Julie C. Fitzgerald, MD, PhD, MSCE, FCCM

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Julie Fitzgerald, MD, PhD, MSCE, FCCM, is a pediatric intensivist in the Department of Anesthesiology and Critical Care Medicine, and the Pediatric Intensive Care Unit at Children's Hospital of Philadelphia.

Locations: Main Hospital
Appointments and Referrals: 1-800-TRY-CHOP (1-800-879-2467)

Background

Dr. Fitzgerald is a graduate of the University of Pennsylvania College of Arts and Sciences and the University of Pennsylvania Perelman School of Medicine, where she obtained both an MD and a PhD in Cell and Molecular Biology. Dr. Fitzgerald completed pediatrics residency and pediatric critical care medicine fellowship training at Children’s Hospital of Philadelphia (CHOP). In 2011, she joined the faculty at the University of Pennsylvania Perelman School of Medicine and is currently an Assistant Professor of Critical Care and Pediatrics, as well as an attending physician in the CHOP pediatric intensive care unit.

In collaboration with a multidisciplinary team in the CHOP PICU, she developed and implemented the CHOP PICU severe sepsis pathway in 2012, a set of recommendations for severe sepsis management in the PICU. In 2016, Dr. Fitzgerald took on the role of physician lead for Hospital-wide sepsis quality improvement/sepsis governance committee at CHOP.  She is a member of the task force that recently updated the American College of Critical Care Medicine Pediatric Shock Practice Parameters, and was a member of a committee convened by the Commonwealth of Pennsylvania Secretary of Health in 2016 to provide recommendations on state-wide hospital regulations for sepsis recognition and response.

In parallel with these quality improvement and regulatory efforts, Dr. Fitzgerald has been collaborating in sepsis-related clinical research at CHOP, with a focus on sepsis epidemiology. She and Dr. Scott Weiss led an international pediatric severe sepsis epidemiologic study that studied pediatric severe sepsis in 128 pediatric intensive care units (PICUs) in 26 countries and described the prevalence, current etiologies and therapies, and outcomes of pediatric severe sepsis. Together with Dr. Fran Balamuth and Dr. Weiss, she has studied the impact of timely sepsis therapies on outcome in children with sepsis locally at CHOP.

In 2017, Dr. Fitzgerald completed her Master of Science in Clinical Epidemiology at the University of Pennsylvania. Currently, she is further focusing on the impact of pediatric sepsis on renal dysfunction, examining biomarkers that may be helpful in predicting renal dysfunction in septic acute kidney injury, and the impact of resuscitative therapies in sepsis on the development of sepsis-related renal dysfunction.

Education and Training

Medical School

MD - University of Pennsylvania School of Medicine, Philadelphia, PA

Residency

Pediatrics - Children's Hospital of Philadelphia, Philadelphia, PA

Fellowship

Critical Care Medicine - Children's Hospital of Philadelphia, Philadelphia, PA

Board Certification

Pediatric Critical Care Medicine – American Board of Pediatrics
Pediatrics – American Board of Pediatrics

Graduate Degree

PhD in Cell and Molecular Biology - University of Pennsylvania, Philadelphia, PA

Titles and Academic Titles

Pediatric Intensivist

Associate Chief of Research, Division of Pediatric Critical Care Medicine

Co-Director, Pediatric Sepsis Program

Associate Professor in Anesthesiology and Critical Care Medicine, Perelman School of Medicine at the University of Pennsylvania

Associate Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania

Departments and Services

Research Interests

Sepsis
Acute kidney injury
Oncology patients in the ICU

Selected Publications

Publications

Books

Chapters

2022

Banigan, M., Fitzgerald, J.C. (2022). Acute Kidney Injury. In: Mattei, P. (eds) Fundamentals of Pediatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-031-07524-7_14

2017

Kakajiwala AK, Ferguson MA, Fitzgerald JC. Chapter: Acute Kidney Injury, Fundamentals of Pediatric Surgery, P Mattei, Editor. Springer International Publishing AG, Switzerland, 2017 p. 75-85.

2016

Balamuth F, Fitzgerald JC, Weiss SL. Chapter 5: Shock In Leisher and Ludwig’s Textbook of Emergency Medicine. 7th Edition, Shaw K, Chamberlain J, Lavelle J, Nagler J, and Shook J. (Editors). 2016, Pg. 55-68.

