Douglas F. Willson

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CONTEXT Despite evidence that patients with acute lung injury (ALI) have pulmonary surfactant dysfunction, trials of several surfactant preparations to treat adults with ALI have not been successful. Preliminary studies in children with ALI have shown that instillation of a natural lung surfactant (calfactant) containing high levels of surfactant-specific(More)
OBJECTIVE To characterize complications among infants hospitalized for bronchiolitis or respiratory syncytial virus (RSV). STUDY DESIGN Retrospective data from 684 infants with bronchiolitis or RSV pneumonia, < or =1 year old, admitted to 10 children's hospitals from April 1995 to September 1996. Outcomes included complication rates and effects on(More)
OBJECTIVE Prospective study of the efficacy of calf lung surfactant extract in pediatric respiratory failure. DESIGN Multi-institutional, prospective, randomized, controlled, unblinded trial. SETTING Eight pediatric intensive care units (ICU) of tertiary medical centers. PATIENTS Forty-two children with acute hypoxemic respiratory failure(More)
OBJECTIVE After prolonged opioid exposure, children develop opioid-induced hyperalgesia, tolerance, and withdrawal. Strategies for prevention and management should be based on the mechanisms of opioid tolerance and withdrawal. PATIENTS AND METHODS Relevant manuscripts published in the English language were searched in Medline by using search terms(More)
OBJECTIVE Hospital care for children with viral lower respiratory illness (VLRI) is highly variable, and its relationship to severity and impact on outcome is unclear. Using the Pediatric Comprehensive Severity Index, we analyzed the correlation of institutional practice variation with severity and resource utilization in 10 children's medical centers. (More)
OBJECTIVE Communicating bad news about a child's illness is a difficult task commonly faced by intensive care physicians. Greater understanding of parents' scope of experiences with bad news during their child's hospitalization will help physicians communicate more effectively. Our objective is to describe parents' perceptions of their conversations with(More)
OBJECTIVE A review of the existing literature on ventilator-associated pneumonia in children with emphasis on problems in diagnosis. DATA SOURCES A systematic literature review from 1947 to 2010 using Ovid MEDLINE, PubMed, Cochrane Central Register of Controlled Trials, and ISI Web of Science using key words "ventilator associated pneumonia" and(More)
RATIONALE Our previous studies in children with acute lung injury/acute respiratory distress syndrome demonstrated improved outcomes with exogenous surfactant (calfactant) administration. Sample sizes in those studies were small, however, and the subject populations heterogeneous, thus making recommendations tenuous. OBJECTIVE To investigate the efficacy(More)
BACKGROUND Septic shock is a heterogeneous syndrome within which probably exist several biological subclasses. Discovery and identification of septic shock subclasses could provide the foundation for the design of more specifically targeted therapies. Herein we tested the hypothesis that pediatric septic shock subclasses can be discovered through(More)
OBJECTIVE Open-label trial of the safety and short-term efficacy of calf's lung surfactant in pediatric respiratory failure. DESIGN Multi-institutional, uncontrolled, observational trial. SETTING Six pediatric intensive care units of tertiary medical centers. PATIENTS Twenty-nine children with acute hypoxemic respiratory failure, characterized by(More)