Randall C. Wetzel, MD

Professor of Pediatrics

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Overview

Dr. Randall Wetzel is the Chairman of the Department of Anesthesiology Critical Care Medicine at Children’s Hospital Los Angeles, Professor (Tenured) of Anesthesiology and Pediatrics, Keck School of Medicine, University of Southern California, and the Director of The Laura P. and Leland K. Whittier Virtual Pediatric Intensive Care Unit (VPICU) at Children’s Hospital Los Angeles. Prior to coming to CHLA, Dr. Wetzel held various faculty appointments in Anesthesiology and Critical Care Medicine at Johns Hopkins Hospital and University from 1981-1997.

After completing his undergraduate studies at Durham University in England, he went on to receive his medical degree from the Medical College of St. Bartholomew’s Hospital, London University, England. He moved stateside for his pediatric residency, then fellowship training in Critical Care and Pediatric Cardiology at Rainbow Babies and Children’s Hospital at University Hospitals in Cleveland, Ohio. He was subsequently a fellow in Pediatric Critical Care and Resident/Chief Resident in Anesthesiology/Critical Care Medicine at Johns Hopkins Hospital in Baltimore. Dr. Wetzel returned to England for a fellowship in Pediatric Anesthesia and Critical Care Medicine at the Hospital for Sick Children and Guy’s Hospital in London. In addition, he earned a Master of Science in Business (Medicine) from Johns Hopkins University (1997). He moved to Los Angeles in 1997.

His current interests in medical informatics led him to develop the VPICU; a Southern California Critical Care Telemedicine Network; he is CEO and Chair of VPS, LLC a Quality Improvement and Data management company with over 120 hospital clients; and he leads a complex big data research team developing data extraction, management, architecture and advanced analytic techniques for highly granular Pediatric Critical Care Data. He has received over $18 million in federal and private foundation grant funding for these projects. He has served as a board member for The American Board of Pediatrics (2000-2003); Editor-in-Chief, the Society for Pediatric Anesthesia (1988-1995). He has authored 94 peer-reviewed articles and 45 book chapters, he is editor of Roger’s Critical Care Medicine and Critical Heart Disease in Infants and Children; and has presented over 100 abstracts at various symposia.

Dr. Wetzel and his wife Ann have been married 34 years and currently reside in La Cañada, California. They have four wonderful daughters.

Publications

  • Prehospitalization Trauma and Physiologic Factors Associated with the Presence of Post-traumatic Stress 3 Months After PICU Discharge J Intensive Care Med. 2024 Mar; 39(3):268-276. . View in PubMed
  • Ventilator Weaning and Terminal Extubation: Withdrawal of Life-Sustaining Therapy in ChildrenSecondary Analysis of the Death One Hour After Terminal Extubation Study. Crit Care Med. 2024 03 01; 52(3):396-406. . View in PubMed
  • A Novel Application of Spectrograms with Machine Learning Can Detect Patient Ventilator Dyssynchrony Biomed Signal Process Control. 2023 Sep; 86(Pt C). . View in PubMed
  • Narrowing the gap: expected versus deployment performance J Am Med Inform Assoc. 2023 08 18; 30(9):1474-1485. . View in PubMed
  • Predicting High Flow Nasal Cannula Failure in an Intensive Care Unit Using a Recurrent Neural Network With Transfer Learning and Input Data Perseveration: Retrospective Analysis JMIR Med Inform. 2022 Mar 03; 10(3):e31760. . View in PubMed