2015

Thomas NJ, Tamburro RF, Rajasekaran S, Fitzgerald JC, Weiss SL, Hall MW. Chapter 87: Bacterial Sepsis. In Rogers’ Textbook of Pediatric Intensive Care. 5th Edition,  David G. Nichols, MD and Donald H. Shaffner, MD, Editors Wolters Kluwer, 2015, Pg. 1377-1396.

2003

Fitzgerald JC and H.C.J. Ertl. Activation of the Innate Immune System by DNA Vaccines. In DNA Vaccines. H.C.J. Ertl, ed. Kluwer Academic/Plenum Publishers, New York, NY, p. 60, 2003.

Posters and Presentations

2022

Yehya N, Fitzgerald J, Hayes K, Zhang D, Bush J, Koterba N, Chen F, Tuluc F, Teachey D, Balamuth F, Lacey S, Melenhorst J, Weiss S: Temperature Trajectory Subphenotypes and the Immunoinflammatory Response in Pediatric Sepsis. Critical Care Medicine 50(1): 722, January 2022 Notes: Research Snapshot Presentation at the 51st Critical Care Congress, February 2022, San Juan, Puerto Rico.

Lindell RB, Fitzgerald JC, Rowan CW, Flori HR, Di Nardo M, Napolitano N, Traynor DM, Lenz KB, Emeriaud G, Jeyapalan A, Nishisaki A: Duration of pre-intubation respiratory support is associated with increased mortality in immunocompromised children with respiratory failure. Critical Care Medicine January 2022 Notes: Research Snapshot Presentation at 51st Critical Care Congress, February 2022, San Juan, Puerto Rico (Virtual).

Fitzgerald JC, Zuppa AF: Population Pharmacokinetic Evaluation of Vancomycin in Critically Ill Children With Sepsis. Critical Care Medicine 50(1): 504, January 2022 Notes: Research Snapshot Presentation at the 51st Critical Care Congress, February 22, San Juan, Puerto Rico.

Fitzgerald JC, Zuppa AF: Nephrotoxic Medication Exposures in Critically Ill Children With Sepsis. Critical Care Medicine 50(1): 732, January 2022 Notes: Research Snapshot Presentation at the 51st Critical Care Congress, February 2022, San Juan, Puerto Rico.

Downes KJ, Sharova A, Gianchetti L, Fitzgerald JC, Zuppa AF: Attainment of Cefepime Therapeutic Targets in Critically Ill Children. Critical Care Medicine 50(1): 698, January 2022 Notes: Research Snapshot Presentation at the 51st Critical Care Congress, February 2022, San Juan, Puerto Rico.

Brennan MM, Lindell RB, Nishisaki A, Fitzgerald JC, Dziorny AC: Application of Machine Learning in a Linked Multicenter Dataset: Classifying MODS in Septic Shock. Critical Care Medicine 50(1): 721, January 2022 Notes: Research Snapshot Presentation at the 51st Critical Care Congress, February 2022, San Juan, Puerto Rico.

2021

Banigan M, Zhang B, Fitzgerald JC: Association of continuous renal replacement therapy (CRRT) timing and mortality in critically ill children. Pediatric Academic Societies May 2021 Notes: Highlighted e-Poster at the Pediatric Academic Societies Virtual Conference.

Sallee CJ, Smith LS, Rowan CM, Fitzgerald JC: Increasing fluid balance is associated with impaired oxygenation in pediatric hematopoietic cell transplant recipients with pediatric acute respiratory distress syndrome. Pediatric Onco-Critical Care Symposium April 2021 Notes: Presented at the Pediatric Onco-Critical Care Symposium, St. Jude Children's Research Hospital, Memphis, TN (virtual).

Stinson H, Dashefsky H, Chiotos K, Woods-Hill C, Weiss SL, Fitzgerald JC: Care delivery related to sepsis in a SARS-CoV-2 Pediatric Intensive Care Unit. Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at the 50th Critical Care Congress, February, 2021 (Virtual).

Sallee CJ, Smith LS, Rowan CM, Fitzgerald JC: Positive fluid balance is associated with worse oxygenation in pediatric HCT recipients with PARDS. Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at 50th Critical Care Congress, February 2021, (Virtual).

