Anesthesiology Research

In Dr. Arnold’s pursuit of an academic career as a translational researcher, he sought to address some of the significant challenges in pediatric critical care. He began his academic journey by focusing on one of the most complex challenges in pediatric critical care which is the optimal mode of sedation and analgesia for infants and children during prolonged stays in intensive care. Dr. Arnold’s contributions include the first description of iatrogenic opioid tolerance and dependence in infants and children and authorship of a practical approach to the management of these problems in pediatric intensive care.  He was the principal investigator of a feasibility study designed to define the risks and benefits of the use of potent inhaled anesthetics as sedating agents in ventilated pediatric patients which has led to the development of a practice guideline for the use of isoflurane in the MSICU at Children’s Hospital. Dr. Arnold currently is a member of the Society of Critical Care Medicine’s Task Force for Pediatric and Neonatal Sedation and Analgesia. His subsequent academic interests have been focused on the optimal approaches to lung protective ventilation. He has been able to combine his roles as an experienced clinician, medical director of Respiratory Care and the Extracorporeal Membrane Oxygenation Program, a mentor to many now successful clinician-scientists and an active translational researcher to become a national and international leader in the management of pediatric acute lung injury. His laboratory efforts have directed at the development of innovative technologies in the arena of respiratory support, including high frequency oscillatory ventilation, partial liquid ventilation and the non-invasive monitoring of regional lung mechanics to guide lung protective ventilation. Of note, Dr. Arnold was the principal investigator of the first randomized, controlled trial of high frequency oscillatory ventilation in pediatric patients with respiratory failure. This study was recognized by the FDA in the device approval process and has led to the widespread use of HFOV in pediatric intensive care units worldwide. Dr. Arnold’s primary research focus at the moment involves a new monitoring technology called Electrical Impedance Tomography (EIT). EIT promises to be a safe, reliable and cost-effective technology which describes regional differences in lung volume change during mechanical ventilation. His research collaboration is now focused on the use of EIT to guide lung protective ventilation in an animal model of lung injury.

As a result of the synergism between Dr. Arnold’s clinical research interests and laboratory research related to lung injury, he has been involved in the evolving dialogue regarding the importance of lung protective ventilation in the management of lung injury. He has developed a strong network of collaborators from the world of adult critical care medicine who share a similar focus on innovative modes of ventilation in lung injury. Dr. Arnold has been sought out by clinical investigators in the adult critical care arena to help refine and monitor clinical trial design regarding innovative modes of ventilatory support in adults. Examples include a consultative role in the clinical trial that led to approval of a high frequency device for adult patients. In addition, he currently serves as a member of the Data Safety Monitoring Board of an ongoing clinical trial designed to further explore the impact of early use of high frequency oscillatory ventilation in adult patients.