  • Development of a deep learning model that predicts Bi-level positive airway pressure failure Sci Rep. 2022 05 26; 12(1):8907. . View in PubMed
  • Interpreting a recurrent neural network’s predictions of ICU mortality risk J Biomed Inform. 2021 02; 114:103672. . View in PubMed
  • Continuous Prediction of Mortality in the PICU: A Recurrent Neural Network Model in a Single-Center Dataset Pediatr Crit Care Med. 2021 06 01; 22(6):519-529. . View in PubMed
  • Diagnosis: A Tricky, Never-Ending Business Pediatr Crit Care Med. 2021 08 01; 22(8):758-761. . View in PubMed
  • Machine Learning to Predict Cardiac Death Within 1 Hour After Terminal Extubation Pediatr Crit Care Med. 2021 02 01; 22(2):161-171. . View in PubMed
  • The Impact of Coronavirus Disease 2019 Pandemic on US. and Canadian PICUs. Pediatr Crit Care Med. 2020 09; 21(9):e643-e650. . View in PubMed
  • The impact of extraneous features on the performance of recurrent neural network models in clinical tasks J Biomed Inform. 2020 02; 102:103351. . View in PubMed
  • The authors reply Pediatr Crit Care Med. 2019 04; 20(4):399-400. . View in PubMed
  • Artificial Intelligence: An Inkling of Caution Pediatr Crit Care Med. 2018 10; 19(10):1004-1005. . View in PubMed
  • Low-dose dexmedetomidine as an adjuvant to propofol infusion for children in MRI: A double-cohort study Paediatr Anaesth. 2018 07; 28(7):639-646. . View in PubMed
  • Applying Machine Learning to Pediatric Critical Care Data Pediatr Crit Care Med. 2018 07; 19(7):599-608. . View in PubMed
  • First Get the Data, Then Do the Science! Pediatr Crit Care Med 2018 04; 19(4):382-383. . View in PubMed
  • Development and Validation of an Empiric Tool to Predict Favorable Neurologic Outcomes Among PICU Patients Crit Care Med. 2018 01; 46(1):108-115. . View in PubMed
  • Predicting individual physiologically acceptable states at discharge from a pediatric intensive care unit J Am Med Inform Assoc. 2018 12 01; 25(12):1600-1607. . View in PubMed
  • The Dependence of Machine Learning on Electronic Medical Record Quality AMIA Annu Symp Proc. 2017; 2017:883-891. . View in PubMed
  • Association of Freestanding Children’s Hospitals With Outcomes in Children With Critical Illness Crit Care Med. 2016 Dec; 44(12):2131-2138. . View in PubMed
  • Mainstream capnography system for nonintubated children in the postanesthesia care unit: Performance with changing flow rates, and a comparison to side stream capnography Paediatr Anaesth. 2016 Dec; 26(12):1179-1187. . View in PubMed
  • Effect of Inhaled Nitric Oxide on Outcomes in Children With Acute Lung Injury: Propensity Matched Analysis From a Linked Database Crit Care Med. 2016 Oct; 44(10):1901-9. . View in PubMed
  • Pediatric Intensive Care Databases for Quality Improvement J Pediatr Intensive Care. 2016 Sep; 5(3):81-88. . View in PubMed
  • Pediatric Triage in a Severe Pandemic: Maximizing Survival by Establishing Triage Thresholds Crit Care Med. 2016 Sep; 44(9):1762-8. . View in PubMed
  • Obesity and Mortality Risk in Critically Ill Children Pediatrics. 2016 Mar; 137(3):e20152035. . View in PubMed
  • Association of house staff training with mortality in children with critical illness Acta Paediatr. 2016 Feb; 105(2):e60-6. . View in PubMed
  • Risk factors for mechanical ventilation and reintubation after pediatric heart surgeryJ Thorac Cardiovasc Surg. 2016 Feb; 151(2):451-8. e3. . View in PubMed
  • Risk factors and outcomes of in-hospital cardiac arrest following pediatric heart operations of varying complexity Resuscitation. 2016 08; 105:1-7. . View in PubMed
