About

Alicia M Alcamo, MD, MPH, is an Assistant Professor of Anesthesiology and Critical Care at the Children's Hospital of Philadelphia. She is an attending physician in anesthesiology and critical care medicine at the same institution. Her educational background includes a Bachelor of Science in Biology from Elizabethtown College (2006), an MD from The Ohio State University (2011), and a Master’s in Public Health with a specialization in Clinical Investigation from The Ohio State University (2011). Her professional focus involves pediatric critical care, with research contributions in areas such as pediatric sepsis, neurologic outcomes in pediatric brain injury, and COVID-19 related neurologic dysfunction. She has co-authored studies on delirium in children with COVID-19, neuropathologic findings in pediatric sepsis, and the impact of sepsis on pediatric oncology patients, among others.

Research topics

• Medicine
• Internal medicine
• Cardiology
• Surgery
• Pediatrics
• Intensive care medicine

Selected publications

• Delirium in Children Hospitalized with Acute COVID-19 or MIS-C: Secondary Analysis of the 2020–2021 Global Consortium Study of Neurologic Dysfunction in COVID-19

  Neurocritical Care · 2026-04-06

  article
  PublisherDOI

• Postoperative Infections and Antimicrobial Prophylaxis in the Pediatric Intensive Care Unit After Liver Transplantation in Children

  Pediatric Transplantation · 2025-08-11 · 1 citations

  article

  OBJECTIVE: To determine the incidence and risk factors for postoperative infections (POI) after pediatric liver transplantation (LT) while in the pediatric intensive care unit (PICU). METHODS: This is a multicenter, retrospective cohort study of isolated pediatric LT recipients from 12 LT centers in the United States over 2 years. Pre- and postoperative variables were examined to determine POI risk factors during the PICU admission. Antimicrobial prophylaxis utilization was assessed. Comparative statistics were performed using chi-squared and Mann-Whitney U tests. Multivariable logistic regression modeling evaluated POI risk factors. RESULTS: 76/327 (23%) patients developed POI (47% bacterial, 3% viral, 4% fungal, 22% polymicrobial, and 21% clinically adjudicated, culture negative). Abdominal/surgical site and bloodstream infections were most common at 29% and 26%, respectively. Independent predictors of POI included age under 1 (OR = 2.37 [95% CI 1.36-4.13], p = 0.002), open fascia (OR = 3.15 [95% CI 1.77-5.61], p < 0.001), and hospitalization pre-transplant (OR = 2.09 [95% CI 1.20-3.64], p = 0.009). Patients with POI had longer hospitalizations (23.0 days [17.0-34.0] vs. 13.0 days [9.0-20.0], p < 0.001), higher graft loss rates (9% vs. 0.4%, p < 0.001), and greater mortality (5% vs. 0.4%, p = 0.01). Significant variability in antimicrobial regimens existed amongst transplant centers. CONCLUSIONS: One in five patients developed POI while in the PICU. Predictors of POI included younger age, open fascia, and hospitalization pre-transplantation. POIs were associated with significant morbidity, including prolonged length of stay, graft loss, and mortality. Future prospective studies are needed to optimize antimicrobial regimens to prevent POI and improve outcomes.

  PublisherDOI

• Neuropathologic Autopsy Findings in Pediatric Sepsis: A Two-Center, Retrospective Study

