About

Christie Glau, MD, is an Assistant Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. She serves as an Attending Physician in Anesthesiology and Critical Care Medicine at the Children's Hospital of Philadelphia. Her clinical expertise includes Critical Care Ultrasound and Ultrasound Guided Vascular Access. Her research focuses on areas such as Ventilator Induced Diaphragm Dysfunction, Point of Care Thoracic Ultrasound, Bedside Ultrasound use in Septic Shock Management, and Bedside Ultrasound Implementation in Pediatric Critical Care. Dr. Glau has contributed to the field through her publications and her role as Director of the Pediatric Critical Care Medicine Ultrasound Fellowship at the Children's Hospital of Philadelphia.

Research topics

• Medicine
• Internal medicine
• Cardiology
• Intensive care medicine
• Anesthesia
• Radiology
• Surgery

Selected publications

• 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

• Association of left ventricular systolic dysfunction with outcome following pediatric traumatic brain injury

  Journal of Neurosurgery Pediatrics · 2025-05-16

  article

  OBJECTIVE: Traumatic brain injury (TBI) is one of the leading causes of morbidity and mortality in children. While left ventricular systolic dysfunction (LVSD) has been observed following TBI in adults, very little is known regarding it in the pediatric TBI population. The aim of this study was to evaluate the frequency and admission risk factors for systolic dysfunction following pediatric TBI. The authors hypothesized that systolic cardiac dysfunction would be associated with morbidity and mortality. METHODS: This was a single-center retrospective observational study from a quaternary children's hospital. Pediatric patients with TBI who were younger than 18 years and had a transthoracic echocardiogram obtained by the pediatric cardiology team from January 2011 to December 2021 were evaluated. The primary outcome was in-hospital mortality. The secondary outcome was the Glasgow Outcome Scale-Extended (GOS-E) score at 6 months in survivors. RESULTS: Of 1059 pediatric patients who presented with TBI, 70 had an echocardiogram, all of which were obtained within 72 hours of admission. LVSD on the echocardiogram was observed in 24 of 70 patients (34%). The mortality rate was 47% (33 of 70). Low admission Glasgow Coma Scale (GCS) score, abusive head trauma, and cardiac arrest were independent risk factors associated with a higher odds of LVSD on univariate analysis, while a low admission GCS score was also a risk factor on multivariate analysis (p < 0.05). Systolic cardiac dysfunction increased the odds for in-hospital mortality or worse outcome (low GOS-E score) in survivors at 6 months on univariate analysis (p < 0.05). When accounting for admission GCS scores, abusive head trauma, and cardiac arrest on multivariate analysis, LVSD did not have a significant association with mortality and morbidity. CONCLUSIONS: Nearly 35% of pediatric TBI patients who underwent transthoracic echocardiography were found to have LVSD within 72 hours of admission. Low admission GCS score, abusive head trauma, or cardiac arrest significantly increased the risk of LVSD on univariate analysis, while the GCS score was a risk factor on multivariate analysis. The presence of LVSD was associated with an increased risk of mortality and morbidity in survivors on univariate analysis. Future prospective studies are warranted to further characterize myocardial dysfunction in pediatric patients with TBI and determine whether earlier recognition and treatment might improve outcomes.

  PublisherDOI

• Early exposure to hemodynamic point-of-care ultrasound during pediatric septic shock resuscitation is associated with decreased fluid overload

  Intensive Care Medicine – Paediatric and Neonatal · 2025-09-24

  articleOpen access1st authorCorresponding

  Abstract Objective Fluid overload (FO) after pediatric septic shock resuscitation increases the risk of secondary organ failure and long-term morbidity. We hypothesized that early hemodynamic point-of-care ultrasound (hPOCUS) use in pediatric septic shock would be associated with decreased FO. Methods Retrospective, observational study between 2015 and 2018 in a large academic Pediatric Intensive Care Unit (PICU) of children &lt; 18 years receiving ≥ 40 mL/kg of bolus fluids or vasoactive infusion for treatment of septic shock. %FO and severe FO (%FO ≥ 15%) at 72 h after shock onset were compared between children with hPOCUS exposure &lt; 6 h after shock onset and those without. %FO was calculated: [(fluid in – out)/weight on PICU admission]*100. The association between hPOCUS &lt; 6 h after septic shock onset and %FO and severe FO were evaluated. Results Of 591 children included, 115 (19.4%) had hPOCUS within 6 h. Children with early hPOCUS vs. without had higher PIM-3; median 4.3, IQR 2.9–9.4 vs. 3.2, IQR 0.9–5.7, p = 0.0012. %FO was not significantly different in the early hPOCUS group, median difference -1.6%, 95% CI -3.2 to 0.03, p = 0.06. After controlling for confounders, %FO was significantly lower in the early hPOCUS group, ß-coefficient= -2.76, 95% CI -4.7 to -0.6, p = 0.012. Those with early hPOCUS had lower occurrence of severe FO 11.3% vs. 22.9%, p = 0.006; adjusted OR 0.41, 95% CI 0.22 to 0.76, p = 0.005. Conclusions Early hPOCUS assessment during septic shock resuscitation was independently associated with decreased FO. Prospective research is needed to optimize hPOCUS use in pediatric septic shock management.

