# Pulmonary Hypertension-Associated Pediatric Cardiac Arrest

> **NIH NIH K23** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $158,097

## Abstract

Project Abstract
 Of the thousands of children with cardiac arrests annually, more than half do not survive. In
hospitalized children, cardiac arrest results from the progression of many disease processes. Targeting these
processes through physiology-directed cardiopulmonary resuscitation (CPR) is a promising means of
personalizing resuscitation to improve survival outcomes. One particularly challenging physiologic process in
children with cardiac arrest is pulmonary hypertension (PH). Based on preliminary data, it appears that by
limiting pulmonary blood flow during CPR, PH impedes cardiac output and leads to lower systemic blood
pressures, values of which are correlated with survival outcomes. Despite consensus opinion that PH-
associated pediatric cardiac arrest is tied to worse outcomes and the American Heart Association and
International Liaison Committee on Resuscitation identifying it as a significant knowledge gap, there is a
paucity of high-quality data on the topic. Our preliminary clinical data indicates that PH is present in 18-35% of
children prior to cardiac arrest. Moreover, PH physiology may be present in far more patients during cardiac
arrest due to the detrimental effects of acidosis and hypoxemia on the pulmonary vasculature. Therefore, we
performed a randomized and blinded trial of inhaled nitric oxide (iNO), a pulmonary vasodilator, during CPR
in a swine model of PH-associated cardiac arrest and demonstrated higher blood pressures and improved rates
of survival with iNO. Thus, there is a readily available potential therapeutic for this serious problem, but
dedicated clinical study is necessary.
 The scientific objectives of this application are to delineate the epidemiology of PH-associated pediatric
in-hospital cardiac arrest and to quantify the physiologic effects of PH and of iNO treatment during CPR. Two
prospective observational cohort studies will be performed. The first will utilize the infrastructure of an
ongoing R01-funded prospective cardiac arrest trial to report on survival from PH-associated cardiac arrest
and the association of PH with intra-arrest hemodynamics. The second will take place in a single center with
extensive, high-fidelity physiology data-capturing systems to better define the physiologic effects of iNO
therapy during CPR. The successful completion of these studies will form the foundation of our knowledge on
this understudied problem and inform the design of prospective clinical trials to treat it. The candidate, Dr.
Ryan Morgan, is a pediatric intensivist and Assistant Professor at the Children's Hospital of Philadelphia and
University of Pennsylvania. His goal is to become an independent, patient-oriented investigator studying
pediatric cardiac arrest and the tailoring of resuscitation therapies to patient-specific physiology. Through the
proposed studies, the parallel career development plan, a team of dedicated and experienced mentors and
advisors, and a world-class environment for resuscita...

## Key facts

- **NIH application ID:** 10388187
- **Project number:** 5K23HL148541-03
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Ryan William Morgan
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $158,097
- **Award type:** 5
- **Project period:** 2020-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10388187

## Citation

> US National Institutes of Health, RePORTER application 10388187, Pulmonary Hypertension-Associated Pediatric Cardiac Arrest (5K23HL148541-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10388187. Licensed CC0.

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