  Pediatric Critical Care Medicine · 2025-12-31

  article1st authorCorresponding

  OBJECTIVES: During sepsis, acute brain dysfunction is associated with death and morbidity. However, there are limited data on the pathophysiology of sepsis brain dysfunction. DESIGN: Retrospective cohort study. SETTING: Two quaternary free-standing children's hospitals (University of Pittsburgh Medical Center [UPMC] Children's Hospital of Pittsburgh and Children's Hospital of Philadelphia [CHOP]). SUBJECTS: Sepsis patients with a neuropathological autopsy from 2009 to 2018 at UPMC and 2011-2021 at CHOP. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We identified 57 patients with a median (interquartile range [IQR]) age at admission of 34.5 months (IQR, 9.2-118.0 mo). Overall, 48 of 57 (84%) patients had preexisting comorbidity including: metabolic/genetic disorders (19/57, 33%), immunocompromise (12/57, 21%), and prematurity (12/57, 21%). Almost all patients required inotropes (53/57, 93%) or invasive mechanical ventilation (54/57, 95%). Forty-four percent of patients (25/57) had a cardiac arrest either before or during admission. Almost half of patients had multisite infections (25/57, 44%), with 23 of 25 having a component of bacteremia and four of 25 having a CNS infection. Gross neuropathological findings included edema in 39% (22/57), ventriculomegaly in 39% (22/57), and hemorrhage in 30% (17/57). Microscopic CNS examination results were available for 51 of 57 patients (89%) and the acute/subacute microscopic findings included: neuronal injury in 45% (23/51), acute infarction in 25% (13/51), and white matter necrosis in 25% (13/51). Most patients (49/57, 86%) had at least one acute gross or microscopic finding. In univariate analyses, premortem CNS infections, was associated with edema ( p = 0.001). Also, absence of comorbidities was associated with gross edema ( p = 0.009) and microscopic acute neuronal injury ( p = 0.008), acute infarction ( p = 0.01), and meningitis ( p = 0.004). CONCLUSIONS: In our retrospective neuropathological study of sepsis cases, we found that pathologies were common. While correlations to sepsis survivors cannot be determined, further studies are needed to develop strategies that prevent and treat neuropathological injury.

  PublisherDOI

• The Landscape of Status <scp>1B</scp> by Exception for Pediatric Acute on Chronic Liver Failure—High Risk, High Mortality, and Low Transplant Rate

  Pediatric Transplantation · 2025-12-22

  articleSenior author

  BACKGROUND: Acute on chronic liver failure (ACLF) leads to increased mortality from multiorgan failure. METHODS: Our objective was to evaluate differences in characteristics and outcomes of children with ACLF listed as Status 1B for liver transplantation (LT) by (1) explicit criteria or (2) exception. We identified 367 children with ACLF who were listed Status 1B for LT in the United Network for Organ Sharing (UNOS) database between January 2007 and March 2019. Children with metabolic diseases and malignancies were excluded. RESULTS: Of 367 children with ACLF listed as Status 1B, 110 (30%) were listed by exception. There were no differences between groups in age, sex, race/ethnicity, or diagnosis. Incidence of cumulative organ failures and MELD/PELD scores were lower in the exception group at waitlisting and at waitlist removal (all p < 0.05). There were regional differences in exception utilization with regions 2 and 10 having a higher proportion of exception listing (43% and 47% vs. overall 30%, p = 0.03). There was no difference in transplantation rate, recovery without transplant, or pre-/post-LT mortality between groups. Narrative summaries in the exception group cited the critical or refractory nature of the patient's illness, with increased risk of waitlist mortality as reasons for urgent LT. CONCLUSION: Our study showed that one third of children with ACLF listed as Status 1B receive this designation using exception criteria. Children listed by exception had similar pre-/post-LT mortality compared to the explicit group. Further study is needed to understand why these children are at higher risk than expected.

  PublisherDOI

• Association of EEG Response to Hypertonic Saline and Neurologic Outcomes in Pediatric Acute Brain Injury

  Research Square · 2025-07-30

  preprintOpen access
  PublisherOA PDFDOI

• New sepsis-associated morbidity and mortality in pediatric oncology patients

  Frontiers in Oncology · 2025-08-27 · 1 citations

  articleOpen access1st author

  Sepsis is a leading cause of morbidity and mortality in children worldwide, yet the development of new morbidity after sepsis has not been clearly defined in high-risk subgroups such as children with cancer. Using the TOPICC (Trichotomous Outcome Prediction in Critical Care) multicenter cohort study dataset, we evaluated whether children with cancer have a higher risk of the composite outcome of death or new morbidity at hospital discharge compared to children without cancer. Among 854 children with sepsis, 88 patients (10.3%) had an underlying cancer diagnosis. Children with cancer were older (median 8.1 vs 3.7 years) and more frequently developed sepsis while in the hospital. The pattern of organ failure differed between groups, with less frequent invasive mechanical ventilation (26.1% vs 49.9%, p &amp;lt;0.001) but more frequent vasoactive infusions (47.7% vs 35.8%, p =0.03) in children with cancer compared to non-oncology patients. Children with cancer had an increased rate of death or new morbidity (22.7% vs 12.1%, p= 0.006) compared to non-oncology patients. New morbidity (defined by ΔFSS score &amp;gt;2 points) occurred in 13.9% of cancer vs 6.9% of non-cancer survivors ( p =0.03), and PICU mortality was similar between groups (10.2% vs 5.6%, p =0.09). Cancer diagnosis was independently associated with higher odds of death or new disability at discharge (adjusted odds ratio 3.71, p &amp;lt;0.001) in multivariable logistic regression, after adjusting for baseline FSS, baseline developmental delay, clinical concern for neurologic injury on PICU admission, and PICU supportive measures. These results suggest that children with cancer who develop sepsis are more likely to experience adverse outcomes at hospital discharge, even after accounting for baseline health and critical illness severity.

