About

Akira Nishisaki, MD, MSCE, is a Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. He serves as an Attending Physician in Pediatric Critical Care Medicine at the Children's Hospital of Philadelphia and is Co-Medical Director of the Center for Simulation, Advanced Education and Innovation at the same institution. His educational background includes an MD from Nagoya University School of Medicine in Japan and an MSCE in Clinical Epidemiology and Biostatistics from the University of Pennsylvania School of Medicine. His professional work focuses on pediatric critical care, with research contributions in areas such as procedural outcomes of minimally invasive surfactant therapy, development of implementation strategies for pediatric emergency airway management, and management guidelines for sepsis and septic shock in children. Nishisaki has been involved in numerous studies related to pediatric respiratory failure, airway management, and critical deterioration prediction, contributing to the advancement of clinical practices and guidelines in pediatric intensive care medicine.

Research topics

• Medicine
• Anesthesia
• Surgery
• Internal medicine
• Emergency medicine
• Intensive care medicine
• Family medicine
• Pathology
• Radiology
• Cardiology
• Psychology
• Pediatrics

Selected publications

• Good Practice Concepts in Pediatric Critical Care Point-of-Care Ultrasound: A Modified Delphi Consensus Initiative

  Pediatric Critical Care Medicine · 2026-02-01 · 1 citations

  article

  OBJECTIVE: We assembled a workgroup within the Pediatric Research Collaborative on Critical UltraSound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI), to define early guidance for point-of-care ultrasound (POCUS) institutional practice and foster future comprehensive guidelines for its broad adoption in pediatric critical care medicine. DESIGN: A modified Delphi method was used for creating the statements. The first meeting was an open proposal session for workgroup members to suggest items for consideration. This was followed by a cycle of voting for levels of agreement along a 7-point Likert-type scale. Items were reviewed, with only items receiving a score of greater than or equal to 6 progressing to the next stage of voting and lower-scoring items reconsidered, with only consensus items proceeding to the next stage for additional rounds of voting until consensus was reached. SETTING: Multi-institutional, multidisciplinary, workgroup of experts on POCUS organized within PeRCCUS as a subgroup of PALISI. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Consensus was obtained for 25 recommendations across five domains: clinical application, quality assurance, equipment, education, and research. CONCLUSIONS: We report consensus recommendations for institutions on clinical use, educational programs, quality assurance, technical requirements, and future research opportunities for the adoption of pediatric critical care medicine POCUS.

  PublisherDOI

• A national needs assessment to inform simulation‐based education for pediatric hospital medicine

  Journal of Hospital Medicine · 2026-02-17

  articleOpen accessSenior author

  BACKGROUND: Pediatric Hospital Medicine (PHM) has historically underutilized simulation-based medical education (SBME), a proven methodology for improving education and patient care. This study sought to identify and prioritize simulation-appropriate topics to inform a comprehensive PHM SBME curriculum for practicing hospitalists. METHODS: In Phase 1, local and national PHM and simulation experts generated and refined a list of potential topics, categorized into cognitive, psychomotor, and affective domains. In Phase 2, a nationally representative sample of pediatric hospitalists from the Pediatric Research in Inpatient Settings (PRIS) Network ranked their top six topics within each domain. Mean priority scores were calculated for each topic, and high-priority topics (HPTs) were identified utilizing natural breaks analysis, then expanded to balance topics across domains. RESULTS: Topic generation and expert panel refinement yielded 19 cognitive, 26 psychomotor, and 12 affective topics. These were prioritized by 52 pediatric hospitalists (of 99 [53%] surveyed). Fifteen HPTs were identified: five cognitive (respiratory distress/failure, shock, behavioral escalation, medical technology failure, sepsis), five psychomotor (lumbar puncture, bag-valve-mask ventilation, tracheostomy management, enteral tube management, chest compressions), and five affective (patient/family communication, de-escalation, interprofessional collaboration, handoffs, diagnostic error avoidance strategies) topics. Subgroup analysis revealed small variations across rater demographic characteristics. CONCLUSION: Fifteen top-rated PHM SBME topics are suitable for inclusion in a comprehensive curriculum that can be adapted at diverse institutions nationwide. Implementation may augment existing continuing medical education in PHM to help standardize care for hospitalized children.