  • Impact of 24/7 In-Hospital Intensivist Coverage on Outcomes in Pediatric Intensive CareA Multicenter Study. Am J Respir Crit Care Med. 2016 12 15; 194(12):1506-1513. . View in PubMed
  • Pediatric Index of Cardiac Surgical Intensive Care Mortality Risk Score for Pediatric Cardiac Critical Care Pediatr Crit Care Med. 2015 Nov; 16(9):846-52. . View in PubMed
  • Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event Pediatr Crit Care Med. 2015 Sep; 16(7):e207-16. . View in PubMed
  • Critical care for rare diseases (and procedures): redux Pediatr Crit Care Med. 2015 Mar; 16(3):297-9. . View in PubMed
  • Variation of ventilation practices with center volume after pediatric heart surgery Clin Cardiol. 2015 Mar; 38(3):178-84. . View in PubMed
  • Causal Phenotype Discovery via Deep Networks AMIA Annu Symp Proc. 2015; 2015:677-86. . View in PubMed
  • Epidemiology and outcomes of in-hospital cardiac arrest in critically ill children across hospitals of varied center volume: a multi-center analysis Resuscitation. 2014 Nov; 85(11):1473-9. . View in PubMed
  • It is too early to declare early or late rescue high-frequency oscillatory ventilation dead–reply JAMA Pediatr. 2014 Sep; 168(9):863. . View in PubMed
  • Algorithms to estimate PaCO2 and pH using noninvasive parameters for children with hypoxemic respiratory failure Respir Care. 2014 Aug; 59(8):1248-57. . View in PubMed
  • Association of center volume with outcomes in critically ill children with acute asthma Ann Allergy Asthma Immunol. 2014 Jul; 113(1):42-7. . View in PubMed
  • Comparison of high-frequency oscillatory ventilation and conventional mechanical ventilation in pediatric respiratory failure JAMA Pediatr. 2014 Mar; 168(3):243-9. . View in PubMed
  • The parsimonious pediatric index of mortality* Pediatr Crit Care Med. 2013 Sep; 14(7):718-9. . View in PubMed
  • Using robotic telecommunications to triage pediatric disaster victims J Pediatr Surg. 2012 Jan; 47(1):221-4. . View in PubMed
  • Are all ICUs the same? Paediatr Anaesth. 2011 Jul; 21(7):787-93.. View in PubMed
  • Who is doing what to whom: a large prospective study of propofol anesthesia in children Anesth Analg. 2009 Mar; 108(3):695-8. . View in PubMed
  • Support for PICUs and the PRISM scoring algorithms Pediatr Crit Care Med. 2009 Jan; 10(1):143-4. . View in PubMed
  • Databases for assessing the outcomes of the treatment of patients with congenital and paediatric cardiac disease–the perspective of critical care Cardiol Young. 2008 Dec; 18 Suppl 2:130-6. . View in PubMed
  • Calcium: a double-edged sword Pediatr Crit Care Med. 2007 May; 8(3):300-1. . View in PubMed
  • Positive end-expiratory pressure and pressure support in peripheral airways obstruction : work of breathing in intubated children Intensive Care Med. 2007 Jan; 33(1):120-7. . View in PubMed
  • Don’t confuse the anesthetic with the anesthesiologist! Anesth Analg 2006 Oct; 103(4):859-62. . View in PubMed
  • Pediatric cardiac critical care patients should be cared for by intensivists J Am Coll Cardiol. 2006 Jul 04; 48(1):221-2; author reply 222-3. . View in PubMed
  • Precise use of medical terminology Crit Care Med. 2006 Jun; 34(6):1854; author reply 1854-5. . View in PubMed
  • Intensivist-led team approach to critical care of children with heart disease Pediatrics. 2006 May; 117(5):1854-6; author reply 1856-7. . View in PubMed
  • Gastrointestinal morbidity after Norwood palliation for hypoplastic left heart syndrome Ann Thorac Surg. 2006 Mar; 81(3):982-7. . View in PubMed
  • Pressure-rate products and phase angles in children on minimal support ventilation and after extubation Intensive Care Med. 2005 Dec; 31(12):1700-5. . View in PubMed
