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Dr John Pappachan

MA MBBChir FRCA FFICM

Consultant in Paediatric Intensive Care, Southampton Children's Hospital
Associate Professor, University of Southampton

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Dr Pappachan was a founding board member of the Paediatric Intensive Care Society Study Group and as such has played a major role in development of clinical research in PICU in the UK.


Over the past ten years, PCCS-SG has been successful in leveraging £19 million of trial grant funding from the National Institute for Health Research (NIHR).

Landmark publications:


Ramnarayan P, Richards-Belle A, Drikite L, Saull M, Orzechowska I, Darnell R, Sadique Z, Lester J, Morris KP, Tume LN, Davis PJ, Peters MJ, Feltbower RG, Grieve R, Thomas K, Mouncey PR, Harrison DA, Rowan KM; FIRST-ABC Step-Up RCT Investigators and the Paediatric Critical Care Society Study Group. Effect of High-Flow Nasal Cannula Therapy vs Continuous Positive Airway Pressure Therapy on Liberation From Respiratory Support in Acutely Ill Children Admitted to Pediatric Critical Care Units: A Randomized Clinical Trial. JAMA. 2022 Jul 12;328(2):162-172. doi: 10.1001/jama.2022.9615. PMID: 35707984; PMCID: PMC9204623.


Sepsis Investigators (PALISI) Network. Mechanical power in pediatric acute respiratory distress syndrome: a PARDIE study. Crit Care. 2022 Jan 3;26(1):2. doi: 10.1186/s13054-021-03853-6. PMID: 34980228; PMCID: PMC8722295.


Ventilator Liberation Protocol vs Usual Care on Duration of Invasive Mechanical Ventilation in Pediatric Intensive Care Units: A Randomized Clinical Trial. JAMA. 2021 Aug 3;326(5):401-410. doi: 10.1001/jama.2021.10296. PMID: 34342620; PMCID: PMC8335576.


Injury and Sepsis Investigators (PALISI) Network. Paediatric acute respiratory distress syndrome incidence and epidemiology (PARDIE): an international, observational study. Lancet Respir Med. 2019 Feb;7(2):115-128. doi: 10.1016/S2213-2600(18)30344-8. Epub 2018 Oct 22. Erratum in: Lancet Respir Med. 2018 Nov 13;: Erratum in: Lancet Respir Med. 2019 Mar;7(3):e12. PMID: 30361119; PMCID: PMC7045907.


Mathur M, Lloyd E, van der Jagt EW, Dobyns EL, Meyer MT, Sanders RC Jr, Clark AE, Dean JM; THAPCA Trial Investigators. Therapeutic Hypothermia after In-Hospital Cardiac Arrest in Children. N Engl J Med. 2017 Jan 26;376(4):318-329. doi: 10.1056/NEJMoa1610493. Epub 2017 Jan 24. PMID: 28118559; PMCID: PMC5310766.


Weiss SL, Fitzgerald JC, Pappachan J, Wheeler D, Jaramillo-Bustamante JC, Salloo A, Singhi SC, Erickson S, Roy JA, Bush JL, Nadkarni VM, Thomas NJ; Sepsis Prevalence, Outcomes, and Therapies (SPROUT) Study Investigators and Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network. Global epidemiology of pediatric severe sepsis: the sepsis prevalence, outcomes, and therapies study. Am J Respir Crit Care Med. 2015 May 15;191(10):1147-57. doi: 10.1164/rccm.201412-2323OC. Erratum in: Am J Respir Crit Care Med. 2016 Jan 15;193(2):223-4. PMID: 25734408; PMCID: PMC4451622.


Macrae D, Grieve R, Allen E, Sadique Z, Morris K, Pappachan J, Parslow R, Tasker RC, Elbourne D; CHiP Investigators. A randomized trial of hyperglycemic control in pediatric intensive care. N Engl J Med. 2014 Jan 9;370(2):107-18. doi: 10.1056/NEJMoa1302564.


Major grants:

  • A pilot cluster randomised clinical trial of the use of selective gut decontamination in critically ill children (Paediatric Intensive Care and Infection Control:-(PICnIC) National Institute for Health Research HTA, 2021-10 to 2022-10, £630,000

  • del Nido versus St. Thomas’ blood cardioplegia: a multi-centre randomised controlled trial in children undergoing cardiac surgery British Heart Foundation, 2021-01 to 2024-01, £601,880

  • I-KID (Infant KIdney Dialysis and ultrafiltration): evaluation of efficacy, outcomes and safety of infant haemodialysis and ultrafiltration in clinical use National Institute for Health Research HTA, 2018-07 to 2022-01, £601,880

  • The Bronchiolitis Endotracheal Surfactant Study (BESS) A phase-2 blinded randomised air-placebo-controlled trial of endotracheal surfactant (poractant alfa) in critically ill infants with bronchiolitis National Institute for Health Research EME, 2018-04 to 2032-04, £1,964,597.94

  • A Randomised Multiple Centre Trial of Conservative versus Liberal Oxygenation Targets in Critically Ill Children-(Oxy-PICU) National Institute for Health Research HTA, 2019-08 to 2023-08, £1,680,300

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