  PublisherOA PDFDOI

• COVID-19 pandemic and enrollment of critically Ill children in randomized clinical trials

  Frontiers in Pediatrics · 2025-11-25

  articleOpen access

  Objective To evaluate the association of the COVID-19 pandemic with enrollment rates of critically ill children in randomized clinical trials (RCT). We hypothesized that enrollment rates declined due to increased parental refusal. Design Cross-sectional analysis of 2 multicenter RCTs conducted pre- and post-COVID-19. Setting A total of 5 centers pre-COVID-19 and 15 centers post-COVID-19 conducting pediatric RCTs on enoxaparin prophylaxis against catheter-associated thrombosis. Patients Critically ill children &amp;lt;18 years old with newly inserted central venous catheters. Interventions Randomization to enoxaparin prophylaxis or usual care. Measurements Enrollment rates and reasons for non-enrollment were analyzed in 622 eligible children: 165 pre-COVID-19 (November 2017–August 2019) and 457 post-COVID-19 (May 2022–August 2024). Main results Enrollment rates declined from 30.9% pre-COVID-19 to 18.2% post-COVID-19 ( P = 0.001). Reasons for non-enrollment differed significantly ( P = 0.001). Parental unavailability decreased post-COVID-19 (17.7% vs. 34.2%, P &amp;lt; 0.001), while research staff unavailability increased (28.6% vs. 15.8%, P = 0.006). Overall parental refusal rates remained similar (38.6% pre-COVID-19 vs. 39.6% post-COVID-19, P = 0.85). However, among all eligible patients, enrollment failure due to parental refusal increased post-COVID-19 (64.1% vs. 46.3%, P = 0.003). Parental refusal inversely correlated with research staff availability ( r = −0.71, P = 0.003). Conclusions The COVID-19 pandemic is associated with lower enrollment rates in RCTs enrolling critically ill children. Increased parental refusal post-pandemic is confounded by reduced research staff availability. Further investigation is needed to assess the role of science denialism and identify strategies to enhance enrollment in RCTs of critically ill children.

  PublisherOA PDFDOI

• Evolution and Impact of a Diagnostic Point-of-Care Ultrasound Program in a PICU*

  Pediatric Critical Care Medicine · 2024-07-18 · 8 citations

  articleOpen access

  OBJECTIVES: To evaluate the impact of point-of-care ultrasound (POCUS) use on clinicians within a PICU and to assess infrastructural elements of our POCUS program development. DESIGN: Retrospective observational study. SETTING: Large academic, noncardiac PICU in the United States. SUBJECTS: Patients in a PICU who had diagnostic POCUS performed. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Between January 1, 2017, and December 31, 2022, 7201 diagnostic POCUS studies were ordered; 1930 (26.8%) had a quality assurance (QA) record generated in an independent POCUS QA database. The cardiac domain was most frequently imaged (81.0% of ordered studies, 81.2% of reviewed studies). POCUS images changed clinician understanding of pathophysiology in 563 of 1930 cases (29.2%); when this occurred, management was changed in 318 of 563 cases (56.5%). Cardiac POCUS studies altered clinician suspected pathophysiology in 30.1% of cases (472/1568), compared with 21.5% (91/362) in noncardiac studies ( p = 0.06). Among cases where POCUS changed clinician understanding, management changed more often following cardiac than noncardiac POCUS ( p = 0.02). Clinicians identified a need for cardiology consultation or complete echocardiograms in 294 of 1568 cardiac POCUS studies (18.8%). Orders for POCUS imaging increased by 94.9%, and revenue increased by 159.4%, from initial to final study year. QA database use by both clinicians and reviewers decreased annually as QA processes evolved in the setting of technologic growth and unit expansion. CONCLUSIONS: Diagnostic POCUS imaging in the PICU frequently yields information that alters diagnosis and changes management. As PICU POCUS use increased, QA processes evolved resulting in decreased use of our initial QA database. Modifications to QA processes are likely necessary as clinical contexts change over time.

