Monitoring at Home Before and After Adenotonsillectomy
Tonsillectomy and/or adenoidectomy are commonly performed procedures in children. Occasionally some children can develop breathing problems after the operation. We are trying to use a new device to make tonsil and/or adenoid removal surgery as safe as possible. The device uses a pulse oximeter sensor connected to a mobile phone or tablet that records the levels of oxygen overnight. Families will use the device for three nights before and after tonsil and/or adenoid removal surgery in order to look at the changes that happen and see if we can predict which children could develop breathing problems after the operation.
Screen-My-Sleep: Validation of the Phone Oximeter as an At‐home Sleep Apnea Screening Tool for Children
The diagnosis of sleep apnea in children and youth presents a challenging problem. Polysomnography (PSG) is the standard test for the diagnosis of sleep apnea. This test requires a comprehensive sleep laboratory and the inconvenience of an overnight stay. We are trying to use a new device to identify sleep apnea in children by using a pulse oximeter sensor connected to a mobile phone or tablet that records the levels of oxygen overnight. We are using the device at the same time as the hospital sleep study, and then again for two nights at home.
VitalPAD: an intelligent monitoring and communication device to optimize safety in the pediatric intensive care unit (PICU)
The goal is to develop a unified, portable and intelligent device that integrates information from multiple patient monitors, mechanical ventilators, infusion pumps and clinical information systems. It will allow PICU healthcare team members, on or off-site, to monitor critically ill patients continuously. The project involves two components: a) We will use feedback obtained in a participatory design process to guide the development of the VitalPAD, and b) We will use simulated ICU scenarios, to evaluate whether clinicians will prioritize the care of critically ill patients more rapidly and more accurately with the use of VitalPAD than without it.
Panda Pain Assessment App
Undertreated post-surgical pain after discharge from hospital presents a real burden to the child, to families and to the health care system, in terms of poor outcomes, and the stress of coping with the recovery at home and of potential hospital readmission. Smartphone apps have shown promise in the support of at-home management of chronic cancer pain and acute sickle cell pain in children. However, there are no apps available for assessment and management of post-surgical pain. Clearly there is room for an efficient, accessible and cost-effective means of providing support to caregivers to improve their management of post-operative pain. The Panda application may provide such support. This study will allow us to improve the app’s usability and to demonstrate feasibility in advance of a larger trial in which Panda will be used by caregivers and children at home.
Sepsis modeling and outcome prediction
Severe sepsis and septic shock are associated with a high burden of morbidity and mortality among critically ill children. Through improvements in supportive care, secular trends reveal a gradual decline in mortality. In collaboration with our critical care colleagues, our goal is to use a large North-American registry cohort to validate and compare the performance of existing risk score, identify new combinations of risk factors, and to develop novel outcome prediction tools.
Testing of a novel pulse oximeter clip
The purpose of this study is to gather data from a novel pulse oximeter clip, which combines an optical and a mechanical measurement method. Traditionally, pulse oximetry obtains oxygen saturation and the plethysmographic waveform through a light absorption method. However, similar data could also be obtained by recording a change in the finger diameter, triggered by the pressure wave of arterial blood in the finger, using a piezoelectric sensor. This mechanical sensor might be a good alternative and/or addition to the common pulse oximeter. The advantages of the mechanical sensor is that provides insight into the pressure/volume relationships of blood flow in the finger required less power than a pulse oximeter so could be used for extracting heart rate in low power applications.
Development of predictive analytics for impending cardiac arrest in children admitted to the Pediatric Intensive Care Unit
Assignment of priority of care and early detection of deterioration of critically ill patients in the Intensive Care Unit (ICU) represent an enormous source of preventable morbidity, mortality and cost. In comparison to adults, children have smaller functional reserves and deteriorate faster when critically ill. The task of preventing/predicting adverse events, such as cardiac arrests, is of paramount importance in improving patient safety in the PICU. Outcomes after cardiac arrest, including arrests witnessed in-facility, remain poor. Hence early detection of deterioration before the arrest is very important. The aim of this project is to develop predictive algorithms to predict adverse events in the PICU.