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Saturday, April 29
8:00am–11:00am
2120—Management of Childhood Hypertension:
Guidelines and Controversies
PAS/ASPN/IPHA Mini Course
Room 2003-2005, Moscone West
Chairs: Steven R. Daniels, University of Colorado, Denver, CO;
and Ronald J. Portman, University of Texas Medical School,
Houston, TX
Target Audience: General
pediatricians, emergency medicine physicians, hospitalists,
intensivists, nephrologists and cardiologists.
The 2004 NHLBI guidelines for the
evaluation and management of childhood hypertension answered
many questions about how to approach hypertensive children,
but left others unanswered. This mini course is designed to
address some of the more controversial aspects of managing
hypertensive children, with the hope of stimulating further
discussion about the optimal approach to these patients.
Practical approaches to clinical management will be
emphasized.
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Overview
Stephen R. Daniels, The Children's Hospital/University of Colorado,
Denver, CO
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Overview of Treatment Guidelines
from the 4th Report
Bonita E. Falkner, Thomas Jefferson University, Philadelphia, PA
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Management of Pre-hypertension:
Lifestyle Changes or Pharmacologic Treatment?
Shawna D. Nesbitt, University of Texas Southwestern Medical Center,
Dallas, TX
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Choice of Agent for Children with
Primary Hypertension
Joseph T. Flynn, Children's Hospital at Montefiore, Bronx, NY
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Treatment of Severe Hypertension
in Ambulatory and Inpatient Settings
Joshua Samuels, University of Texas, Houston, TX
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Treatment of Hypertension in
Special Populations
Donald L. Batisky, Columbus Children's Hospital/The Ohio State
University College of Medicine, Columbus, OH
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Discussion
Sponsored jointly by
the American Society of Pediatric Nephrology, the
International Pediatric Hypertension Association and the
Pediatric Academic Societies
10:30am–12:30pm
2315—Brain Metabolism and Injury:
Mechanisms of Neuronal Injury and Neuroprotection
PAS Poster Symposium
Room 3024, Moscone West
Chairs: John D.E. Barks and Jeremy D. Marks
11:45am–2:45pm
2434—Pain
APA Special Interest Group
Pacific Suite H, SF Marriott
Chair: Bruce Bernstein, BBernste@StFrancisCare.org.
The APA Pain SIG provides a venue
for discourse and research on the unique issues associated
with the recognition, assessment and management of pain
problems in childhood. Last year, an expert panel provided a
set of discussions on complementary/alternative techniques for
reducing pain, including hypnotism, acupuncture, yoga and
therapeutic touch.
This year's SIG meeting will
focus on palliative and end-of-life care in children. Members
of the Pediatric Palliative Care Program at the Lucile Packard
Children's Hospital, Stanford University School of Medicine
will lead the session. It will focus on basic clinical
concepts and dilemmas in this newly emerging discipline.
Presenters and topics include:
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Palliative Care in Children:
An Overview
Barbara Sourkes, PhD
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End-of-Life Issues in the
Intensive Care Unit
Lorry Frankel MD, MBA
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Pain and Symptom Management in
Pediatric Palliative Care
Sandy Sentivani-Collins MSN
Past meetings have been attended
by attendees with general interest in children’s pain, as
well as those with interest in the session’s specific focus.
We continue to encourage participation for either of these
reasons. In addition to the presentations, this year’s
meeting will provide an opportunity for discussion of future
directions of the SIG, in keeping with our goal of developing
a core group of practitioners interested in pain as a
discipline and not solely as it applies to a specific subgroup
or problem.
We have constructed an email list
of individuals interested in receiving periodic communications
from the Pain SIG concerning key developments in the field,
articles, upcoming meetings, etc. Individuals who wish to be
added to this list or who desire further information on this
year’s SIG should email the session chair.
