Jimmy W. Huh
VerifiedUniversity of Pennsylvania · Rehabilitation Medicine
Active 1999–2026
About
Jimmy W. Huh, MD, is a Professor of Anesthesiology and Critical Care at the Hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. His clinical expertise includes Pediatric Critical Care Medicine and Pediatric Neurosurgical Neurocritical Care, with a focus on neuromonitoring and long-term outcomes in pediatric patients. His research expertise centers on Pediatric Traumatic Brain Injury, where he investigates the mechanisms of brain injury, neuroprotection, and recovery in children. Dr. Huh has contributed to understanding the effects of serum sodium levels in severe pediatric traumatic brain injury, the age-dependent effects of brain trauma, and the neurobiological consequences of head injury in immature models. His work also explores the structural and functional impacts of brain injury, including synapse damage and cognitive deficits, aiming to improve clinical outcomes for pediatric patients with traumatic brain injuries.
Research topics
- Medicine
- Pediatrics
- Anesthesia
- Surgery
- Intensive care medicine
Selected publications
Pediatric Critical Care Medicine · 2026-03-23 · 1 citations
articleOpen accessOBJECTIVES: To characterize the quality of bag-mask ventilation (BMV) before tracheal intubation in children in the PICU and to evaluate the association between poor BMV quality and adverse airway outcomes. DESIGN: Single-center, pilot observational study, 2019-2022. SETTING: Large, urban quaternary care PICU. PATIENTS: Pediatric patients requiring BMV before tracheal intubation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Using a respiratory function monitor, we collected flow and pressure data from 8446 BMV breaths before tracheal intubation in 85 children in the PICU (median age, 3.3 yr [interquartile range, 1.4-8.3 yr]). Adverse airway outcomes (i.e., tracheal intubation-associated event and/or pulse oximetry desaturation < 80%) occurred in 14 of 85 patients (16.5%). Low-quality BMV breaths were defined as: 1) inadequate or excessive exhaled tidal volume (VTe < 4 or > 12 mL/kg); 2) excessive peak inspiratory pressure (PIP) and excessive VTe; 3) excessive facemask leak (> 40%); or 4) failure to relieve upper airway obstruction. Overall, 78.0% of BMV breaths met at least one low-quality criterion; most frequently inadequate or excessive VTe (55.5%), followed by excessive leak (46.2%). Infants (< 1 yr) and young children (1-7 yr), compared with older children (8-17 yr), had a higher proportion of low-quality BMV breaths overall (86.0%, 85.5% vs. 57.9%; p < 0.001 for both), with inadequate or excessive VTe (57.7%, 61.1% vs. 43.7%; p < 0.001 for both), excessive leak (50.6%, 49.2% vs. 37.0%; p < 0.001 for both), and excessive PIP with excessive VTe (17.5%, 19.4% vs. 6.4%; p < 0.001). After controlling for respiratory pathology, low-quality BMV was associated with 2.8-times greater odds of adverse airway outcome (adjusted odds ratio, 2.8 [95% CI, 1.2-6.2]; p = 0.01). CONCLUSIONS: The majority of BMV breaths delivered to children before tracheal intubation in the PICU were of low-quality. And, such breaths, were more frequent in younger children and were associated with greater odds of adverse airway outcomes.
Neurocritical Care · 2026-01-08
articleOpen accessBACKGROUND: Electroencephalography (EEG) is a critical tool for neuromonitoring and neuroprognostication in children with acute brain injury. Quantitative EEG (qEEG), particularly the alpha-delta ratio (ADR), can detect worsening cerebral ischemia in adults, but it is unknown whether it can identify more subtle and transient changes in cerebral blood flow, such as those induced by hypertonic saline (HTS), in children with acute brain injury. We aimed to determine whether we could identify a cohort of patients with an ADR response to HTS and to evaluate the association between an ADR response and neurologic outcomes in critically ill children with acute brain injury. METHODS: We conducted a retrospective cohort study of patients admitted to a pediatric intensive care unit with acute brain injury who received HTS during EEG monitoring from 2018 to 2023. The ADR was calculated before and after HTS administration. An ADR response was defined as a > 20% increase from baseline to within 30 min of receiving HTS in either hemisphere. The primary outcome was survival with favorable neurologic outcome, defined as a Functional Status Scale score change < 3 from prehospital baseline to discharge. Secondary outcome was survival to hospital discharge. RESULTS: Among 87 patients (median age 10 years [interquartile range 3.6-14.5], 46% female), 28% (24 of 87) had an ADR response to HTS. ADR responders were older (12.9 vs. 8.0 years; p = 0.004) and more likely to have continuous, normal-voltage EEG backgrounds (67% vs. 40%; p = 0.006). Patients with an ADR response had four times increased odds of favorable outcome and survival (odds ratio [OR] 4.0 [95% confidence interval (CI) 1.3-12.7] and OR 3.9 [95% CI 1.0-10.7], respectively). CONCLUSIONS: An ADR increase > 20% following HTS was associated with increased odds of survival with favorable neurologic outcome and survival to hospital discharge in critically ill pediatric patients with acute brain injury. qEEG response to HTS may serve as a real-time, noninvasive biomarker of cerebral perfusion responsiveness.
