• Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a highly collegial group that is dedicated to the pursuit of excellence and advancement of critical care research in Canada.
  • Canadian Critical Care Trials Group
    The CCCTG has are more than 30 research programs underway and over 100 peer-reviewed publications to its credit, with direct impact on clinical practice in critical care.
  • Canadian Critical Care Trials Group
    The Canadian Critical Care Trials Group (CCCTG) is a national organization of more than 300 individuals with research interests in the management of the critically ill patient.
  • Canadian Critical Care Trials Group
    Endorsement by the CCCTG communicates our full commitment to ensure that the work is undertaken in a rigorous and ethical manner, and communicated in a timely and effective way.
Programs

Principal Investigator(s)

Coordinator(s)

Katie O’Hearn

Status

Completed

STRIPES — Steroid Use in Pediatric Fluid and Vasoactive Infusion Dependent Shock

STRIPES.CCCTG.CA - Approximately 20,000 children per year in North America present to emergency departments and pediatric wards with shock. Normally the body responds to this by producing larger amounts of a hormone called cortisol which help them heal faster. However, some children do not produce enough cortisol and/or do not respond appropriately to the cortisol that they have produce and may become very sick, needing extensive support in the pediatric intensive care unit. It is not clear as to why this happens which makes appropriate treatment of these patients difficult. Our research consists of a multi-step program that aims to determine which patients are at risk of inadequate cortisol production and to determine the right dose and timing of cortisol replacement for them so as to provide evidence based guidelines for the treatment of these children in the future.

Relevant links:

  • Click here for study protocol publication
  • Click here to access study in Clinicaltrials.gov registry 

Relevant references:

  1. Menon K, McNally D, Choong K, Sampson M. A Systematic Review of Steroids in Pediatric Shock. Accepted to Pediatric Critical Care Medicine.
  2. Menon K, McNally D, Choong K, Lawson M, Ward R, Ramsay T, Wong H. A Survey of Physician Practices and Beliefs on the Use of Steroids in Pediatric Shock. Accepted to Pediatric Critical Care Medicine.
  3. McNally JD, Menon K, Chakraborty P, Fisher L, Williams KA, Al-Dirbashi OY, Doherty DR. The Association of Vitamin D Status With Pediatric Critical Illness. Pediatrics. 2012 Sep;130(3):429-436. Epub 2012 Aug 6.
  4. Menon K, Ward R, Lawson M, Gaboury I, Hutchison JS, Hebert P. A Prospective Multi-Center Study of Adrenal Function in Pediatric Critical Illness. Am J Resp Crit Care Med. 2010 Jul 15;182(2):246-51. Epub Mar 18 2010.
  5. Choong K, Bohn, D, Fraser D, Gaboury I, Hutchison JS, Joffe AR, Litalien C, Menon K, McNamara P, Ward, R. – Vasopressin in Pediatric Vasodilatory Shock. Am J. Respir Crit Care Med. October 2009; 180:623-639.
  6. fMenon K, Lawson M. Identification of Adrenal Insufficiency in Pediatric Critical Illness. Ped Crit Care Med 2007; 8(3):276-278.
  7. Menon K, Clarson C, Sim D. The Incidence of Adrenal Insufficiency in Pediatric Critical Illness. Ped Crit Care Med, 2002;3(2):112-116.

Co-Investigators

Dr. Dayre McNally, Dr. Karen Choong, Dr. Margaret Lawson, Dr. Tim Ramsay, Dr. Hector Wong, Dr. Anand Acharya, Dr. Lynda Khalaf, Dr. Lauralyn A. McIntyre

Participating Centers

Retrospective Study: Children’s Hospital of Eastern Ontario, Ottawa (Kusum Menon); McMaster Children’s Hospital, Hamilton (Karen Choong); Hospital for Sick Children, Toronto (Jamie Hutchinson); London Health Sciences Centre, London (Jennifer Foster)

Prospective Pilot RCT: Children’s Hospital of Eastern Ontario, Ottawa (Kusum Menon); IWK Health Centre, Halifax (Gavin Morrison); Ste Justine Children’s Hospital, Montreal (Marisa Tucci); Montreal Children’s Hospital, Montreal (Ronald Gottesman); McMaster Children’s Hospital, Hamilton (Karen Choong); Alberta Children’s Hospital, Calgary (Elaine Gilfoyle); British Columbia Children’s Hospital, Vancouver (David Wensley)