1:00pm–3:00pm
2610—Genetics and Epigenetics of Neonatal
Disease
PAS Platform Session
Room 3022, Moscone West
Chairs: Aaron Hamvas and Jeffrey C. Murray
3:15pm–5:15pm
2774—Telemedicine and Its Applications in
Pediatrics: Improving Quality and Addressing Access Barriers
PAS Educational Workshop
Golden Gate Hall C2, SF Marriott
Leader: James Marcin, Sacramento, CA; Co-leader: Stacey Cole
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
and community practitioners.
This workshop will provide an
overview of telemedicine, and demonstrate how telemedicine
assists in the care of pediatric patients in various settings.
Interactive lectures will be given on the critical components
of a successful telemedicine program. Video clips of
consultations and interviews will be shown to provide an
understanding of telemedicine from various perspectives. A
step-by-step process will be laid out to help evaluate the
possibility of using telemedicine for their services.
Panelists: Juan Trujano, Anita
Grady and Kristi MacLeod
Objectives:
– To understand the technology
of telemedicine, including telecommunications.
– To become familiar with the important structural,
managerial and financial considerations of telemedicine.
– To understand the impact of telemedicine on measures of
quality of care and satisfaction.
Format: This workshop will
primarily be conducted in a lecture/panel format. Sessions
will be interactive and include discussion, sample video
clips, and a live demonstration of equipment and telemedicine
consultations.
Sunday, April 30
1:45pm–3:45pm
3650—Hematologic Issues in the PICU
PAS/ASPHO Topic Symposium
Room 3016-3018, Moscone West
Chairs: Roshni Kulkarni, Michigan State University, East
Lansing, MI; and Prasad Mathew, University of New Mexico,
Albuquerque, NM
Target Audience: Pediatric
hematologists/oncologists, pediatric critical care physicians,
pediatric surgeons and basic science researchers in
hematology.
Critically ill children often
suffer complications related to hematological consequences of
the primary illness or injury. Timely realization of these by
critical care physicians and hematology consultants is key to
improving outcomes in critically ill children. During the past
decade, hematology research (particularly in coagulation and
thrombophilia) has given new information that will help
clinicians care for these children.
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Introduction: Hematologic Issues
in the PICU
Prasad Mathew, University of New Mexico, Albuquerque, New Mexico
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Disseminated Intravascular
Coagulation
Keith Hoots, The University of Texas Health Science Center and The
University of Texas M.D. Anderson Cancer Center, Houston,
TX
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Massive Hemorrhage: A
Hematologists Perspective
Roshni Kulkarni, Michigan State University, East Lansing, MI
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Thrombosis Including
Heparin-Induced Thrombocytopenia in the PICU
Guy Young, Children's Hospital of Orange County, Mattel Children's
Hospital at UCLA, Orange County, CA
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Discussion
Sponsored jointly by
the American Society of Pediatric Hematology/Oncology and the
Pediatric Academic Societies
2:00pm–4:00pm
3722—Neonatal Lung Inflammation: Mechanisms
and Clinical Implications
PAS Platform Session
Room 3014, Moscone West
Chairs: Rose M. Viscardi and Stephen E. Welty
Supported by an unrestricted educational grant from Dey,
L.P.
2:00pm–5:00pm
3765—High-Fidelity Pediatric Simulation:
Setting a National Human Performance and Patient Safety
Research and Training Agenda
PAS Educational Workshop
Yerba Buena Gardens Salon 2, SF Marriott
Leader: Louis Halamek, Palo Alto, CA; Co-leaders: Mary
Patterson, Joseph Lopreiato
Target Audience: Trainees,
fellows, junior faculty, and mid-level faculty, senior
faculty.
The goal of this workshop is to
bring together those who are interested in using high fidelity
multidisciplinary pediatric simulation to improve the training
of healthcare professionals and in establishing the evidence
base to support the use of this methodology. This will be an
interactive panel-led session coupled with video presentations
and small breakout group discussions that will allow
participants to identify the elements of a national
simulation-based research and training agenda and a strategy
for implementation of such a plan. Participants will learn
what they can do on the local and national levels to validate
and disseminate its use.