Therapeutic potential of ketamine after severe traumatic brain injury
Journal of Intensive Medicine · 2026-04-01
articleOpen accessResearch Square · 2025-07-30
preprintOpen accessSystems-Based Care of the Injured Child: Policy Statement
PEDIATRICS · 2025-08-18 · 1 citations
articleOpen accessInjury is the leading cause of death and a frequent cause of disability in children and negatively affects physical health, mental health, and quality of life in both the short- and long-term. The goal of a pediatric trauma system is to optimize the care for children within a state or region encompassing the entire continuum of care regardless of where children live or where traumatic events occur. This continuum includes injury prevention, prehospital care, emergency department care, interfacility transport, acute and critical inpatient care, inpatient and outpatient rehabilitation, and reintegration into the community and primary care medical home. A systems-based approach requires distinct elements of structure and function to perform together in an interrelated and cohesive manner to improve care quality. In this case, it represents a sequential practice of evidence-based evaluation and management along the continuum of care. To improve outcomes after injury, a cohesive system must effectively provide optimal care for the "right child, at the right place, at the right time" across this continuum.
Systems-Based Care of the Injured Child: Technical Report
PEDIATRICS · 2025-08-18 · 1 citations
articleOpen accessInjury is the leading cause of death and a cause of disability in children and negatively affects physical health, mental health, and quality of life in both the short- and long-term. The goal of a pediatric trauma system is to optimize the care for children within a state, regional, or national trauma system across the entire continuum of care regardless of where they live or where the traumatic event occurs. This continuum includes injury prevention, prehospital care, interfacility transport between hospitals providing different levels of care, acute and critical inpatient care, inpatient and outpatient rehabilitation, and reintegration into the community and primary care medical home. A systems-based approach, one that requires distinct elements of structure and function to perform together in an interrelated and cohesive manner to improve care quality, is essential. To improve outcomes after injury, a cohesive system must effectively provide optimal care for the "right child, at the right place, at the right time" across this continuum.
1756: SEVERE PEDIATRIC TBI AND TRANSPORT TO A QUATERNARY PEDIATRIC FACILITY: AN OUTCOME ANALYSIS
Critical Care Medicine · 2025-01-01
articleSenior authorJournal of Neurosurgery Pediatrics · 2025-05-16
articleSenior authorOBJECTIVE: 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.
Medical management of cerebellar mutism syndrome at a quaternary children’s hospital
Child s Nervous System · 2025-02-03
articleOpen accessPURPOSE: We aimed to evaluate the efficacy of selective serotonin reuptake inhibitors (SSRIs) in treating cerebellar mutism syndrome (CMS). METHODS: We retrospectively reviewed all pediatric patients who underwent a posterior fossa tumor resection between May 2007 to September 2022 at a single quaternary pediatric hospital. We evaluated clinical presentation and hospital course, including imaging findings, pathology, and surgical approaches. Propensity score matching was used to compare the symptom duration of patients who received SSRIs versus those who did not. RESULTS: A total of 292 patients met the criteria with 25% (n = 73) being diagnosed with CMS. Several factors were significantly associated with a CMS diagnosis, such as pre-operative hydrocephalus (p = 0.002), a vermis-splitting approach (p = 0.007), tumor in the fourth ventricle (p = 0.010), medulloblastoma diagnosis (p = 0.009), and postoperative complication (p < 0.001). Of the patients diagnosed with CMS, 32.9% (n = 24) received SSRI treatment, specifically fluoxetine (n = 18) and sertraline (n = 6). Overall, treatment did not decrease the duration of CMS symptoms or shorten the inpatient rehab course compared to matched controls. However, within the cohort of fluoxetine-treated patients, earlier initiation of medication was significantly correlated with a shorter duration of mutism (p = 0.007). CONCLUSIONS: We report the largest cohort of CMS patients treated with SSRIs. The lack of overall clinical benefit when compared to untreated patients in our study may be due to the length of delay in starting an SSRI, since early initiation of fluoxetine correlated with shorter CMS symptoms. These results support the importance of early clinical detection of CMS and potentially treating CMS early in the patient's postoperative course.
PEDIATRICS · 2025-08-18
articleOpen accessOpioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Around-the-clock dosing of opioids can produce physiologic opioid dependence within 5 days. According to a 2001 consensus paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as "a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, or administration of an antagonist." The experience of children undergoing iatrogenic withdrawal symptoms is variable and may be mild and go unreported or can be severe and even life threatening. Guidance on opioid withdrawal is available only for adults and primarily for adults with substance use disorders. This report will summarize existing literature and provide readers with information on how to screen for symptoms of iatrogenic opioid withdrawal as well as mechanisms for opioid withdrawal prevention.
Recent grants
NIH · $853k · 2011
Frequent coauthors
- 104 shared
Shih‐Shan Lang
- 104 shared
Todd J. Kilbaugh
Children's Hospital of Philadelphia
- 88 shared
Phillip B. Storm
Children's Hospital of Philadelphia
- 64 shared
Gregory G. Heuer
- 64 shared
Matthew P. Kirschen
- 62 shared
Alexis A. Topjian
- 58 shared
Alexander M. Tucker
Children's Hospital of Philadelphia
- 49 shared
Ian Yuan
Children's Hospital of Philadelphia
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