Sallee CJ, Smith LS, Rowan CM, Fitzgerald JC: Renal replacement modifies effect of fluid balance on PICU mortality in pediatric HCT recipients. Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at 50th Critical Care Congress, February 2021, (Virtual).

Periasamy U, Fitzgerald JC, Balamuth F, Chiliutti M, Hickey C, Weiss SL: Avascular necrosis diagnosed after pediatric sepsis Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at the 50th Critical Care Congress, February, 2021, (Virtual).

Lenz K, Nishisaki A, Lindell RB, Yehya N, Laverriere EK, Bruins BB, Napolitano N, Craig D, Traynor D, Fitzgerald JC: Stem cell transplant status is not associated with adverse events during tracheal intubation. Critical Care Medicine 49(1): 462, January 2021 Notes: Research Snapshot Presentation at 50th Critical Care Congress, February 2021, (Virtual).

Dashefsky H, Hayes K, Liu H, Stinson H, Balamuth F, Fitzgerald J, Chilutti M, Weiss SL: Incidence and risk factors for hospital readmission after treatment for sepsis in children. Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at the 50th Critical Care Congress, February, 2021 (Virtual).

Banigan M, Traynor D, Fitzgerald JC: Association of continuous renal replacement therapy timing and mortality in critically ill children. Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at the 50th Critical Care Congress, February, 2021, (Virtual).

Alcamo A, Fitzgerald JC, Weiss SL, Kirschen MP, Lofis L, Tang S, Thomas N, Nadkarni VM, Nett S: Impact of timing of acute neurologic dysfunction on outcomes in pediatric sepsis Critical Care Medicine 49(1), January 2021 Notes: Research Snapshot Presentation at 50th Critical Care Congress, SCCM Star Research Achievement Award winning abstract, February, 2021 (Virtual).

2020

Arnoldi S, Glau C, Walker S, Himebauch A, Parikh D, Udeh S, Weiss SL, Fitzgerald JC, Nishisaki A, Conlon TW: Integrating focused cardiac ultrasound into pediatric septic shock assessment. Critical Care Medicine 48(1): 760, January 2020 Notes: Research Snapshot Presentation, 49th Critical Care Congress, February 2020, Orlando, FL

Becker A, Teixeira S, Fitzgerald JC, Lunig N, Schramm S, Murphy M, Traynor D, Kubis S, Weiss SL, Topjian AA, Vossough A, Kirschen MP: Prevalence of brain MRI abnormalities in pediatric sepsis patients. Critical Care Medicine 48(1): 324, January 2020 Notes: Research Snapshot Presentation at 49th Critical Care Congress, February 2020, Orlando, FL.

Dziorny A, Lindell R, Moore J, Nishisaki A, Fitzgerald JC: Classification of MODS beyond Day 1 of illness in pediatric severe sepsis and septic shock. Critical Care Medicine 48(1): 754, January 2020 Notes: Research Snapshot Presentation, 49th Critical Care Congress, February 2020, Orlando, FL.

Rowan C, Fitzgerald JC, Agulnik A, Sharron M, Mahadeo K, Moffet J, Tarquinio K, Zinter M, Bajwa R, Slaven J, Steiner M: Factors Associated With Failure of Noninvasive Ventilation in Children After Stem Cell Transplant. Critical Care Medicine 48(1): 6, January 2020 Notes: Star Research Presentations: Pediatric Pulmonology, 49th Critical Care Congress, February 2020, Orlando, FL.

Banigan M, Lindell RB, Fitzgerald JC: Timing Of renal replacement therapy in critically ill oncology and hematopoietic stem cell transplant patients. Frontiers in Oncology April 2020 Notes: Poster at Pediatric Onco-Critical Care Symposium at St. Jude Children's Research Hospital, Winner of "POCCS Best Abstract Award", April 2020 (conference cancelled due to COVID-19), Memphis, TN.

2019

Becker A, Fitzgerald JC, Kubis S, Traynor D, Vossough A, Weiss SL, Topjian A, Kirschen M: MRI abnormalities in pediatric sepsis. Critical Care Medicine 47(1 Suppl 1), January 2019 Notes: Research Presentation at the 48th Society of Critical Care Medicine Annual Congress, 2019 February 17-20, San Diego, CA.

