The UAB Division of Pediatric Critical Care has many important research endeavors housed both within and outside of our division.

Basic/Translational Science

Michele Kong, M.D., is leading basic and translational science research focusing on acute lung injury and respiratory viral infections. She was recently awarded a $3.2 million R01 award to conduct a multicenter Phase III trial of azithromycin treatment in children with respiratory syncytial virus (RSV)-induced respiratory failure. In addition, she is delineating the role and impact of protease dysregulation in the pathogenesis of RSV infection. Her Phase II trial showing that azithromycin treatment led to decreased days of hospitalization in children with RSV-induced respiratory failure was published in JAMA Network Open.

Robert (Robby) Richter, M.D., is studying vascular endothelial disruption and activation in the setting of sepsis under the mentorship of Amit Gaggar, M.D., Ph.D., Division of Pulmonary, Allergy and Critical Care, UAB Department of Medicine, and Namasivayam Ambalavanan, M.D., Division of Neonatology. He recently received a K08 award to support this work and his transition toward scientific independence.

Quality Improvement Science

Vidit Bhargava, M.D., is our director of PICU ultrasound. He has developed a curriculum for both pediatric critical care and neonatology fellows, which he is finalizing for publication. He is an ultrasound educator for the Society of Critical Care national ultrasound course. He has also published a curriculum in ultrasound-guided IV placement for PICU nurses in 2021. He is leading the credentialing process for point of care ultrasound for the entire Children’s hospital. He received a faculty development grant (FDGP) to study the role of ultrasound in predicting difficult airway.

Leslie Hayes, M.D., leads the division’s quality improvement efforts and is the director for our clinical database, Virtual Pediatric Systems (VPS), and manages its use for research and quality improvement in the pediatric intensive care unit (PICU). She has just been named national chair of VPS PICU rankings task force. Her published research in 2021 showed how early mobility in the PICU can be augmented using virtual reality boxing gaming.

Jeremy Loberger, M.D., leads our ventilation liberation efforts. He is continuously collecting ventilation data on children in the PICU and currently maintains a database of more than 1,100 ventilation courses at Children’s of Alabama. His research published in 2021 disproved commonly held beliefs about sedation administration and nocturnal extubation safety. He continues to work with international partners to develop a multicenter ventilation liberation collaborative and answer important clinical research questions in the field.

Simulation/Education Research

Chrystal Rutledge, M.D., has developed an important simulation outreach program, COACHES (Children’s of Alabama Community Healthcare Education Simulation Program), to assist hospitals throughout the state of Alabama with pediatric emergency preparedness. She provides guidance and education to the critical care transport team and assists with development and revision of transport protocols and guidelines. She is publishing her work, the program development, as well as the significant improvement in diabetic ketoacidosis management with outreach simulation and case feedback forms.

Nancy Tofil, M.D., and Dr. Rutledge published work evaluating the role of rapid cycle deliberate practice (RCDP) on the quality of Pediatric Advanced Life Support (PALS) skills in pediatric residents and the effect of training time compared to their first PALS certification. They found that regardless of the duration since certification, skills were poor and could be greatly enhanced with RCDP training. In addition, as part of the INSPIRE (International Network for Simulation-based Pediatric Innovation, Research, Education) CPR (cardiopulmonary resuscitation) Investigators group, research found that over a 12-minute CPR scenario, chest compression depth did not decline.

Clinical Science Research/National Research Collaboratives

Michele Kong, M.D., as the site PI for several multi-center trials, was part of several important publications in 2021, many of them centering on COVID-19 infection, MIS-C and outcomes in children. The group published in key medical journals, including NEJM, JAMA Pediatrics and JAMA Neurology. She is also the site PI for the NIH-funded “Prone and Oscillation Pediatric Clinical Trial” (PROSpect) with the aim of identifying the most optimal positional and/or ventilation practice that leads to improved patient outcomes in critically ill children with severe acute respiratory distress syndrome.

Madhura Hallman, M.D., is the site PI for the upcoming NIH-funded Post-Intensive Care Syndrome-pediatrics (PICS-p) study through the PALISI network. This is a prospective longitudinal cohort study that aims to evaluate patient and family longitudinal outcomes and the trajectory of recovery in children who survive critical illness over a period of two years. As part of the POST-PICU investigators through PALISI, Dr. Hallman is involved in efforts to develop a core outcomes set to describe post-intensive care recovery in children and the newly formed Social Determinants of Health interest group.

Robby Richter, M.D. is also the site PI for the NIH-funded “ARDS in Children and ECMO Initiation Strategies Impact on Neuro-Development” (ASCEND) study, which aims are to determine the functional status of children following usual care in children requiring extracorporeal membrane oxygenation (ECMO) for pediatric acute respiratory distress syndrome (PARDS) relative to children who receive protocolized respiratory care for PARDS according to the NIH-funded “Prone and Oscillation Pediatric Clinical Trial” (PROSpect) and ECMO for protocol failure.