  • [Assessment of health-related quality of life with the German SF-8A comparison of telephone and postal survey modes]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2005 Dec; 48(12):1322-9. . View in PubMed
  • Cumulative fluid intake minus output is not associated with ventilator weaning duration or extubation outcomes in children Pediatr Crit Care Med. 2005 Nov; 6(6):642-7. . View in PubMed
  • Telemedicine: basic technical considerations J Intensive Care Med. 2004 Sep-Oct; 19(5):297-8. . View in PubMed
  • Respiratory inductance plethysmography used to diagnose bilateral diaphragmatic paralysis: a case report Pediatr Crit Care Med. 2004 Jul; 5(4):399-402. . View in PubMed
  • Telemedicine and intensive care: are we ready and willing? J Intensive Care Med. 2004 Mar-Apr; 19(2):117-8.. View in PubMed
  • Phase I trial of intranasal and endobronchial administration of a recombinant adeno-associated virus serotype 2 (rAAV2)-CFTR vector in adult cystic fibrosis patients: a two-part clinical study Hum Gene Ther. 2003 Jul 20; 14(11):1079-88. . View in PubMed
  • Effect of mechanical ventilator weaning protocols on respiratory outcomes in infants and children: a randomized controlled trial JAMA. 2002 Nov 27; 288(20):2561-8. . View in PubMed
  • Multiple trauma in children: critical care overview Crit Care Med. 2002 Nov; 30(11 Suppl):S468-77. . View in PubMed
  • Critical care for rare diseases Pediatr Crit Care Med. 2002 Jan; 3(1):89-90. . View in PubMed
  • The virtual pediatric intensive care unitPractice in the new millennium. Pediatr Clin North Am. 2001 Jun; 48(3):795-814. . View in PubMed
  • The safety and efficacy of parent-/nurse-controlled analgesia in patients less than six years of age Anesth Analg. 2000 Sep; 91(3):573-9. . View in PubMed
  • Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society J Pediatr Orthop B. 1999 Oct; 8(4):231-45. . View in PubMed
  • Potential paracrine role of the pericardium in the regulation of cardiac function Cardiovasc Res. 1998 Nov; 40(2):332-42. . View in PubMed
  • Gastro-oesophageal reflux: theory over experience? Paediatr Anaesth. 1998; 8(2):101-4.. View in PubMed
  • Pressure-support ventilation in children with severe asthma Crit Care Med. 1996 Sep; 24(9):1603-5. . View in PubMed
  • Fatal intramuscular bleeding misdiagnosed as suspected nonaccidental injury Pediatrics. 1995 May; 95(5):771-3. . View in PubMed
  • Endotoxin induces organ-specific endothelial cell injury Shock. 1995 Jan; 3(1):46-50. . View in PubMed
  • Comparison between endocardial and great vessel endothelial cells: morphology, growth, and prostaglandin release Am J Physiol. 1995 Jan; 268(1 Pt 2):H250-9. . View in PubMed
  • 17 beta-Estradiol inhibits flow- and acute hypoxia-induced prostacyclin release from perfused endocardial endothelial cells Circulation. 1994 Nov; 90(5):2519-24. . View in PubMed
  • Optimal release time during airway pressure release ventilation in neonatal sheep Crit Care Med. 1994 Mar; 22(3):486-93. . View in PubMed
  • Preoperative evaluation of children Pediatr Clin North Am. 1994 Feb; 41(1):93-110. . View in PubMed
  • Postoperative analgesia following thoracotomy in children: interpleural catheters J Pediatr Surg. 1993 Nov; 28(11):1466-70. . View in PubMed
  • The intensivist’s system Crit Care Med. 1993 Sep; 21(9 Suppl):S341-4. . View in PubMed
  • Cardiorespiratory responses to epidural analgesia in the awake child: a retrospective review of postoperative patients J Post Anesth Nurs. 1993 Aug; 8(4):257-61. . View in PubMed
