NIH Study Assesses Cooling After Pediatric Cardiac Arrest

Controlled therapeutic hypothermia after cardiac arrest may improve survival and outcomes for adults, but is the same true for infants, children and adolescents? The CHOC Children’s Pediatric Intensive Care Unit is one of 33 in the nation participating in the NIH-funded Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) study investigating the potential benefits.

“There are significant differences between the pediatric and adult populations,” said pediatric intensivist Adam Schwarz, M.D., who is leading the study at CHOC. “First, the causes of cardiac arrest in children are usually quite different than for adults. About 90 percent of pediatric cardiac arrests are secondary to asphyxiation or hypoxia. Additionally, control groups in the adult studies showed a high incidence of fever.” The THAPCA study seeks to answer whether one strictly controlled temperature or another, after resuscitation from cardiac arrest, lead to significant survival outcomes. Half of the participants are randomized to being placed onto temperature-controlled blankets and cooled to 32°C – 34°C for 48 hours, then slowly re-warmed back to 37°C and maintained at normal body temperature for three more days until five days of study are completed. The control group keeps body temperature at 37°C for all five days. Cooling is not without potential risks. Dr. Schwarz said a study involving children who were cooled following traumatic brain injuries showed worse outcomes than those in the control group. “Controlled hypothermia after pediatric cardiac arrest is absolutely not a proven therapy in our patient population and shouldn’t be done outside a strictly controlled study until such results are known,” Dr. Schwarz said. CHOC went live with the THAPCA study in April 2011, and three patients have been enrolled. Nationwide, more than 250 infants, children and adolescents are currently enrolled with a target of 800. For more information about research at CHOC, please visit www.choc.org.

UCLA, Stanford Gastroenterologists Join CHOC

Anup Patel, M.D. & Jeffrey Ho, D.O.

Two fellowship-trained pediatric gastroenterologists with special interests in hepatology and eosinophil-associated gastrointestinal disorders have joined the CHOC Children’s medical staff. Jeffrey Ho, D.O., and Anup Patel, M.D., who trained at the University of California, Los Angeles and Stanford University, respectively, provide a full range of pediatric gastroenterology procedures.

Additionally, both physicians have extensive training in liver transplantation. During his fellowship at UCLA, Dr. Ho participated in research identifying the prevalence, risk factors and co-morbidities for obesity in pediatric liver transplant recipients. He is currently interested in bringing Video Capsule Endoscopy to CHOC.

Dr. Patel was a research fellow at the Stanford University Nadeau Lab and continues to have strong interests in eosinophilic esophagitis. During his fellowship, he received the university’s Transplant and Tissue Engineering Endowment and was the Alan M. Krensky Endowed Clinical Fellow.

Appointments are available at CHOC Children’s Hospital, CHOC Children’s at Mission Hospital and the CHOC Children’s Specialty Center at Hoag Health Center.

For more information or to arrange a referral, please call 714-289-4099.

Anup Patel, M.D.
Pediatric Gastroenterology, Hepatology and Nutrition
Fellowship: Stanford University

Pediatric Residency: University of Nevada, Las Vegas

Medical School: Albany Medical College, New York

Board-Eligible: Pediatric Gastroenterology

Board-Certified: Pediatrics

Jeffrey Ho, D.O.
Pediatric Gastroenterology, Hepatology and Nutrition
Fellowship: University of California, Los Angeles

Pediatric Residency: University of Nevada School of Medicine, Las Vegas

Medical School: Touro University College of Osteopathic Medicine, Vallejo

Board Eligible: Pediatric Gastroenterology

Board-Certified: Pediatrics

CHOC Welcomes New Chief Strategy Officer – Elaine Bauer

She began her professional life as a hospital-based medical technologist performing immunopathology research, and advanced into strategic planning and development for three major health systems. Most recently, Elaine Bauer was vice president of strategic initiatives for the Catholic Health Association of the United States, and worked in Washington, D.C., during the healthcare legislation creation process. In becoming CHOC Children’s first chief strategy officer, her career has come full circle.

