Goal 2: Reduce Human Disease

Addition of albumin to fluid conservative management of AL

Does the addition of albumin to fluid conservative management of ALI (ARDSnet FACTT trial protocol, Wiedemann et al) further shorten ventilator time and/or improve survival?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 4: Develop Workforce and Resources

Which factors are associated with systems performance?

What are the institutional factors, including structure and culture of care, that characterize systems performance? Which of these factors are potentially modifiable and/or scalable?

Submitted by (@rebecca.lehotzky)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : AHA Staff & Volunteers

Voting

-3 net votes
2 up votes
5 down votes
Active

Goal 3: Advance Translational Research

The use of administrative and billing data in COPD care quality improvement

What is the validity of administrative/billing data to evaluate the quality of COPD care as part of quality improvement initiatives? What care practices can be assessed using these data?

Submitted by (@ngrude)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Nina Bracken, COPD Foundation advocate

Voting

2 net votes
2 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

Relation of environmental factors to lung injury

What is the relation of environmental factors such as cigarette smoke exposure to the risk of developing acute lung injury as well as the outcome from acute lung injury and sepsis?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

Diaphragmatic dysfunction in critical illness

Diaphragmatic dysfunction occurs more frequently than clinically recognized in the setting of acute critical illness or injury. This contributes to both incipient and prolonged respiratory failure, as well as the growth of long-term acute care/rehab hospitalizations. We need a better understanding of the mechanisms of dysfunction as well as strategies to mitigate loss of diaphragmatic muscle mass, ultimately leading ...more »

Submitted by (@greg.martin)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

This problem can be addressed through a combination of Integrative physiology and real-time data analytics.

Feasibility and challenges of addressing this CQ or CC :

Patients receiving critical care services in the United States are among the most close monitored, including continuous monitoring of cardiorespiratory physiology. Integrating high dimensional data from ICU data streams and applying big data analytics, in combination with primetime genomic and metabolomic technologies, makes answering this question imminently feasible.

Name of idea submitter and other team members who worked on this idea : Society of Critical Care Medicine Executive Committee/Council

Voting

-1 net votes
1 up votes
2 down votes
Active

Goal 2: Reduce Human Disease

Benefits of intraosseous access on outcomes from OHCA

Vascular access is a challenge in the setting of out-of-hospital cardiac arrest (OHCA). The failure of medications to impact outcomes may be in part related to the delay in drug delivery from the IV route. EMS systems have adopted intraosseous (IO) access but it is not clear if these are affecting outcome and there has been no large RCT. The current IO access devices are expensive and use different routes (sternal, tibia, ...more »

Submitted by (@dayam0)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

At over a 100 dollars per device, the costs of using an IO line for estimated 300K arrests in the United States is 30 million dollars. We need to know if this route works and the optimal location for placement.

Feasibility and challenges of addressing this CQ or CC :

Funding, willingness to study this in a well designed clinical trial

Name of idea submitter and other team members who worked on this idea : Mohamud Daya

Voting

0 net votes
2 up votes
2 down votes
Active

Goal 2: Reduce Human Disease

Dietary nitrates and the enterosalivary nitrate cycle

Are dietary fruits and vegetables, particularly leafy greens, protective against cardiovascular disease due to their ability to increase bioavailability of nitric oxide?

Submitted by (@nhlbiforumadministrator1)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Details on the impact of addressing this CQ or CC :

Understanding the biological rationale behind the benefit of a particular dietary component that promotes CV health will substantiate public health recommendations about diet.

Feasibility and challenges of addressing this CQ or CC :

Our understanding of the nitrate/nitrite cycle and of cardiovascular activity of nitric oxide has advanced rapidly in the past 10-15 years. The time is ripe for linking these advances in the science of nitrates to the consequences of dietary nitrate.

The role of dietary fruits and vegetables in the protection against cardiovascular disease is supported by many studies, especially leafy green vegetables. However, identification of the component of fruits and vegetables affording this protection has been elusive. Recent discoveries about the ability of the body to cycle dietary nitrates to produce bioactive nitric oxide via the enterosalivary cycle and lingual microbiome lends strength to the argument that leafy green vegetables may be protective due to their high nitrate content. This possibility should be examined in both large cohort studies and in clinical series. Would be helpful for the USDA to add nitrates to their standard database of food nutrients. NHLBI needs to partner with NCI to coordinate with ongoing research about the potential nitrosylation of dietary nitrites to carcinogenic n-nitrosamines in the setting of low antioxidant intake.

Name of idea submitter and other team members who worked on this idea : NHLBI Staff

Voting

17 net votes
52 up votes
35 down votes
Active

Goal 3: Advance Translational Research

Coordination of COPD care when comorbidities are present

How should providers coordinate management strategies and treatment goals in patients with COPD and other co-existing chronic diseases?

Submitted by (@jsullivan)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : Janice Cotton, COPD Foundation State Captain for IL, PPRN Governing Board Member

Voting

11 net votes
12 up votes
1 down votes
Active

Goal 2: Reduce Human Disease

Early cognitive rehabilitation

Does early cognitive rehabilitation (while on vent) improve long term cognitive function in ALI survivors?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

1 net vote
1 up votes
0 down votes
Active

Goal 2: Reduce Human Disease

What is the optimal process for terminal withdrawal of mechanical ventilation?

This palliative care process permits a natural death. The process is largely unstandardized and reflects local practice customs. In fact, the process may vary across ICUs and even within an ICU based on whose attending the patient. This process continues to be an under-investigated area of ICU care for terminally ill patients undergoing terminal ventilator withdrawal.

Submitted by (@megcampbell)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Voting

1 net vote
7 up votes
6 down votes
Active

Goal 2: Reduce Human Disease

Statins and ICU patients

Do statins improve the outcome of ICU patients with sepsis or at great risk of developing sepsis?

Submitted by (@nhlbiforumadministrator)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Compelling Question (CQ)

Name of idea submitter and other team members who worked on this idea : American Thoracic Society member

Voting

3 net votes
3 up votes
0 down votes
Active

Goal 3: Advance Translational Research

psychosocial care in sickle cell disease

What are the most effective trans-disciplinary and multi-level strategies for accelerating psychosocial care with sickle cell disease and how psychosocial factors impact families?

Submitted by (@sicklecellwarrior)

Is this idea a Compelling Question (CQ) or Critical Challenge (CC)? : Critical Challenge (CC)

Details on the impact of addressing this CQ or CC :

Since sickle cell has multiple layers in medical treatment strategies, how can the same thought process happen when it comes to psychosocial matters? How can the NHLBI develop effective patient engagement trans-disciplinary and multi-level strategies that work with medical strategies to deal with psychosocial matters for individuals and families?

Name of idea submitter and other team members who worked on this idea : Sickle Cell Warriors, Inc community members

Voting

38 net votes
46 up votes
8 down votes
Active