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Acute Care

Theme Lead

Dr Becky Mitting

Consultant in Paediatric Critical Care Medicine

Becky is Consultant in Paediatric critical care medicine and service lead for Children's Critical Care at St Mary's London. Her research interests include bronchiolitis, sedation, and mechanical ventilation.

She is an honorary Senior Clinical Lecturer at Imperial. Her current research roles/grants include being the domain lead for PIVOTAL-sedation, the PICU platform trial, Critical Care and PPIE lead for the Bach-B trial, and a co-applicant and PPIE lead for an RFPB trial emulation study based on PICANET data. She is local PI for GASTRIC and PRESSURE trials and an NIHR API champion having mentored many APIs through the scheme.

Deputy Theme Lead

Dr Ruud Nijman

Consultant in Paediatric Emergency Medicine

Ruud Nijman is an Honorary Senior Clinical Lecturer at Imperial with a special interest in observational studies and clinical trials in diagnostics and clinical decision making in paediatric emergency medicine and acute childhood infections. He is also a consultant in Paediatric Emergency Medicine at St. Mary’s, London. He leads the EPISODES and ReSync projects - multinational studies looking at the epidemiology of children with acute illness and injuries presenting to emergency departments across Europe and is a member of the DIAMONDS consortium aiming to discover and validate new diagnostic biomarkers for childhood infections. Ruud co-authored two children’s books to promote patient education of children presenting to the emergency department. He is an active steering committee member of the Research in European Pediatric Emergency Medicine (REPEM) network and a member of the executive committee of the European Society of Emergency Paediatrics (EUSEP).

Research in paediatric emergency medicine at Imperial is closely aligned with the Acute Care Theme and the Paediatrics and Child Health Centre, with a shared ambition to deliver inclusive, high-quality research embedded in routine emergency care for children and young people. Our focus is on common acute conditions, ensuring that every child across the wider North West London region has the opportunity to participate in research, regardless of diagnosis, background, or point of entry into the health system. We deliver a balanced portfolio of Imperial College–led studies (e.g. DIAMONDS, WHAM), adopted NIHR portfolio studies (e.g. FIDO, CURLY), and act as a recruiting site for large multicentre UK trials led by Imperial investigators (e.g. BACHb, EVITA).

Our research addresses key priorities in acute care, including fever and acute childhood infections with a strong focus on antimicrobial stewardship and point-of-care diagnostics; respiratory conditions such as asthma, wheeze and bronchiolitis; childhood trauma and injuries; intoxications; allergy and eczema; and acute care health systems and pathways spanning pre-hospital, emergency department and community settings. We also lead and contribute to work on AI and patient safety. Methodologically, we contribute to large linked dataset studies, clinical trials, registries, prospective observational studies, and mixed-methods and qualitative research. We work closely with multiple BRC and PAECH themes, provide an inclusive and diverse clinical academic training environment, actively support the NIHR Associate PI scheme, and collaborate with national (PERUKI) and international (REPEM, EUSEP) research networks to maximise impact and scalability.

In paediatric critical care at Imperial it is our goal that every child admitted to our services is offered the opportunity to participate in research. NIHR studies therefore focus on broad inclusion criteria, and testing interventions that apply to the majority of patients. We are particularly excited about PIVOTAL, the PICU platform trial with domains testing multiple interventions simultaneously.

Professor Ramnarayan leads children’s critical care research within Imperial College, and is Chief Investigator on the BachB study. He also leads the Paediatric Critical Care Society Study Group, and the NIHR incubator programme in paediatric critical care. His interests include paediatric ventilation research and novel trial designs, including use of artificial intelligence. The PICU team have also led many smaller charity and BRC funded projects such as the BRANCH and 4PICU studies. Dr Mitting is the research lead for St Mary’s PICU, is the lead for the sedation domain of PIVOTAL, and a national Associate PI scheme champion. We collaborate with other acute care teams within the organisation to deliver DIAMONDS, BachB and EVITA as well as many other paediatric studies.