  • Intravascular volume loading reversibly decreases airway cross-sectional area Chest. 1993 Mar; 103(3):865-70. . View in PubMed
  • Right and left ventricular cultured endocardial endothelium produces prostacyclin and PGE2 J Mol Cell Cardiol. 1993 Mar; 25(3):245-8. . View in PubMed
  • High-resolution computed tomography–physiologic correlation J Thorac Imaging. 1993; 8(4):265-72. . View in PubMed
  • Halothane enhances pulmonary artery endothelial eicosanoid release Anesth Analg. 1992 Dec; 75(6):1007-13. . View in PubMed
  • Anaesthesia for critically ill children during magnetic resonance imaging Br J Anaesth. 1992 Nov; 69(5):482-6. . View in PubMed
  • Extracorporeal membrane oxygenation for perioperative support during congenital tracheal stenosis repair Anesth Analg. 1992 Nov; 75(5):825-9. . View in PubMed
  • Acute effects of increased intravascular volume and hypoxia on the pulmonary circulation: assessment with high-resolution CT Radiology. 1992 Jun; 183(3):655-62. . View in PubMed
  • Acute hypoxia alters eicosanoid production of perfused pulmonary artery endothelial cells in culture Prostaglandins. 1992 Apr; 43(4):371-82. . View in PubMed
  • Airway pressure release ventilation in a neonatal lamb model of acute lung injury Crit Care Med. 1991 Mar; 19(3):373-8. . View in PubMed
  • Phenol as an adjuvant anesthetic for tympanostomy tube insertion Int J Pediatr Otorhinolaryngol. 1991 Feb; 21(1):51-8. . View in PubMed
  • Midazolam-fentanyl intravenous sedation in children: case report of respiratory arrest Pediatrics. 1990 Sep; 86(3):463-7. . View in PubMed
  • Ketamine by continuous infusion for sedation in the pediatric intensive care unit Crit Care Med. 1990 Aug; 18(8):819-21. . View in PubMed
  • Intrathecal morphine as an adjunct to anesthesia for head and neck surgery South Med J. 1990 Jun; 83(6):649-52. . View in PubMed
  • Postoperative analgesiaUse of intrathecal morphine in children. Clin Pediatr (Phila). 1990 Jan; 29(1):44-8. . View in PubMed
  • Inspiratory work and response times of a modified pediatric volume ventilator during synchronized intermittent mandatory ventilation and pressure support ventilation Anesthesiology. 1989 Dec; 71(6):977-81. . View in PubMed
  • Prediction of successful primary closure of congenital abdominal wall defects using intraoperative measurements J Pediatr Surg. 1989 Dec; 24(12):1217-20. . View in PubMed
  • Separation of craniopagus Siamese twins using cardiopulmonary bypass and hypothermic circulatory arrest J Thorac Cardiovasc Surg. 1989 Nov; 98(5 Pt 2):961-7. . View in PubMed
  • Pentobarbital attenuates pulmonary vasoconstriction in isolated sheep lungs Am J Physiol. 1989 Sep; 257(3 Pt 2):H898-903. . View in PubMed
  • Age-dependent effects of indomethacin on hypoxic vasoconstriction in neonatal lamb lungs Pediatr Res. 1988 Jun; 23(6):580-4. . View in PubMed
  • Chloramphenicol toxicity in critically ill children with cardiac disease Crit Care Med. 1987 Nov; 15(11):1069-71. . View in PubMed
  • High frequency ventilation Pediatr Clin North Am. 1987 Feb; 34(1):15-38. . View in PubMed
  • Anesthetic implications of protein C deficiency Anesth Analg. 1986 Sep; 65(9):982-4. . View in PubMed
  • Arterial blood gas derived variables as estimates of intrapulmonary shunt in critically ill children Crit Care Med. 1985 Dec; 13(12):1029-33. . View in PubMed
  • Hemodynamic responses in brain dead organ donor patients Anesth Analg. 1985 Feb; 64(2):125-8. . View in PubMed
  • Hypoxic bronchodilation J Appl Physiol (1985). 1992 Sep; 73(3):1202-6. . View in PubMed
  • Gypsies and acute medical intervention Pediatrics. 1983 Nov; 72(5):731-5. . View in PubMed