Adrienne G. Randolph, M.D.,
M.Sc.
-
Associate Director, Multidisciplinary ICU and Director, ICU
Information Systems, Children's Hospital,
Boston, Massachusetts
-
Assistant Professor of Pediatrics (Anaesthesia), Harvard Medical School, Boston, Massachusetts
-
Director, Pediatric Acute Lung Injury Clinical Investigators (PALICI) Network
(send email
/
snailmail address / educational background
/ website)
Informatics
Projects:
Research Projects:
-
- Publications:
Projects
PedsCCM Journal Club (go to Journal Club)
Pediatric Critical Care Medicine Online Evidence-Based Journal Club: With the
joint goals of teaching the principles of evidence-based medicine to pediatric critical
care practitioners and of developing a repository of critically appraised trials in
Pediatric Critical Care Medicine, Drs. Barry Markovitz and Adrienne Randolph started the
PedsCCM Evidence-Based Journal Club. Fellowship directors from many institutions across
the United States have now agreed to support this concept and to have their fellows apply
the principles of critical appraisal and submit reviews.
Mechanical
Ventilator Weaning and Extubation Study:
Weaning Critically Ill Pediatric Patients from Mechanical Ventilator Support:
A Multicenter Randomized Controlled Trial Comparing Two Protocols to Standard Care. Volume
support is a new mode of mechanical ventilation where a computer algorithm automatically
adjusts the level of pressure support to achieve a tidal volume goal. We are conducting a
multicenter randomized controlled trial comparing two protocols (pressure support versus
volume support) to no protocol for weaning critically ill pediatric patients from
mechanical ventilator support. We are also evaluating the predictiveness of multiple
parameters for extubation success and failure. (For more
information about this study). This trial is being performed across the
PALICI Network which is comprised of investigators at 12
large pediatric intensive care units. Funding for
the study is from Ronald McDonald House Charities, Novametrix Medical Systems, Inc., and
Siemen's Medical Systems, Inc.
Genetic
Epidemiology of RSV and Asthma:
Genetic Epidemiology of Respiratory Syncytial Virus Bronchiolitis in
Infancy and the Development of Asthma in Childhood. Respiratory
syncytial virus (RSV) infection is the main cause of pneumonia in healthy
infants. RSV bronchiolitis results in approximately 75,000 hospitalizations
annually among children less than one year of age in the United States.
Approximately half of these children develop symptoms of asthma that persist
into childhood. The National Heart Lung and Blood Institute of the
National Institutes of Health has funded Dr. Randolph to evaluate the
association of RSV with the later development of asthma. She is following
over 1,000 healthy infants who have been hospitalized at Children's Hospital,
Boston from 1990 through 2000 with RSV bronchiolitis.
Publications
Decision Analysis / Cost
Effectiveness Analysis
- Randolph AG, Washington AE. Screening for Chlamydia
trachomatis in adolescent males: cost and benefits of the leukocyte esterase urine
dipstick test. Am J Pub Health 1990;80:545-550. (abstract)
- Randolph AG, Washington AE, Prober CG. Cesarean delivery for
women presenting with genital herpes lesions: efficacy, risks, and cost. JAMA
1993;270:77-82. (abstract)
- Randolph AG, Hartshorn RH, Washington AE. Acyclovir prophylaxis
in late pregnancy to prevent neonatal herpes: A cost-effectiveness analysis. Obstet
Gynecol 1996;88:603-610. (abstract)
- Randolph AG, Goldmann DA. Cost-effectiveness of 10 strategies
for managing suspected central venous catheter-related infections. Pediatr Res
1998; 43: 155A.
Systematic Reviews / Meta-Analysis
- Cook DJ, Randolph AG, Kernerman P, Cupido C, Soukup M, King D,
Brun-Buisson C. Central venous catheter exchange strategies: a meta-analysis of randomized
controlled trials. Crit Care Med 1997;25:1417-1424. (abstract)
- Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin
use in central venous and pulmonary artery catheters: a meta-analysis of randomized
controlled trials. CHEST 1998;113:165-171. (abstract)
(full text
PDF version)
- Randolph AG, Wang EEL. Ribavirin for respiratory syncytial
virus lower respiratory tract infection: a systematic overview and meta-analysis. Arch
Pediatr Adol Med 1996;150:942-947 (abstract)
and Cochrane Database for Systematic Reviews,
December 1996.
- Randolph AG, Cook DJ, Gonzales CA, Pribble CG. Ultrasound
guidance for placement of central venous catheters: a meta-analysis of the literature. Crit
Care Med 1996;24:2053-2058. (abstract)
- Randolph AG, Cook DJ, Gonzales CA, Andrew M. Benefit of heparin
use in peripheral venous, central venous and arterial catheters: a systematic review and
meta-analysis of randomized controlled trials. BMJ 1998;316:969-974.
(full text)
- Randolph AG, Cook DJ, Gonzales CA, Brun-Buisson C. Tunneling
short-term central venous catheters to prevent catheter-related infections: a
meta-analysis of randomized controlled trials. Crit Care Med
1998;26:1452-7. (abstract)
- Azzam MA, Randolph AG, Butt W. Positive predictive value of
bilateral absence of somatosensory evoked potentials in severe traumatic brain injury. Pediatr
Res 1998; 43: 33A.