  PublisherOA PDFDOI

• Creation of an Implementation Blueprint for the National Emergency Airway Registry for Pediatric Emergency Medicine (NEAR4PEM) Pre-Intubation Checklist

  Research Square · 2026-01-20

  preprintOpen accessSenior author
  PublisherOA PDFDOI

• Procedural Outcomes of Minimally Invasive Surfactant Therapy: An International Matched Cohort Study

  The Journal of Pediatrics · 2026-02-18

  article
  PublisherDOI

• Validation of Lung Ultrasound Score for Disease Severity and Outcomes in Pediatric Acute Respiratory Failure

  Pediatric Critical Care Medicine · 2026-02-16

  article

  OBJECTIVES: The objective of this study was to investigate the validity of global lung ultrasound (LUS) scores among critically ill children with different etiologies and severities of acute respiratory failure as well as associations with outcomes. DESIGN: Prospective, observational study. SETTING: PICUs at two large children's hospitals. PATIENTS: Children receiving noninvasive or invasive mechanical ventilation and met criteria for acute respiratory distress syndrome (ARDS), lower respiratory tract infection (LRTI), or control group (no lung disease). INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: LUS was performed and LUS scores calculated at two time points: 1) within 24 hours of respiratory failure for all groups (time 1) and 2) at 24 hours of time 1 for patients with ARDS and LRTI (time 2). A total of 76 patients (25 ARDS, 26 LRTI, and 25 control) were included. There was a significant difference in median time 1 global LUS scores between groups (ARDS, 19; interquartile range [IQR], 12-24; LRTI, 8 [IQR, 2-11]; and control, 2 [IQR, 0-6]; p < 0.001). Global LUS scores remained similar from time 1 to time 2 in both ARDS (19 to 17) and LRTI (8 to 7) groups. There were moderate correlations between LUS scores and oxygen saturation index ( r = 0.67; p < 0.001), peripheral oxygen saturation/F io2 ratio ( r = -0.63; p < 0.001), mean airway pressure ( r = 0.63; p < 0.001), positive end-expiratory pressure ( r = 0.52; p < 0.001), and dynamic compliance ( r = -0.43; p = 0.001). Higher LUS scores were associated with fewer ventilator-free days at 28 days ( p < 0.001), fewer positive pressure ventilation-free days at 28 days ( p < 0.001), and fewer ICU-free days at 28 days ( p < 0.001). CONCLUSIONS: In critically ill children with acute respiratory failure, global LUS scores within 24 hours of admission differed by severity of parenchymal lung disease, correlated with oxygenation parameters, and were associated with patient-centered outcomes of duration of respiratory support and PICU length of stay.

  PublisherDOI

• Apneic time during intubation in critically ill children

  Pediatric Research · 2026-01-13

  articleSenior author
  PublisherDOI

• Proposing Entrustable Professional Activities for Pediatric Critical Care Ultrasound: A Modified Delphi Consensus Approach

  Pediatric Critical Care Medicine · 2026-02-01

  article

  OBJECTIVE: Develop a consensus-based framework for point-of care ultrasound in pediatric critical care, or critical care ultrasound (CCUS) education using entrustable professional activities (EPAs). DESIGN: A modified Delphi method utilizing cycles of meetings and surveys for consensus-building. SETTING: The endeavor involved members of the Pediatric Research Collaborative on Critical Ultrasound (PeRCCUS), a subgroup of the Pediatric Acute Lung Injury And Sepsis Investigators. SUBJECTS: An expert panel consisting of 23 members representing 17 institutions, including diverse healthcare professionals involved in pediatric critical care ultrasound. INTERVENTIONS: Three iterative modified Delphi rounds were conducted to propose and refine critical care ultrasound EPAs. MEASUREMENTS AND MAIN RESULTS: The endeavor achieved a 74% response rate. Fourteen EPAs were formulated across five domains: Cardiac, Pulmonary, Abdomen, Procedures, and Vascular, along with two consensus opinions on educational content and methods. EPAs were evaluated using 5-point Likert items, requiring a median score of greater than or equal to 4.5 for progression. CONCLUSIONS: This collaborative effort led to the establishment of fourteen EPAs for pediatric critical care ultrasound, offering a structured approach for education and competency assessment in pediatric critical care. This initiative lays the groundwork for evolving standards in pediatric critical care ultrasound education and practice.

  PublisherDOI

• Comparison of Learning Experience With On-Site Versus Off-Site Telesimulation for Medical Students in Pediatric Emergency Care