  PublisherOA PDFDOI

• Protocol for the Catheter-Related Early Thromboprophylaxis With Enoxaparin (CRETE) Studies

  Pediatric Critical Care Medicine · 2024-11-19 · 6 citations

  articleOpen access

  OBJECTIVES: In post hoc analyses of our previous phase 2b Bayesian randomized clinical trial (RCT), prophylaxis with enoxaparin reduced central venous catheter (CVC)-associated deep venous thrombosis (CADVT) in critically ill older children but not in infants. The goal of the Catheter-Related Early Thromboprophylaxis with Enoxaparin (CRETE) Studies is to investigate this newly identified age-dependent heterogeneity in the efficacy of prophylaxis with enoxaparin against CADVT in critically ill children. DESIGN: Two parallel, multicenter Bayesian superiority explanatory RCTs, that is, phase 3 for older children and phase 2b for infants, and an exploratory mechanistic nested case-control study (Trial Registration ClinicalTrials.gov NCT04924322, June 7, 2021). SETTING: At least 15 PICUs across the United States. PATIENTS: Older children 1-17 years old ( n = 90) and infants older than 36 weeks corrected gestational age younger than 1 year old ( n = 168) admitted to the PICU with an untunneled CVC inserted in the prior 24 hours. Subjects with or at high risk of clinically relevant bleeding will be excluded. INTERVENTIONS: Prophylactic dose of enoxaparin starting at 0.5 mg/kg then adjusted to anti-Xa range of 0.2-0.5 international units (IU)/mL for older children and therapeutic dose of enoxaparin starting at 1.5 mg/kg then adjusted to anti-Xa range of greater than 0.5-1.0 IU/mL or 0.2-0.5 IU/mL for infants while CVC is in situ. MEASUREMENTS AND MAIN RESULTS: Randomization is 2:1 to enoxaparin or usual care (no enoxaparin) for older children and 1:1:1 to either of 2 anti-Xa ranges of enoxaparin or usual care for infants. Ultrasonography will be performed after removal of CVC to assess for CADVT. Subjects will be monitored for bleeding. Platelet poor plasma will be analyzed for markers of thrombin generation. Samples from subjects with CADVT will be counter-matched 1:1 to subjects without CADVT from the opposite trial arm. Institutional Review Board approved the "CRETE Studies" on July 1, 2021. Enrollment is ongoing with planned completion in July 2025 for older children and July 2026 for infants.

  PublisherOA PDFDOI

• Ultrasound in Cardiopulmonary Arrest and Resuscitation

  Pediatric Emergency Care · 2024-05-02 · 3 citations

  articleOpen accessCorresponding

  OBJECTIVES: Information obtained from point-of-care ultrasound during cardiopulmonary arrest and resuscitation (POCUS-CA) can be used to identify underlying pathophysiology and provide life-sustaining interventions. However, integration of POCUS-CA into resuscitation care is inconsistent. We used expert consensus building methodology to help identify discrete barriers to clinical integration. We subsequently applied implementation science frameworks to generate generalizable strategies to overcome these barriers. MEASURES AND MAIN RESULTS: Two multidisciplinary expert working groups used KJ Reverse-Merlin consensus building method to identify and characterize barriers contributing to failed POCUS-CA utilization in a hypothetical future state. Identified barriers were organized into affinity groups. The Center for Implementation Research (CFIR) framework and Expert Recommendations for Implementing Change (CFIR-ERIC) tool were used to identify strategies to guide POCUS-US implementation. RESULTS: Sixteen multidisciplinary resuscitation content experts participated in the working groups and identified individual barriers, consolidated into 19 unique affinity groups that mapped 12 separate CFIR constructs, representing all 5 CFIR domains. The CFIR-ERIC tool identified the following strategies as most impactful to address barriers described in the affinity groups: identify and prepare champions, conduct local needs assessment, conduct local consensus discussions, and conduct educational meetings. CONCLUSIONS: KJ Reverse-Merlin consensus building identified multiple barriers to implementing POCUS-CA. Implementation science methodologies identified and prioritized strategies to overcome barriers and guide POCUS-CA implementation across diverse clinical settings.

