Ronald C Sanders

Publications (2)7.6 Total impact

• Article: Critically ill children during the 2009-2010 influenza pandemic in the United States.

  Adrienne G Randolph, Frances Vaughn, Ryan Sullivan, Lewis Rubinson, B Taylor Thompson, Grace Yoon, Elizabeth Smoot, Todd W Rice, Laura L Loftis, Mark Helfaer, Allan Doctor, Matthew Paden, Heidi Flori, Christopher Babbitt, Ana Lia Graciano, Rainer Gedeit, Ronald C Sanders, John S Giuliano, Jerry Zimmerman, Timothy M Uyeki
  [show abstract] [hide abstract]
  ABSTRACT: The 2009 pandemic influenza A (H1N1) (pH1N1) virus continues to circulate worldwide. Determining the roles of chronic conditions and bacterial coinfection in mortality is difficult because of the limited data for children with pH1N1-related critical illness. We identified children (<21 years old) with confirmed or probable pH1N1 admitted to 35 US PICUs from April 15, 2009, through April 15, 2010. We collected data on demographics, baseline health, laboratory results, treatments, and outcomes. Of 838 children with pH1N1 admitted to a PICU, the median age was 6 years, 58% were male, 70% had ≥1 chronic health condition, and 88.2% received oseltamivir (5.8% started before PICU admission). Most patients had respiratory failure with 564 (67.3%) receiving mechanical ventilation; 162 (19.3%) received vasopressors, and 75 (8.9%) died. Overall, 71 (8.5%) of the patients had a presumed diagnosis of early (within 72 hours after PICU admission) Staphylococcus aureus coinfection of the lung with 48% methicillin-resistant S aureus (MRSA). In multivariable analyses, preexisting neurologic conditions or immunosuppression, encephalitis (1.7% of cases), myocarditis (1.4% of cases), early presumed MRSA lung coinfection, and female gender were mortality risk factors. Among 251 previously healthy children, only early presumed MRSA coinfection of the lung (relative risk: 8 [95% confidence interval: 3.1-20.6]; P < .0001) remained a mortality risk factor. Children with preexisting neurologic conditions and immune compromise were at increased risk of pH1N1-associated death after PICU admission. Secondary complications of pH1N1, including myocarditis, encephalitis, and clinical diagnosis of early presumed MRSA coinfection of the lung, were mortality risk factors.
  PEDIATRICS 11/2011; 128(6):e1450-8. · 4.47 Impact Factor
• Article: The Collaborative Pediatric Critical Care Research Network Critical Pertussis Study: collaborative research in pediatric critical care medicine.

  Jeri S Burr, Tammara L Jenkins, Rick Harrison, Kathleen Meert, K J S Anand, John T Berger, Jerry Zimmerman, Joseph Carcillo, J Michael Dean, Christopher J L Newth, Douglas F Willson, Ronald C Sanders, Murray M Pollack, Eric Harvill, Carol E Nicholson
  [show abstract] [hide abstract]
  ABSTRACT: To provide an updated overview of critical pertussis to the pediatric critical care community and describe a study of critical pertussis recently undertaken. The six sites, seven hospitals of the Collaborative Pediatric Critical Care Research Network, and 17 outside sites at academic medical centers with pediatric intensive care units. Despite high coverage for childhood vaccination, pertussis causes substantial morbidity and mortality in US children, especially among infants. In pediatric intensive care units, Bordetella pertussis is a community-acquired pathogen associated with critical illness and death. The incidence of medical and developmental sequelae in critical pertussis survivors remains unknown, and the appropriate strategies for treatment and support remain unclear. The Collaborative Pediatric Critical Care Research Network Critical Pertussis Study has begun to evaluate critical pertussis in a prospective cohort. Research is urgently needed to provide an evidence base that might optimize management for critical pertussis, a serious, disabling, and too often fatal illness for U.S. children and those in the developing world.
  Pediatric Critical Care Medicine 11/2010; 12(4):387-92. · 3.13 Impact Factor