Objectives:
– Define high fidelity
simulation.
– Describe the unique challenges of pediatric simulation.
– Understand why a national research and training agenda is
indicated.
– Develop the major elements of this agenda and develop an
action plan.
Format: I plan to use the three
panelists to lead a facilitated, interactive discussion with
the audience in order to accomplish the workshop objectives
(setting a national agenda and creating an action plan).
4:15pm–5:45pm
3810—RNA Interference, Technological
Development of siRNAs and Potential Treatments for Childhood
Diseases
PAS State of the Art Plenary
Room 3016-3018, Moscone West
Chair: R. Alan B. Ezekowitz, Harvard Medical School,
Massachusetts General Hospital, Boston, MA
Target Audience: Basic scientists
studying a broad range of childhood diseases, translational
scientists of all disciplines studying clinical implications
of basic science research, clinical scientists studying
childhood and other diseases in need of improved therapies and
clinicians interested in cutting-edge science and its medical
implications.
RNA interference is a recently
discovered, naturally occurring intracellular process that
regulates gene expression through the silencing of specific
mRNAs. Methods of harnessing this natural pathway are being
developed that allow the catalytic degradation of targeted
mRNAs using specifically designed complementary small
inhibitory RNAs (siRNA). siRNAs are being chemically modified
to acquire drug-like properties. Numerous recent high-profile
publications have provided proofs of concept that RNA
interference may be useful therapeutically. Much of the design
of these siRNAs can be accomplished bioinformatically, thus
potentially expediting drug discovery and opening new avenues
of therapy for many childhood diseases including uncommon
pediatric and orphan diseases. A discussion of the science
behind RNA interference will be followed by a presentation of
the potential practical issues in applying this technology to
disease. The program then describes two therapeutic programs
currently under way with applications to pediatric diseases. A
question-and-answer time will follow each discussion.
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The Science of RNA Interference
John J. Rossi, Beckman Research Institute of City of Hope, Duarte, CA
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RNA Interference and Its
Potential Applications for Controlling Disease
Judy Lieberman, CBR Institute for Biomedical Research and Harvard
Medical School, Boston, MA
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Silencing the VEGF Pathway with
siRNAs and the Potential Application to Retinopathy of
Prematurity
Pamela Pavco, Sirna Therapeutics, Boulder, CO
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siRNA as Therapy for Respiratory
Syncytial Virus
John P. DeVincenzo, University of Tennessee School of Medicine,
Memphis, TN
4:15pm–6:15pm
3840—Cell Biology of Lung Disease
PAS Platform Session
Room 2004, Moscone West
Chairs: Michael M. Grunstein and Craig M. Schramm
4:15pm–6:15pm
3845—Endocrinology: Insulin
Resistance/Obesity
PAS/LWPES Poster Symposium
Room 3003-3005, Moscone West
Chairs: I. David Schwartz and Svetlana Ten
4:15pm–6:15pm
3875—Neonatal Pulmonary Hypertension
PAS Poster Symposium
Room 2002, Moscone West
Chairs: Steven H. Abman and Bernard Thebaud
Monday, May 1
8:00am–10:00am
4105—MRI of the Brain in Neonates
PAS Topic Symposium
Room 3022-3024, Moscone West
Chairs: Terrie E. Inder and Jeff J. Neil, St. Louis Children's
Hospital, St. Louis, MO
Target Audience: Neonatologists,
neurologists, radiologists and trainees.
Magnetic resonance (MR) imaging
remains a rapidly evolving field, particularly in its
application to newborn infants. This symposium will first
review the basics of MR imaging methods (including
conventional and diffusion MR imaging) and then highlight
clinical applications of these methods to common neonatal
clinical conditions in the term and premature infant. The
talks will be targeted to clinicians and aimed to address key
clinical questions such as:
– In which infants should I
undertake an MR scan in my NICU?