  PublisherOA PDFDOI

• 21: THE PREVALENCE OF NEUROCOGNITIVE DECLINE IN CHILDREN FOLLOWING SEPSIS ADMISSION

  Critical Care Medicine · 2025-01-01 · 1 citations

  article1st authorCorresponding
  PublisherDOI

• 891: PERFORMANCE OF PIM-2 AND PRISM-III MORTALITY PREDICTION SCORES IN CHILDREN WITH SEPSIS

  Critical Care Medicine · 2025-01-01

  article
  PublisherDOI

• Diagnostic Identification of Acute Brain Dysfunction in Pediatric Sepsis and Septic Shock in the Electronic Health Record: A Comparison of Four Definitions in a Reference Dataset*

  Pediatric Critical Care Medicine · 2024-05-13 · 8 citations

  articleOpen access1st authorCorresponding

  OBJECTIVES: Acute brain dysfunction (ABD) in pediatric sepsis has a prevalence of 20%, but can be difficult to identify. Our previously validated ABD computational phenotype (CP ABD ) used variables obtained from the electronic health record indicative of clinician concern for acute neurologic or behavioral change. We tested whether the CP ABD has better diagnostic performance to identify confirmed ABD than other definitions using the Glasgow Coma Scale or delirium scores. DESIGN: Diagnostic testing in a curated cohort of pediatric sepsis/septic shock patients. SETTING: Quaternary freestanding children's hospital. SUBJECTS: The test dataset comprised 527 children with sepsis/septic shock managed between 2011 and 2021 with a prevalence (pretest probability) of confirmed ABD of 30% (159/527). MEASUREMENTS AND MAIN RESULTS: CP ABD was based on use of neuroimaging, electroencephalogram, and/or administration of new antipsychotic medication. We compared the performance of the CP ABD with three GCS/delirium-based definitions of ABD-Proulx et al, International Pediatric Sepsis Consensus Conference, and Pediatric Organ Dysfunction Information Update Mandate. The posttest probability of identifying ABD was highest in CP ABD (0.84) compared with other definitions. CP ABD also had the highest sensitivity (83%; 95% CI, 76-89%) and specificity (93%; 95% CI, 90-96%). The false discovery rate was lowest in CP ABD (1-in-6) as was the false omission rate (1-in-14). Finally, the prevalence threshold for the definitions varied, with the CP ABD being the definition closest to 20%. CONCLUSIONS: In our curated dataset of pediatric sepsis/septic shock, CP ABD had favorable characteristics to identify confirmed ABD compared with GCS/delirium-based definitions. The CP ABD can be used to further study the impact of ABD in studies using large electronic health datasets.

  PublisherOA PDFDOI

• Corrigendum: Post-discharge outcomes of hospitalized children diagnosed with acute SARS-CoV-2 or MIS-C

  Frontiers in Pediatrics · 2024-07-01

  erratumOpen access

  [This corrects the article DOI: 10.3389/fped.2024.1340385.].

  PublisherOA PDFDOI

Frequent coauthors

• Rajesh K. Aneja

  26 shared

• Brian Appavu

  Phoenix Children's Hospital

  23 shared

• Julie C. Fitzgerald

  23 shared

• Ericka L. Fink

  Children's Hospital of Pittsburgh

  20 shared

• Alexis A. Topjian

  20 shared

• Juan D. Roa

  Universidad Nacional de Colombia

  20 shared

• Jennifer L. McGuire

  University of Pennsylvania

  18 shared

• Jessica Cummings

  University of Pittsburgh

  16 shared

Education

• B.S., Biology

  Elizabethtown College

  2006

• Other, Specialization in Clinical Investigation

  The Ohio State University

  2011

• M.D.

  The Ohio State University

  2011

Awards & honors

• Critical Care Congress Gold Snap Shot Award (2025)