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Oxidative stress, burnout, National Institutes of Health, work relative value units, and Medicaid: Need for an emergency transfusion

Pediatric Research (2025)Cite this article

Abstract

There are several similarities between oxygen transport and medical economics. In a critically ill, anemic patient, increasing inspired oxygen is not an effective strategy to improve tissue oxygen delivery. A transfusion of packed red cells to increase hemoglobin increases arterial oxygen content and delivery to the tissues. Similarly, low reimbursement by Medicaid and reduced funding from National Institutes of Health (NIH) and National Science Foundation (NSF) cannot be compensated by increased provider work hours. Increased federal funding of Centers for Medicare and Medicaid Services (CMS), NIH and NSF are needed to sustain pediatric clinical and research workforce.

Impact

  • Reduction in funding to Medicaid, NIH and NSF will impact pediatric clinical care and research.

  • Increased work hours to compensate for low Medicaid, NIH and NSF funding can lead to burnout and stress.

  • There are similarities between oxidative stress related to high FiO2 and burnout related to high FTE (full-time equivalent) work hours.

  • Providing a blood transfusion increases arterial oxygen content and delivery to tissues.

  • Supporting Medicaid, NIH and NSF will enhance pediatric clinical care and research.

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Fig. 1: Characteristics of oxygen cascade, work hours, productivity and compensation in academic medicine.
Fig. 2: Possible cuts to Medicaid.

References

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Funding

HD072929 (SL) – optimal oxygenation in neonatal lung injury.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, UC Davis School of Medicine, Sacramento, CA, USA

    Satyan Lakshminrusimha

  2. Division of Pulmonary and Critical Care, Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA, USA

    Timothy E. Albertson & Susan Murin

  3. Dean, UC Davis School of Medicine, Sacramento, CA, USA

    Susan Murin

Authors
  1. Satyan Lakshminrusimha
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  2. Timothy E. Albertson
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  3. Susan Murin
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Corresponding author

Correspondence to Satyan Lakshminrusimha.

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The authors declare no competing interests.

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Lakshminrusimha, S., Albertson, T.E. & Murin, S. Oxidative stress, burnout, National Institutes of Health, work relative value units, and Medicaid: Need for an emergency transfusion. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04254-z

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  • DOI: https://doi.org/10.1038/s41390-025-04254-z

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