– What are the strengths and weakness of MRI/CT/cranial
ultrasound?
– How can I undertake MR imaging in my institution—safety,
image sequences and interpretation?
– When should I undertake an MR scan in the term or
premature infant?
– What do the abnormalities in the MR scan mean for
long-term neurological outcome?
– How should I use this information in my clinical practice
in the NICU?
– Where is MR imaging taking us in the next 10 years in
newborn medicine?
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A-B-C of M-R-I
Jeffrey J. Neil, Washington University and St. Louis Children's
Hospital, St. Louis, MO
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Application of MR Imaging to the
Term Infant
Mary Rutherford, Hammersmith Hospital, London, UK
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Application of MR Imaging to the
Preterm Infant
Terrie E. Inder, Washington University and St. Louis Children's
Hospital, St. Louis, MO
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X-Y-Z- of M-R-I—The Future with
Advanced MR Methods
Petra S. Huppi, Children's Hospital, University of Geneva, Geneva,
Switzerland
8:00am–10:00am
4110—Pediatric Fluids and Hyponatremia: Are
We Giving Too Much Water?
PAS/ASPN/LWPES Topic Symposium
Room 3007-3011, Moscone West
Chairs: John W. Foreman, Duke University Medical Center,
Durham, NC; and D. Michael Foulds, University of Texas Health
Science Center at San Antonio, San Antonio, TX
Target Audience: Nephrologists,
general pediatricians, emergency room doctors, intensivists,
hospitalists, endocrinologists and anyone who administers IV
maintenance fluids.
In the 1950s, Holiday and Segar
devised formulae for calculating intravenous maintenance
fluids for infants and children who were unable to drink.
These formulae have been taught and used now for over 40 years
and have generally stood the test of time. However, several
recent investigators have challenged these formulae and argued
that they put children at risk of hyponatremia. Since Holiday
and Segar devised these formulae, new information has arisen,
such as the concept of non-osmotic stimulation of ADH release
in sick children and our ability to measure ADH levels in
plasma on a routine basis. Arieff and Ayus were the first to
point out that children and women are at particular risk for
developing hyponatremic encephalopathy. Moritz and Ayus have
subsequently argued that hypotonic parenteral fluid should not
be used unless there are ongoing free water losses or
hypernatremia. In addition to this new clinical data,
Verkman’s group has exciting data identifying molecular
mechanisms of cerebral edema, including after water
intoxication. Dr. Arieff will review who is at risk and why.
Dr. Verkman’s group has developed data regarding mechanisms
of cerebral edema in experimental animals. Dr. Moritz will
describe the new concepts of maintenance fluids. Dr. Friedman
will defend the current practice. At the end there will be
time for an exchange between the speakers and the audience on
the right fluid to use in today’s children.
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Hyponatremic Encephalopathy:
Special Risk Factors for Children and Women
Allen I. Arieff, University of California San Francisco, San Francisco,
CA
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Aquaporin 4 and Cerebral Edema
Alan S. Verkman, University of California San Francisco, San Francisco,
CA
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0.9% Sodium Chloride: The New
Approach to Maintenance Fluids in Pediatrics
Michael L. Moritz, Children's Hospital of Pittsburgh, Pittsburgh, PA
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Maintenance Therapy: Tried and
True
Aaron L. Friedman, Brown Medical School, Hasbro Children's Hospital,
Providence, RI
Sponsored jointly by
the AAP Section on Nephrology, the American Society of
Pediatric Nephrology, the Lawson Wilkins Pediatric Endocrine
Society and the Pediatric Academic Societies
8:00am–10:00am
4132—Mechanisms of Neonatal Lung Injury
PAS Platform Session
Room 3003-3005, Moscone West
Chairs: Vineet Bhandari and Vasanth H.S. Kumar
10:15am–12:15pm
4350—Mechanisms of Brain Injury
PAS Poster Symposium
Room 3020, Moscone West
Chairs: Maria Delivoria-Papadopoulos and Jeffrey M. Perlman
10:15am–12:15pm
4365—Nitric Oxide and Oxygen: A Marriage
Made in Heaven or Hell?
