intubation in a 3D motion capture laboratory to determine kinematic variables during tracheal intubation in order to improve provider proficiency. Results will inform prospective investigations to validate an “expert” profile on patients and as the basis of interventional studies to measure and accelerate acquisition of procedural competency by trainees.
  • Dr. Erica Lin is developing curricula using a mind-body medicine education program as an intervention to improve providers’ sense of wellness. Training in a variety of healing modalities including meditation, guided imagery, autogenic training, journal writing, and movement are used to help professionals both personally and professionally.
  • Dr. Marc Mecoli performs studies to evaluate the incidence of and factors associated with peripheral venous infiltration and extravasation (PIVIE) in pediatric patients undergoing general anesthesia to define incidence of and risk factors for perioperative PIVIE using Cincinnati Children'a Peripheral Venous Infiltration and Extravasation Assessment Tool. Results will allow providers to identify severe harm (absence of distal pulse, limb ischemia, or injury requiring fasciotomy) resulting from venous infiltrations and improve patient care.
  • Dr. Dave Moore developed a data-driven approach to teaching and evaluating ultrasound-guided regional anesthesia techniques using a novel simulator with an electrical feedback circuit. He conducts studies comparing a new process of general anesthesia in dental outpatient clinics, which improves failure rate and patient and staff experience while being safe and cost effective.
  • Dr. Pornswan Ngamprasertwong uses modeling and simulation knowledge to predict staffing in the operating room. She is also currently researching eye protection and periorbital skin injury during general anesthesia to improve patient outcomes.
  • Dr. Rupi Parikh is researching anesthesic management for fetal interventions and fetal surgical repair of myelomeningocele. She is also working on single and multi-center trials of quality improvement in anesthesia for fetal surgery.
  • Dr. Paul Samuels studies anesthetic considerations for pediatric obesity and adolescent bariatric surgery. He evaluates the incidence of respiratory complications and institutional efficiency among different anesthetic techniques in children undergoing esophagogastroduedenoscopy. He is currently performing quality improvement studies designed to improve pre-operative medication compliance in patients with developmental disabilities and behavioral diagnoses.
  • Dr. Michael Sikora’s perioperative simulation research focuses on system of care issues. He developed and executed a simulation curriculum for a team’s response to changes in intraoperative neuromonitoring signals based upon feedback from the institutional root-cause analysis of a sentinel event. He has also developed induction room simulations for fellows and developed and executed an ongoing simulation curriculum to help providers learn the perioperative code blue response.