Front Pediatr. 2021 Jul 2;9:689485. Outcome Measures Following Critical Illness in Children With Disabilities: A Scoping Review. Julia A Heneghan, Sarah A Sobotka, Madhura Hallman, Neethi Pinto, Elizabeth Y Killien, Kathryn Palumbo, Sinead Murphy Salem, Kilby Mann, Barbara Smith, Rebecca Steuart, Manzilat Akande, Robert J Graham.

J Pediatr Intensive Care. 2021 Mar;10(1):45-51. Diurnal Variation and Nursing Perspectives in Analgesic and Sedation Medication Administration to Mechanically Ventilated Children in a Single Pediatric ICU. Jeremy M Loberger, Nicholas Rockwell, Laura Daniel, Inmaculada B Aban, Priya Prabhakaran.

JAMA. 2021 Feb 24. Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19. Leora R Feldstein, Mark W Tenforde, Kevin G Friedman, Margaret Newhams, Erica Billig Rose, Heda Dapul , Vijaya L Soma, Aline B Maddux, Peter M Mourani, Cindy Bowens, Mia Maamari, Mark W Hall, Becky J Riggs, John S Giuliano Jr, Aalok R Singh, Simon Li, Michele Kong, Jennifer E Schuster, Gwenn E McLaughlin, Stephanie P Schwartz, Tracie C Walker, Laura L Loftis, Charlotte V Hobbs, Natasha B Halasa, Sule Doymaz, Christopher J Babbitt, Janet R Hume, Shira J Gertz, Katherine Irby , Katharine N Clouser, Natalie Z Cvijanovich, Tamara T Bradford, Lincoln S Smith, Sabrina M Heidemann, Sheemon P Zackai, Kari Wellnitz, Ryan A Nofziger, Steven M Horwitz, Ryan W Carroll, Courtney M Rowan , Keiko M Tarquinio, Elizabeth H Mack, Julie C Fitzgerald, Bria M Coates, Ashley M Jackson, Cameron C Young, Mary Beth F Son, Manish M Patel, Jane W Newburger, Adrienne G Randolph, Overcoming COVID-19 Investigators.

JAMA Neurol. 2021 Mar 5. Neurologic Involvement in Children and Adolescents Hospitalized in the United States for COVID-19 or Multisystem Inflammatory Syndrome. Kerri L LaRovere, Becky J Riggs, Tina Y Poussaint, Cameron C Young, Margaret M Newhams, Mia Maamari , Tracie C Walker, Aalok R Singh, Heda Dapul, Charlotte V Hobbs, Gwenn E McLaughlin, Mary Beth F Son, Aline B Maddux, Katharine N Clouser, Courtney M Rowan, John K McGuire, Julie C Fitzgerald, Shira J Gertz , Steven L Shein, Alvaro Coronado Munoz, Neal J Thomas, Katherine Irby, Emily R Levy, Mary A Staat, Mark W Tenforde, Leora R Feldstein, Natasha B Halasa, John S Giuliano Jr, Mark W Hall , Michele Kong, Christopher L Carroll, Jennifer E Schuster, Sule Doymaz, Laura L Loftis, Keiko M Tarquinio, Christopher J Babbitt, Ryan A Nofziger, Lawrence C Kleinman, Michael A Keenaghan, Natalie Z Cvijanovich, Philip C Spinella, Janet R Hume, Kari Wellnitz, Elizabeth H Mack, Kelly N Michelson, Heidi R Flori, Manish M Patel, Adrienne G Randolph, Overcoming COVID-19 Investigators.

JMIR Rehabil Assist Technol. 2021 May 27;8(2):e28210. Examining the Feasibility of Early Mobilization With Virtual Reality Gaming Using Head-Mounted Display and Adaptive Software With Adolescents in the Pediatric Intensive Care Unit: Case Report. Byron Lai, Maegen Powell, Anne Grace Clement, Drew Davis, Erin Swanson-Kimani, Leslie Hayes.

N Engl J Med. 2021 Jun 16.;10.1056/nejmoa2102605. Multisystem Inflammatory Syndrome in Children—Initial Therapy and Outcomes. Mary Beth F Son, Nancy Murray, Kevin Friedman, Cameron C Young, Margaret M Newhams, Leora R Feldstein, Laura L Loftis , Keiko M Tarquinio, Aalok R Singh, Sabrina M Heidemann, Vijaya L Soma, Becky J Riggs, Julie C Fitzgerald, Michele Kong, Sule Doymaz, John S Giuliano Jr, Michael A Keenaghan, Janet R Hume , Charlotte V Hobbs, Jennifer E Schuster, Katharine N Clouser, Mark W Hall, Lincoln S Smith, Steven M Horwitz, Stephanie P Schwartz, Katherine Irby, Tamara T Bradford, Aline B Maddux, Christopher J Babbitt, Courtney M Rowan, Gwenn E McLaughlin, Phoebe H Yager, Mia Maamari, Elizabeth H Mack, Christopher L Carroll, Vicki L Montgomery, Natasha B Halasa, Natalie Z Cvijanovich, Bria M Coates, Charles E Rose , Jane W Newburger, Manish M Patel, Adrienne G Randolph, Overcoming COVID-19 Investigators.

