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Pediatric Acute Lung Injury and Sepsis Investigators (PALISI): Evolution of an Investigator-Initiated Research
Adrienne G Randolph1,2, Melania M Bembea3, Ira M Cheifetz4
1Division of Critical Care Medicine, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA.
Insights
The Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network has evolved over 20 years, expanding research beyond sepsis and lung injury to all pediatric critical care. This multidisciplinary network now operates independently, fostering global research and over 350 publications.
Area of Science:
- Pediatric Critical Care Medicine
- Clinical Research Networks
- Translational Research
Background:
- The Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network was established over two decades ago to advance critical care for infants and children.
- The network has undergone significant evolution, formalizing its infrastructure and broadening its research scope.
- PALISI transitioned to an independent, nonprofit 501c3 structure in 2020, enabling greater fundraising and operational flexibility.
Purpose of the Study:
- To detail the evolution and expansion of the PALISI Network's research focus and organizational structure.
- To highlight the network's multidisciplinary approach and global collaborations.
- To showcase the breadth of research areas now encompassed within pediatric critical care.
Main Methods:
- The network comprises investigators from over 90 pediatric intensive care units (PICUs) in the US and Canada, with international collaborations.
- Research methodologies span the full spectrum of clinical and translational science, including immunobiology, surveys, consensus conferences, observational studies, case-control studies, and randomized controlled trials.
- Activities are funded by member subscriptions, supporting infrastructure and future initiatives.
Main Results:
- PALISI's research focus has expanded from sepsis and acute lung injury to encompass diverse areas such as mechanical ventilation liberation, blood product use, intubation safety, sedation, glucose control, and pandemic research (influenza, COVID-19).
- The network has published over 350 peer-reviewed publications between 2002 and September 2022.
- The independent nonprofit structure facilitates investment in infrastructure and broader fundraising opportunities.
Conclusions:
- The PALISI Network has successfully evolved into an independent, robust research entity.
- Its expanded research agenda and multidisciplinary, global approach are optimizing the care of critically ill children.
- The network's comprehensive research strategy is generating significant evidence to inform pediatric critical care practices.
Abstract:
The Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network originated over 20 years ago to foster research to optimize the care of critically ill infants and children. Over this period, PALISI has seen two major evolutions: formalization of our network infrastructure and a broadening of our clinical research focus. First, the network is unique in that its activities and meetings are funded by subscriptions from members who now comprise a multidisciplinary group of investigators from over 90 PICUs all over the United States (US) and Canada, with collaborations across the globe. In 2020, the network converted into a standalone, nonprofit organizational structure (501c3), making the PALISI Network formally independent of academic and clinical institutions or professional societies. Such an approach allows us to invest in infrastructure and future initiatives with broader opportunities for fund raising. Second, our research investigations have expanded beyond the original focus on sepsis and acute lung injury, to incorporate the whole field of pediatric critical care, for example, efficient liberation from mechanical ventilator support, prudent use of blood products, improved safety of intubation practices, optimal sedation practices and glucose control, and pandemic research on influenza and COVID-19. Our network approach in each field follows, where necessary, the full spectrum of clinical and translational research, including: immunobiology studies for understanding basic pathologic mechanisms; surveys to explore contemporary clinical practice; consensus conferences to establish agreement about literature evidence; observational prevalence and incidence studies to measure scale of a clinical issue or question; case control studies as preliminary best evidence for design of definitive prospective studies; and, randomized controlled trials for informing clinical care. As a research network, PALISI and its related subgroups have published over 350 peer-reviewed publications from 2002 through September 2022.
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