Chiotos K, Biedron L, Fitzgerald JC, Robbins-Tighe S, Weiss SL, Woods-Hill C: Sepsis huddles in the PICU: Understanding the impact on timely antibiotics, perceptions, and barriers. Critical Care Medicine 47(1 Suppl 1), January 2019 Notes: Research Presentation at the 48th Society of Critical Care Medicine Annual Congress, 2019 February 17-20, San Diego, CA.

Lindell R, Fitzgerald JC, Nishisaki A, Traynor D, Weiss SL: Predictive validity of mortality prediction scores in pediatric severe sepsis and septic shock. Critical Care Medicine 47(1 Suppl 1), January 2019 Notes: Research snapshot Presentation at 48th Critical Care Congress, February 2019, San Diego, CA.

Lindell R, Nishisaki A, Weiss SL, Traynor D, Fitzgerald JC: Risk of mortality in immunocompromised children with severe sepsis and septic shock. Critical Care Medicine 47(1 Suppl 1), January 2019 Notes: Research snapshot Presentation at 48th Critical Care Congress, February 2019, San Diego, CA

Walker SB, Conlon TW, Zhang B, Mensinger J, Fitzgerald JC, Himebauch AS, Glau CL, Nishisaki A, Ranjit S, Nadkarni VM, Weiss SL: Targeting vasoactive therapies to warm versus cold pediatric septic shock. Critical Care Medicine 47(1 Suppl 1), January 2019 Notes: Research Snapshot Presentation at 48th Critical Care Congress, February 2019, San Diego, CA.

Invited Lectures

2020

Fitzgerald JC. "Acute Kidney Injury in Pediatric Sepsis: Epidemiology and Prevention", lecture for Pediatric Departmental Research Series at Penn State University College of Medicine/Penn State Hershey Children's Hospital, October 28, 2020, Hershey, PA.

Fitzgerald JC. "Cytokine release syndrome and other complications of cancer immunotherapy: a new reason for PICU admission", lecture at the 1st European Pediatric Onco-Critical Care Hot Topics Symposium, September 17, 2020, UMC Utrecht Wilhelmina Children's Hospital, Utrecht, The Netherlands. Cancelled due to COVID-19.

Fitzgerald JC. "COVID-19 and Pediatric Patients", invited webinar for the Pennsylvania Society for Respiratory Care Neonatal-Pediatric Webinar, September 9, 2020.

Fitzgerald JC. "Immunomodulatory therapy for COVID-19", invited talk at the International PICU-COVID 19 Collaboration webinar, August 1, 2020, hosted by Harvard University/Boston Children's Hospital, Boston, MA

Fitzgerald JC. "IPSO Pediatric Sepsis Annual Literature Review", invited webinar for the Children's Hospital Association Improving Pediatric Sepsis Outcomes Collaborative, June 29, 2020.

Fitzgerald JC. "Cytokine Directed Therapies for COVID-19", invited talk at the International PICU-COVID 19 Collaboration webinar, April 18, 2020, hosted by Harvard University/Boston Children's Hospital, Boston, MA

Fitzgerald JC. "Is there a cytokine storm in COVID-19?", invited talk at the International PICU-COVID 19 Collaboration webinar, March 25, 2020, hosted by Harvard University/Boston Children's Hospital, Boston, MA

2019

Fitzgerald JC. "Pediatric Sepsis: Epidemiology, Outcomes, and Challenges of Caring for the Child with Sepsis", lecture at the Solving the Puzzle of Sepsis - Putting the Pieces Together in Pennsylvania conference, hosted by the Hospital and Healthsystem Association of Pennsylvania (HAP), September 23, 2019, Lancaster, PA

Fitzgerald JC. "Association of Hypotension Early in Pediatric Severe Sepsis with Development of New or Persistent Acute Kidney Injury and with Renal Recovery", lecture at the 3rd World Nephrology and Therapeutics Congress, June 24, 2019, Philadelphia, PA

Fitzgerald JC. "How Do We Measure Adherence to Sepsis Protocols", webinar for the Sepsis Steering Committee at Lucile Packard Children's Hospital/Stanford School of Medicine, June 19, 2019, Palo Alta, CA

Fitzgerald JC. "Critical Complications of Chimeric Antigen Receptor T Cell Therapy", lecture at the Pediatric Onco-Critical Care Symposium, St. Jude Children's Research Hospital, Memphis, TN, Apr, 2019.