“I wanted to work once again with healthcare delivery at the provider level and join an organization I could help move from ‘good’ to ‘great,’” Bauer said. “My goal is to help ensure CHOC’s future in light of reimbursement and healthcare delivery changes, and the next phase of the pending legislation that is likely to happen.”

Bauer also led strategic planning for Catholic Health East, in Pennsylvania; Sutter Health, in Sacramento; and Sisters of Mercy Health System, in St. Louis. She is a fellow of the American College of Healthcare Executives, and has master’s degrees in finance and healthcare management from Webster University, in St. Louis. Her professional activities include teaching and research. She has been an adjunct professor at Immaculata University, near Philadelphia; Golden Gate University, Sacramento; and served as preceptor for administrative fellows and residents from the University of Minnesota, Washington University in St. Louis, and the University of Southern California.

“Strategic planning has to be a partnership between the physicians and the administrative suite. Physician input is very important—we walk this road together.”

“With the new building project and the recent affiliation with the University of California, Irvine, CHOC is poised to becoming great,” Bauer said. “I am thrilled to be a member of the team that pushes through that last mile.”

Meet Our Chief Residents

Jacqueline Chak, M.D., Georgie Joven Pechulis, M.D., & Geoffrey Kenyota, M.D.

CHOC Children’s Chief Residents

Jacqueline Chak, M.D.
Undergraduate: University of California, Berkeley
Medical School: Albert Einstein College of Medicine
Future Interests: Hospitalist medicine or general pediatrics and medical missions

Georgie Joven Pechulis, M.D.
Undergraduate: University of Illinois at Urbana-Champaign
Medical School: University of Illinois at Chicago
Future Interests: Hospitalist within an academic center

UC Irvine/CHOC Children’s Chief Resident

Geoffrey Kenyota, M.D.
Undergraduate: Northwestern University, Chicago
Medical School: SUNY Downstate Medical Center
Future Interests: Hospitalist and resident teaching opportunities

To contact either Dr. Chak and Dr. Pechulis, please call the CHOC Children’s chief residency office at 714-532-8547. For Dr. Kenyota, please call the UC Irvine/CHOC Children’s residency office at 714-456-5631.

Dr. Waffarn Retires From Clinical Practice

A pioneer in neonatal medicine, Feizal Waffarn, M.D., came to Orange County in 1980, shortly after completing fellowship training at the University of Southern California. At the University of California, Irvine, Dr. Waffarn worked with neonatologist Louis Gluck, M.D., in analyzing the efficacy of surfactant therapy for premature infants with lung disease and helped build that hospital’s NICU into a Level III referral center. In 2001, he became chair of the UC Irvine department of pediatrics and pursued the successful affiliation with CHOC Children’s.

Career highlights also include Dr. Waffarn’s work with the Children and Families Commission of Orange County and the NI H National Children’s Study. He is a founding member of the California Association of Neonatologists and represents the perinatal medicine section of the American Academy of Pediatrics, California Chapter 4. Dr. Waffarn has published more than 40 scientific articles in peer-reviewed journals.

“Of Dr. Waffarn’s many accomplishments over the past 30 years, perhaps the most enduring legacy will be the CHOC and UC Irvine affiliation,” said Nick Anas, M.D., CHOC Children’s Pediatrician-in-Chief. “Dr. Waffarn has also been instrumental in establishing a vision for research and developed a renowned research faculty.”

Dr. Waffarn plans to continue teaching at UC Irvine and abroad. Additionally, he will serve as co-investigator for three NIH research studies and remain involved with global health initiatives for developing countries, including the Southeast Asia Regional Organization, a subsidiary of the World Health Organization.

Dr. Waffarn has played a pivotal role in improving health access and outcomes for the children of Orange County. On behalf of CHOC, we thank him for his tireless dedication and wish him the best in all his future endeavors.