PAS Poster Symposium
Room 3003-3005, Moscone West
Chairs: Satyan
Lakshminrusimha and Leif D. Nelin
12:00pm–6:45pm
Commercial Exhibits Open and Posters
Available for Viewing
PAS Exhibits
Levels 1 and 2, Moscone West
Posters Available for Viewing:
12:00pm–6:45pm
Author Attendance: 5:15pm–6:45pm
Level 1:
– Critical Care
– Gastroenterology
– Genetics
– Neonatal Epidemiology and Follow Up
– Neonatal Pulmonology
– Neonatology
– Nephrology
– Pulmonology
Level 2:
– Developmental–Behavioral Pediatrics
– Emergency Medicine
– General Pediatrics
– Medical Education
3:00pm–5:00pm
4650—CPCCRN: The NICHD Collaborative
Pediatric Critical Care Research Network
PAS Educational Workshop
Room 2004, Moscone West
Leader: Carol Nicholson, Bethesda, MD; Co-leader: Douglas
Willson
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, and community
practitioners.
There are 10,500 critically ill
and injured children admitted each year to the PICUs covered
in the Network. We would welcome the opportunity to interact
with all of the pediatric subspecialties in the context of
PAS. Our work and our research are interwoven with each
pediatric subspecialty as well as with pediatric surgery and
surgical subspecialties.
Objectives:
– How cutting edge informatics
can be used for collaborative pediatric research.
– Understand the Network structure, vision and function, in
a multidisciplinary field.
– Learn about new approaches to nosocomial infection during
critical illness.
Format: An introductory
presentation of Network structure and function, with emphasis
on innovation in collaborative research will begin the
workshop. A series of pediatric critical care scientists will
present some of the newer work being undertaken in the Network
in informatics, sedation, immunology, infectious disease, and
outcomes after pediatric critical illness and injury.
Here is a specific overview, with
each speaker being available for questions, and audience
interaction.
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The CPCCRN: Overview
Douglas Willson, MD
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Functional Disability Outcomes
in Pediatric Critical Care
Murray Pollack, MD
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Toward Science-Based
Guidelines for Sedation and Mechanical Ventilation in
Pediatric Critical Care
Christopher Newth and/or Sunny Anand
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Nosocomial Sepsis and
Lymphocytic Apoptosis: GI Prophylaxis, Glutamine and Zinc
in Pediatric Critical Illness
Joseph Carcillo, MD
3:00pm–5:00pm
4662—Standardizing Prescription of Fluids
and Medications in the NICU: Principles, Practical Tools and
Applications
PAS Educational Workshop
Yerba Buena Gardens Salon 3, SF Marriott
Leader: Joaquim Pinheiro, Albany, NY; Co-leaders: Amy
Mitchell, Vinay Vaidya
Target Audience: Trainees,
fellows, junior faculty, mid-level faculty, senior faculty,
community practitioners, pharmacists, and nurses.
Emphasis on patient safety has
led some NICUs to implement standardized dosing methods,
replacing customized fluid and medication dosing in neonates.
JCAHO has mandated a transition from
"rule-of-6"-based prescription to standardized
concentrations. Without national standards, NICU practitioners
are struggling to comply with the mandate.
Workshop goals are to review
principles of error prevention in NICU, focusing on
standardized methods of prescription and administration. The
leaders will share their experience with paper, electronic and
logistic systems for standardizing fluid, medication and TPN
prescription.
Objectives:
– Participants will learn a
variety of practices and tools used to implement standardized
prescription in NICUs.
– Participants will have practiced multidisciplinary
development of solutions to standardized prescription relevant
to their institutions.