Fitzgerald JC. "Chimeric Antigen Receptor T Cell-Associated Cytokine Storm", lecture at the 48th Critical Care Congress Meeting, February 19, 2019. San Diego, CA, Feb, 2019.

Fitzgerald JC. "How Do We Measure Adherence to Protocols" lecture at the 48th Critical Care Congress Meeting, February 17, 2019, San Diego, CA, Feb, 2019.

Awards and Honors

2020, Presidential Citation, Society of Critical Care Medicine Fellow of the American, College of Critical Care Medicine
2019, Pediatric Critical Care Medicine "Editor's Top Picks of Original Reports 2016, 2017, 2018"
2019, Pediatric Critical Care Medicine “Editors Top Picks of Original Reports 2015’” for Conlon et al, PCCM 16(3):219-226.
2019, Presidential Citation, Society of Critical Care Medicine
2017-2019, CHOP Department of Pediatrics Chair’s Initiative Awardee to develop CHOP Pediatric Sepsis Program, Children’s Hospital of Philadelphia
2002-2003, Graduate work supported by NCI training grant
2005, Henrietta and Jacob Lowenburg Prize in Pediatrics
2002-2003, Graduate work supported by NCI training grant
1997, Completed Bachelor of Arts summa cum laude
1994-1997, Benjamin Franklin Scholar
1997, Phi Beta Kappa
1997, Gold Key National Honor Society

Editorial and Academic Positions

Editorial Positions

2021-present, Reviewer, Critical Care Medicine
2020-present, Associate Editor in Pediatric Critical Care, Frontiers in Pediatrics
2020-present, Reviewer, The Lancet Child & Adolescent Health
2020-present, Reviewer, BMC Pediatrics
2019-present, Reviewer, Inflammation
2019-present, Reviewer, JAMA Network Open
2019-present, Reviewer, Hospital Pediatrics
2019-present, Reviewer, Resuscitation
2019-present, Reviewer, Pediatrics
2019-present, Reviewer, Pediatric Quality & Safety
2019-present, Reviewer, The Lancet Infectious Diseases
2018-present, Reviewer, Critical Care
2018-present, Reviewer, Journal of Critical Care
2017-present, Reviewer, Journal of Intensive Care Medicine
2017-present, Reviewer, American Journal of Respiratory and Critical Care Medicine
2016-present, Reviewer, Pediatric Critical Care Medicine
2015-present, Reviewer, Bone Marrow Transplantation
2014-present, Reviewer, JAMA Pediatrics
2014-present, Reviewer, Respiratory Care
2013-present, Reviewer, Pediatric Emergency Care
2013-present, Reviewer, Clinical Journal of the American Society of Nephrology
2010-present, Ad hoc reviewer, Pediatric Critical Care Medicine
2008-present, Ad hoc reviewer, Critical Care Medicine

Academic and Institutional Committees

2021-present, Member, Pediatric Critical Care Medicine Program Evaluation Committee
2021-present, Member, Nephrology Division Chief Search Committee
2020-present, Member, Anesthesia and Critical Care Medicine Research Council
2020-present, Member, Critical Care Medicine Research Operations Committee
2018-2021, Member, Scholarship Oversight Committee, Pediatric Critical Care Medicine Fellowship Class 2018-2021
2017-present, Member, ICU Acute Kidney Injury Quality Improvement Project
2016-present, Physician Lead for Hospital-Wide Sepsis Quality Improvement
2013-present,Critical Care Medicine Clinical Documentation Workgroup
2011-2016, PICU Severe Sepsis Quality Improvement Committee, Co-chair
2010-present, CHOP Preventing Codes Outside of the ICU Steering Committee

Leadership and Memberships

Memberships in Professional Organizations

2020, Swiss National Science Foundation (External grant reviewer)
2018-present, Children's Hospital Association Improving Pediatric Sepsis Outcomes Research Working Group
2017-present, Pediatric Organ Dysfunction Information Update Mandate
 - 2017-present, Chair, Renal Organ Dysfunction Workgroup
2010-present, Pediatric Acute Lung Injury and Sepsis Investigators
2007-present, Society of Critical Care Medicine
2005-present, American Academy of Pediatrics