David Kane

Dr. Kantor is pursuing 2 main research areas:

Gene-environment interactions that contribute to illness severity.

The susceptibility to and severity of many diseases in the ICU are likely subject to gene-environment interactions in which inter-individual variation in disease manifestation is influenced both by host genetic background and environmental exposure. Our overall goal is to use genetic association methods to identify genes that explain inter-individual variation in disease manifestation following environmental exposure. We are using rhinovirus triggered asthma exacerbation as a model because:

1. rhinovirus-triggered acute asthma exacerbation is a dominant cause of morbidity among children with asthm
2. there is marked inter-individual variation in the susceptibility to and severity of rhinovirus-triggered asthma exacerbation, ranging from mild symptoms to life-threatening episodes
3. accumulating evidence suggests that variation in asthma severity is likely influenced by host genetic background. Characterizing the genetic basis of inter-individual variation in the clinical phenotype of rhinovirus infection will provide insights into the biological mechanisms that pre-dispose some children to severe episodes of rhinovirus-triggered asthma exacerbation, and ultimately will improve risk stratification and treatment. Further, we expect that our approach can be used more broadly to study the genetics of severe disease in the intensive care unit.

Point of care ultrasound in the pediatric intensive care unit.

Point of care ultrasound in the critical care setting comprises a set of focused applications utilized to monitor physiological states, guide invasive procedures, and diagnose potentially life-threatening conditions. Accumulating evidence in adults demonstrates point of care ultrasound alters clinical management, improves the safety and efficacy of invasive procedures, and may potentially improve the outcomes of critically ill patients. We are broadly interested in investigating the utility of point of care ultrasound in the pediatric intensive care unit. Current projects include:

1. using ultrasound to measure anterior thigh muscle thickness as a proxy for muscle mass and nutritional statu
2. nvestigating ultrasound-based physiological parameters that might predict volume responsiveness
3. using ultrasound to assess lung recruitment of patients on ECMO. In addition, we are collaborating with a number of other academic centers to investigate how ultrasound-derived data alters the timing and nature of clinical management decisions in the pediatric intensive care unit.