As a pediatric intensivist, Katie Nielsen's primary interest is in improving the health care systems involved in the delivery of care to critically ill children in resource-limited settings. She started partnering with colleagues at Instituto Nacional de Salud del Niño (INSN) in Lima, Peru in 2013 as a Fogarty Global Health Research Fellow with the University of Washington. With the help of pediatric colleagues in the emergency department, general pediatrics, and critical care, her group performed a case-control study of 1094 patients to develop an emergency department-specific risk score to identify children at high risk of having a serious adverse event during hospitalization. Our score had an area under the ROC curve of 0.768.
After her return to the United States to join the University of Washington faculty, Dr. Nielsen's Peruvian colleagues identified a need for alternative non-invasive respiratory support due to challenges in maintaining adequate support with their CPAP device. With approximately 80% of PICU patients at INSN receiving invasive mechanical ventilation for an average of 8 days, Dr. Nielsen and her Peruvian colleagues proposed using high flow nasal cannula (HFNC) after extubation to increase the number of ventilator-free days. Alumni support from the Fogarty Global Health Research Fellowship (NIH 3R25TW009345-01) and internal support from Seattle Children’s Center for Clinical and Translational Research Clinical Research Scholars Program have made this project possible.
Ongoing opportunities for collaboration involving implementation of standard protocols and/or building upon the emergency department risk score to improve monitoring of critically-ill children exist. If you are interested in learning more about collaborations with INSN, please contact us.