Pediatr Crit Care Med. 2021 Jul 14; 10.1097/pcc.0000000000002803. Transport Medical Control Education for Pediatric Critical Care Fellows: A National Needs Assessment Study. Ryan J Good, Adrian D Zurca, David A Turner, Ashley R Bjorklund, Donald L Boyer, Emily C Krennerich, Toni Petrillo, Ranna A Rozenfeld, William C Sasser, Jennifer Schuette, M Hossein Tcharmtchi, Christopher M Watson, Angela S Czaja, Education in Pediatric Intensive Care (EPIC) Investigators.

Pediatr Emerg Care. 2021 Mar 1;37(3):133-137. Change in Cardiopulmonary Resuscitation Performance Over Time During Simulated Pediatric Cardiac Arrest and the Effect of Just-in-Time Training and Feedback. Jonathan P Duff, Farhan Bhanji, Yiqun Lin, Frank Overly, Linda L Brown, E Alexis Bragg, David Kessler, Nancy M Tofil, Ilana Bank, Elizabeth A Hunt, Vinay Nadkarni, Adam Cheng, INSPIRE CPR Investigators.

Pediatr Res. 2021 Jun 1. Ultrasound education improves safety for peripheral intravenous catheter insertion in critically ill children. Vidit Bhargava, Erik Su, Bereketeab Haileselassie, Daniel Davis, Katherine M Steffen.

Respir Care. 2021 Feb 9;respcare.08494. Challenging Convention: Daytime Versus Nighttime Extubation in the Pediatric ICU. Jeremy M Loberger, Ryan M Jones, Amy M Hill, Shannon E O'Sheal, Christy L Thomas, Nancy M Tofil, Priya Prabhakaran.

Shock. 2021 Oct 1. Increased Plasma Hyaluronan Levels Are Associated with Acute Traumatic Coagulopathy. Shannon C Walker, Robert P Richter, Lei Zheng, Amit R Ashtekar, Jan O Jansen, Jeffrey D Kerby, Jillian R Richter.

 

Michele Kong, M.D.

• Dr. Kong was named one of the Birmingham Business Journal Women to Watch 2021.
• She was named to Good Morning America Inspiration List.
• She was elected to American Pediatric Society (APS).
• She was selected for the Jefferson County Board of Health.

Robert Richter, M.D.

• Dr. Richter was elected to the Society for Pediatric Research.
• He was selected as an award winner of the NIH repayment program.

The UAB Pediatric Critical Care Fellowship Program combines research and clinical experiences to prepare our trainees to be excellent intensivists who are also successful in the academic setting. Our program is the only fully accredited comprehensive critical care fellowship program in the state of Alabama. We have a 100% pass rate for first-time board takers of the American Board of Pediatrics Subspecialty board exam in pediatric critical care medicine. As the only Level I pediatric trauma center and ECMO center in the state, fellows encounter a wide variety of common and rare critical illnesses representing all subspecialties and acquire the necessary skills to become excellent academic intensivists. They learn to diagnose and care for patients with a wide variety of conditions, such as multiple traumas, respiratory failure, surgical diagnoses, shock and multi-organ failure dysfunction. During their training, our fellows also devote time and effort to academic interests, including research projects (clinical, translational or bench research), and are able to select a research mentor from across all specialties on the UAB campus.

2021–2022 Fellows

Aphton Lane, D.O.
First-Year Fellow
Residency: Wright State University

Mitchell Moore, M.D.
First-Year Fellow
Residency: University of Mississippi

Hugh Quach, M.D.
First-Year Fellow
Residency: East Carolina University

Jeremy Ruhlmann, M.D.
First-Year Fellow
Combined Critical Care & Emergency Medicine
Residency: University of Alabama at Birmingham

Luke Burton, M.D.
Second-Year Fellow
Residency: Greenville Health System

Ananya Manchikalapati, M.D.
Second-Year Fellow
Residency: Icahn School of Medicine at Mount Sinai, New York City Health and Hospitals, Elmhurst, New York

Joshua Cooper, M.D.
Third-Year Fellow
Combined Critical Care & Infectious Diseases
Residency: University of Alabama at Birmingham

Nick Rockwell, M.D.
Third-Year Fellow
Residency: University of Alabama at Birmingham

Lece Webb, M.D.
Third-Year Fellow
Residency: University of South Carolina/Greenville Health System

Program Director

Priya Prabhakaran, M.D.

Program Coordinator

Keundria Steele