Dr. Agus is engaged in clinical research activities that attempt to address unanswered questions concerning endocrine homeostasis in critically ill children. The major recent focus has involved investigation of the value of tight glycemic control in critically ill children. He completed a prospective, randomized controlled trial of euglycemia in 980 post-operative cardiac surgery patients below three years of age at two centers, the largest trial then to date in the cardiac surgery field. At its outset, this was the only pediatric euglycemia trial ongoing in the United States, and the only one in the world utilizing the most advanced continuous glucose monitoring techniques available combined with expert design of an insulin delivery algorithm by a member of his team. He has one related patent application under review in this field, and a second in the pediatric ICU arena. He was also the principal investigator, along with Dr. Vinay Nadkarni, of a more complex, NHLBI/NIH U01-funded 713 patient, thirty-five-center randomized controlled trial of euglycemia in medical-surgical patients in the pediatric ICU. Results of both trials were published in New England Journal of Medicine. Taken together, these trials have represented important work in the field and continue to have definitive impact on patient care. Planning is currently underway for a similarly-sized trial of stress-dose hydrocortisone in pediatric septic shock. Dr. Agus represents his field in national organizations and on three active guideline committees addressing multi-system organ failure, sepsis, and glycemic conrol.
Michael S.D. Agus, MD