– Participants will learn about computerized methods for
rapid implementation of standardized infusions.
Format: Short presentations,
question-and-answer periods, and problem solving in groups.
3:00pm–5:00pm
4670—Brain Metabolism and Injury
PAS Platform Session
Room 3020, Moscone West
Chairs: Steven P. Miller and Frances J. Northington
Includes:
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SPR Fellow's Basic Research
Award: The Neuron-Glia Lactate Shuttle Protects
Neurological Function in Neuron-Specific Glucose
Deficiency
Camille Fung, David Geffen School of Medicine at UCLA, Los Angeles, CA
3:00pm–5:00pm
4690—Sepsis: Pathogenesis and Outcomes
PAS Platform Session
Room 3000, Moscone West
Chairs: John H. Arnold and Joseph A. Carcillo
5:15pm–6:45pm
Poster Session III
PAS Poster Session
Levels 1 and 2, Moscone West
Posters Available for Viewing:
12:00pm–6:45pm
Author Attendance: 5:15pm–6:45pm
Level 1:
– Critical Care
– Gastroenterology
– Genetics
– Neonatal Epidemiology and Follow Up
– Neonatal Pulmonology
– Neonatology
– Nephrology
– Pulmonology
Level 2:
– Developmental–Behavioral Pediatrics
– Emergency Medicine
– General Pediatrics
– Medical Education
Tuesday, May 2
8:00am–10:00am
5158—Endocrinology: Diabetes—Immune
Mediated
PAS Poster Symposium
Room 3020, Moscone West
Chairs: Bruce A. Boston and Susan B. Nunez
8:00am–10:00am
5168—Oxidants, Antioxidants and the Battles
They Wage
PAS Poster Symposium
Room 3014, Moscone West
Chairs: Jonathan M. Davis and Charles V. Smith
10:15am–11:45am
5410—Pediatric Acute Lung Injury: Results
of Therapeutic Trials and Future Directions
PAS State of the Art Plenary
Room 3003-3005, Moscone West
Chairs: Martha A.Q. Curley and John H. Arnold, Children's
Hospital, Boston, MA
Target Audience: Attendees
practicing in acute care pediatrics.
This session will summarize the
latest developments in clinical trials regarding management of
patients with acute lung injury, particularly in the pediatric
population. Experts in the conduct and evaluation of clinical
trials will present recent developments of critical importance
to the clinician and the clinical investigator. Topics include
an update on liquid ventilation, the usefulness of the prone
position, the utility of surfactant in pediatric patients, the
value of biomarkers and fluid management strategies in
patients with acute lung injury. At the conclusion of this
session, the participant will be able to:
– Critically assess recent
clinical trial results regarding interventions in the
pediatric population.
– Develop a framework for the successful application of
results from adult clinical trials to pediatric patients.
– Identify the major areas for future clinical investigation
in pediatric lung injury.
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Partial Liquid Breathing: Where
Are We?
John H. Arnold, Children's Hospital, Boston, MA
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Prone Positioning in the
Pediatric ICU: Where Are We?
Martha A.Q. Curley, Children's Hospital, Boston, MA
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Pathogenetic and Prognostic Value
of Biomarkers in Pediatric Lung Injury
Heidi R. Flori, Oakland Children's Hospital, Oakland, CA
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The Surfactant Saga
Douglas F. Willson, The University of Virginia Children's Hospital,
Charlottesville, VA
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Results of the NHLBI Phase III
Trial in 1,000 Patients of Fluid Therapy and Central
Venous Versus Pulmonary Artery Catheters in Adult Lung
Injury—Implications for Pediatrics
Michael A. Matthay, University of California San Francisco, San
Francisco, CA
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Discussion
1:45pm–3:45pm
5755—Neonatal Brain Injury: How Can We Do
More Good Than Harm?
PAS Platform Session
Room 3003-3005, Moscone West
Chairs: Sylvain Chemtob and Augusto Sola
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