  PublisherOA PDFDOI

• Advances in Point-of-Care Ultrasound in Pediatric Acute Care Medicine

  The Indian Journal of Pediatrics · 2024-06-06 · 1 citations

  reviewSenior author
  PublisherDOI

• 680: LUNG ULTRASOUND SCORE IS ASSOCIATED WITH SEVERITY OF RESPIRATORY DISEASE IN CRITICALLY ILL CHILDREN

  Critical Care Medicine · 2023-12-14

  article

  Introduction: Lung ultrasound (LUS) is a useful tool for diagnosing and assessing the disease severity of pediatric respiratory illness, however, its role in the pediatric ARDS is ill-defined. We hypothesize that LUS score will be higher among children with ARDS compared to those with less severe lung disease within 48 hours of respiratory failure. Methods: Prospective, two-center study of children admitted to PICU with acute respiratory failure requiring respiratory support. Patients were stratified into 3 groups by diagnosis: 1) pediatric ARDS, 2) lower respiratory tract infection (LRTI) and 3) respiratory failure due to non-respiratory cause (control). A single sonographer performed a protocolized 12-region LUS study at 0-24 hours of respiratory failure (Time 1) and a second LUS between 24-48 hours (Time 2) for patients with ARDS and LRTI. Raters blinded to the clinical information scored LUS images between 0 to 3 (0= normal, 3 = least aerated) for each region (max score = 36). Statistic comparison utilized Kruskal-Wallis test, Dunn test or Chi-square test. A p-value < 0.05 inferred statistical significance and continuous values appear as median (IQR). Results: 60 children (ARDS: n=16, LRTI: n=25, control: n=21) were included; median age was 1.6 (0.5, 6.0) year. At time 1 LUS, all children with ARDS were on conventional mechanical ventilation with a median oxygen saturation index of 7.2 (6.4, 9.8). Children with LRTI were on HFNC (n=3), CPAP (n=6), BiPAP (n=12) and conventional mechanical ventilation (n=5). The majority of controls (20/21) were on conventional mechanical ventilation. Median time 1 LUS score was 15.5 (11, 23.5) in ARDS, 7 (2, 11) in LRTI and 2 (1, 7) in control group (p=0.001). Pairwise comparison showed higher LUS scores in ARDS than in LRTI and control group (p=0.015, 0.003). There was no significant difference in LUS scores between LRTI and control group (p=0.27). Median time 2 LUS score was 16.5 (11, 22) in ARDS and 6 (2,10) in LRTI. Conclusions: Children with ARDS had higher LUS scores within 24 hours of respiratory failure compared to children with respiratory failure secondary to LRTI or non-respiratory illnesses. LUS scores for ARDS remained during the first 48 hours. Effects of ventilatory setting on LUS scores need to be further investigated in future studies.

  PublisherDOI

• Ultrasound assessment of diaphragm thickness, contractility, and strain in healthy pediatric patients

  Pediatric Pulmonology · 2023-12-01 · 6 citations

  articleOpen access1st authorCorresponding

  Abstract Background Ultrasound‐based diaphragmatic assessments are becoming more common in pediatric acute care, but baseline pediatric diaphragm thickness and contractility values remain unknown. Methods We conducted a prospective, observational study of healthy children aged &lt;18 years undergoing elective surgery. Diaphragm thickness at end‐expiration (Tdi‐exp), thickening fraction (DTF) and excursion were measured by ultrasound during spontaneous breathing and during mechanical ventilation. Diaphragm strain and peak strain rate were ascertained post hoc. Measurements were compared across a priori specified age groups (&lt;1 year, 1 to &lt;3, 3 to &lt;6, 6 to &lt;12, and 12 to &lt;18 years) and with versus without mechanical ventilation. Results Fifty subjects were evaluated ( n = 10 per age group). Baseline mean Tdi‐exp was 0.19 ± 0.04 cm, DTF 0.19 ± 0.09, excursion 1.69 ± 0.97 cm, strain −10.3 ± 4.9, peak strain rate −0.48 ± 0.21 s −1 . No significant difference in Tdi‐exp or DTF was observed across age groups ( p &gt; .05). Diaphragm excursion increased with age ( p &lt; .0001). Diaphragm strain was significantly greater in the 12–17‐year age group (−14.3 ± 6.4), p = .048, but there were no age‐related differences in peak strain rate ( p = .08). During mechanical ventilation, there were significant decreases in DTF 0.12 ± 0.04 ( p &lt; .0001), excursion 1.08 ± 0.31 cm ( p &lt; .0001), strain −4.60 ± 1.93 ( p &lt; .0001), and peak strain rate −0.20 ± 0.10 s −1 ( p &lt; .0001) while there was no change in Tdi‐exp 0.18 ± 0.03 cm ( p = .25) when compared to baseline values. Conclusion Pediatric Tdi‐exp, DTF, and diaphragm peak strain rate were similar across age groups. Diaphragm excursion and strain varied across age groups. All measures of diaphragm contractility were diminished during mechanical ventilation.

  PublisherOA PDFDOI

Frequent coauthors

• Thomas Conlon

  Children's Hospital of Philadelphia

  66 shared

• Akira Nishisaki

  University of Pennsylvania

  52 shared

• Adam S. Himebauch

  University of Pennsylvania

  50 shared

• Scott L. Weiss

  Thomas Jefferson University

  26 shared

• Mark D. Weber

  Children's Hospital of Philadelphia

  16 shared

• Julie C. Fitzgerald

  15 shared

• Sarah B. Walker

  Lurie Children's Hospital

  13 shared

• Garrett Keim

  Children's Hospital of Philadelphia

  11 shared

Labs

• Christie Glau LabPI

Education

• MD

  University of Texas Southwestern Medical School

  2012

• BA Biology and Psychology

  Claremont McKenna College

  2009

Awards & honors

• Focused Ultrasound Education (FUSED) Award, Children's Hospi…