  Pediatric Emergency Care · 2025-07-17

  article

  OBJECTIVE: The learner experience with on-site versus off-site telesimulation participation is not well described. We hypothesized that off-site participation was associated with lower debriefing effectiveness, higher taskload, and less performance improvement. DESIGN: In a telesimulation program between the Children's Hospital of Philadelphia, USA, and Kanazawa University, Japan, fifth-year medical students in Japan were assigned to either on-site (simulation room) or off-site (different location) participation in a 1-hour simulation session during a 4-week pediatric rotation. Facilitators in Philadelphia remotely ran the session with 2 on-site and 2 off-site students (4 total) using an emergency department scenario of an infant. Debriefing effectiveness was assessed using Debriefing Assessment for Simulation in Healthcare student version: DASH-SV (score 1 to 7). The taskload was evaluated by the NASA Task Load Index (taskload, maximum 100). Student's performance was measured by pre-test and post-test simulation with a checklist (15 items, maximum 30) at the beginning and end of pediatric rotation. RESULTS: Between December 2020 and October 2022, 225 students (on-site 90, off-site 135) participated. Debriefing effectiveness was not different (DASH on-site median: 6.7, IQR: 6 to 7 vs. off-site median: 6.5, IQR: 5.8 to 7, P =0.864). Taskload was higher among the on-site group: 59.6±12.9 versus off-site 55.2±14.4, P =0.026. In the taskload subscale, physical demand and frustration were higher among on-site participants ( P <0.001, P =0.023). There was no difference in performance improvement (on-site: 10.4±3.5 vs. off-site: 9.6±3.9, P =0.121). CONCLUSIONS: The experience of on-site versus off-site learners participating in pediatric emergency telesimulation was similar in debriefing effectiveness and performance improvement, but the taskload was higher for on-site learners.

  PublisherDOI

• External Validation, Re-Calibration, and Extension of a Prediction Model of Early Acute Kidney Injury in Critically Ill Children using Multi-Center Data

  medRxiv · 2025-02-06

  preprintOpen access

  Background: Acute kidney injury (AKI) is common among children with critical illness and is associated with high morbidity and mortality. Risk prediction models designed for clinical decision support implementation offer an opportunity to identify and proactively mitigate AKI risks. Existing models have been primarily validated on single-center data, owing partly to the lack of appropriately detailed multicenter datasets. Objective: To determine the accuracy of a single-center model to predict new AKI at 72 hours of ICU admission across two multicenter datasets and extend this model to improve prediction accuracy while maintaining acceptable alert burden. Derivation and Validation Cohorts: We separately derived models in two datasets: PEDSNET-VPS, created through the linkage of PEDSnet electronic health record (EHR) extraction with Virtual Pediatric Systems (VPS); and the PICU Data Collaborative dataset, created through EHR extraction and harmonization from eight participating institutions. Derivation datasets comprised temporal and location-specific spit of these datasets (80%), while the holdout test split comprised the remaining (20%). Prediction Model: We recalibrated an existing single-center model and measured discrimination and accuracy. We then add features guided by precision and recall measures. All features were available at 12 hours of ICU admission. We measure discrimination and accuracy at multiple cut-points and identify the features contributing most to the risk score. Results: In two datasets comprising 186,540 ICU admissions, we report an incidence of early AKI of 2.2 - 2.7%. Initial recalibration of an existing single-center model demonstrated poor discrimination (AUROC 0.60 - 0.78). Following the addition of new features, we report higher AUROC values of 0.79 - 0.80 and AUPRC values of 0.13 - 0.21 in both datasets. We report accuracy at several cutpoints as well as cross-validate between datasets. Conclusions: In this first use of two new multicenter datasets, we report improved discrimination and accuracy in a model designed specifically for implementation, balancing sensitivity and precision to predict patients at risk for AKI development.

  PublisherOA PDFDOI

• Impact of a Two-Person Mask Ventilation Technique During Neonatal Resuscitation: A Simulation-Based Randomized Controlled Trial

  The Journal of Pediatrics · 2025-03-30 · 4 citations

  articleSenior author
  PublisherDOI

Recent grants

• Quality of bag mask ventilation in critically ill children

  NIH · $100k · 2019–2021

• NIH Grant R18HS022464

  NIH · $499k · 2016

• Apneic Oxygenation to Prevent Oxygen Desaturation During Intubation in the NICU

  NIH · $485k · 2022–2025

• Improving safety and quality of tracheal intubations in neonatal ICUs

  NIH · $470k · 2017–2020

• Improving the Safety of Pediatric Tracheal Intubations in ICUs with Apneic Oxygenation and Video Laryngoscopes

  NIH · $996k · 2016–2021

Frequent coauthors

• Vinay Nadkarni

  Children's Hospital of Philadelphia

  475 shared

• Natalie Napolitano

  166 shared

• Robert A. Berg

  University of Pennsylvania

  144 shared

• Mark A. Helfaer

  126 shared

• Robert M. Sutton

  Children's Hospital of Philadelphia

  100 shared

• Dana Niles

  Children's Hospital of Philadelphia

  94 shared

• Thomas Conlon

  Children's Hospital of Philadelphia

  91 shared

• Lee Polikoff

  Providence College

  79 shared

Education

• M.D.

  Nagoya University School of Medicine

  1995

• Other

  University of Pennsylvania School of Medicine

  2011