- Randolph AG, Cook DJ. Antiseptic hub
connectors reduce central venous catheter-related sepsis. Crit Care Med
1999;27:A141.
- Randolph AG, DeJonghe B, Merrer J, Cook DJ. Single versus multilumen
central venous catheters: a critical appraisal of the infection risk. Crit Care Med
1999;27:A141.
- Bateman S, Randolph AG. Efficacy of continuous vs. intermittent
furosemide. Crit Care Med 1999;27;A59.
Clinical Epidemiology &
Evidence-Based Medicine
- Randolph AG. Paediatric Index of Mortality (PIM): Do we need
another paediatric mortality prediction score? (Editorial) Intensive Care Med
1997;23:1441-2.
- Randolph AG. The critical care database of randomized
controlled trials: A resource to facilitate evidence-based practice in the intensive care
unit. Critical Care 1997;0:25-8.
- Randolph AG, Markovitz B. Resources for applying evidence based
medicine in the Pediatric Intensive Care Unit (PICU). J Int Care Med1997;12:316-320.
- Randolph AG. An evidence based approach to central venous
catheter management. In press, Crit Care Clinics.
- McGinn T, Randolph A, Richardson WS, Sackett DL. Clinical
prediction guides (CPG's). Evidence Based Medicine 1998;3:5-6 and ACP Journal
Club 1998;128:538-556..
- Randolph AG, Guyatt GH, Richardson WS. Determining prognosis in
the intensive care unit (ICU): finding accurate and useful estimates for counseling
patients. Crit Care Med 1998; 26: 767-772. (abstract)
- Randolph AG, Guyatt GH, Carlet J. Understanding articles
comparing outcomes among intensive care units to rate quality of care. Crit Care Med
1998; 26: 773-781. (abstract)
- Randolph AG, Guyatt GH, Doig G, Calvin J. Understanding
articles describing clinical prediction tools. Crit Care Med
1998;26:1603-12. (abstract)
- Truog R, Robinson W, Randolph AG, Morris, AH. Is informed consent always
necessary for randomized controlled trials? N Engl J Med 1999;340:804-6.
- Markovitz B, Randolph AG. The Pediatric Critical Care Evidence-Based
Internet Journal Club: interim evaluation. Crit Care Med 1999;27:A99.
Medical Informatics
- Randolph AG, Clemmer TP, East TD, Kinder AT, Orme JF, Wallace
CJ, Morris AH. Evaluation of compliance with a computerized protocol: weaning from
mechanical ventilator support using pressure support. Comput
Meth Progr Biomed 1998;57:201-15. (abstract)
- Sailors RM, East TD, Wallace CJ, Carlson DA, Franklin MA,
Heerman LK, Kinder AT, Bradshaw RL, Randolph AG, Morris AH. Testing and validation of
computerized decision support systems. In: Proceedings of the twentieth annual meeting of
the American Medical Informatics Association. Washington D.C: American Medical Informatics
Association, 1996:27. (abstract)
- Randolph AG, Kane J. Potential for meeting clinician information
requirements in an intensive care unit (ICU) via the web. Proc AMIA Symp
1998:96-100. (abstract)
- Randolph AG, Haynes RB, Wyatt JC, Cook DJ, Guyatt GH. Users’ guides
to the medical literature: XVIII. How to use an article evaluating the clinical impact of
a computer-based clinical decision support system. JAMA 1999;282:67-74.(full
text article)
Pediatric Critical Care
- Gonzales CA, Randolph AG, Perloff WH, Yeh TS. Pediatric
intensive care units in 1995: numbers, characteristics, and distribution. Pediatrics
1997;100 (3):449.
- Randolph AG. Learning airway management skills: guidelines for
pediatrics. Arch Pediatr Adoles Med 1994;148:227-8.
- Randolph AG, Zollo MB, Wigton RS, Yeh T. Factors explaining
variability among caregivers in the intent to restrict life-support interventions in a
pediatric intensive care unit (ICU). Crit Care Med, 1997;25:435-439.
(abstract)
- Azzam MA, Randolph AG, Butt W. Positive predictive value of bilateral
absence of somatosensory evoked potentials in severe traumatic brain injury. Pediatr
Res 1998;43:33A.
- Randolph AG, Zollo MB, Egger JM, Guyatt GH, Nelson RM, Stidham GL.
Variability in physician opinion on limiting pediatric life support. Pediatrics
1999;103:807. (full
text article)
- Randolph AG. Reorganizing the delivery of intensive care may improve
patient health outcomes. JAMA 1999;281:1330-31. (full
text)
- Randolph AG. Weaning from mechanical ventilation. New Horiz
1999;7:374-385
Education
Dr. Randolph received her Bachelors and Master's degrees in
Psychology before completing her MD in 1989 at Stanford University School of
Medicine. She is board certified in Pediatrics and Pediatric Critical Care
Medicine. She completed a fellowship at the Institute for Health Policy
Studies at the University of California at San Francisco. She received her Master of Science degree in Medical Informatics from the
University of Utah in 1996.
- Contact Information:
Dr. Adrienne G. Randolph
Children's Hospital
MICU, Farley 517
300 Longwood Avenue
Boston, MA 02115
- (617) 355-7327
- (617) 734-3863 fax
- email: adrienne.randolph@tch.harvard.edu
- URL: http://www.intensivecare.com
last updated: 12/29/99