Palliation of symptoms associated with a number of pulmonary conditions; promotion of patient participation in symptom self-management across the spectrum of illness, from ICU admission to rehabilitation to home; requires a multi-disciplinary perspective and team. There are a plethora of distressing symptoms (anxiety, shortness of breath, cough, fatigue, weakness) associated with a number of chronic pulmonary conditions, ...more »
We know that vasopressin layered on to norepinephrine treatment for septic shock tends to produce better outcomes (VASST trial, Russell et al) than norepinephrine alone. We still need to know if norepinephrine should be first line or if vasopressin should be first line (and perhaps monotherapy) for septic shock.
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?
Large scale implementation of “change of culture” studies by which to revamp the approach to early removal of sedation and mechanical ventilation, coupled with monitoring of the brain and early mobility.
Does early cognitive rehabilitation (while on vent) improve long term cognitive function in ALI survivors?
Does early mobilization, i.e. as soon as mechanical ventilation begins, improve long term outcomes in ALI survivors??
Do statins improve the outcome of ICU patients with sepsis or at great risk of developing sepsis?
What is the most effective way to phenotype (classify) patients with respiratory failure requiring mechanical ventilation?
Ventilating patients in the operating room constitutes the largest number of patients exposed to mechanical ventilation in this country and world wide [many millions of patients]. Postoperative pulmonary problems may, in part, due to the mechanical ventilation received in the OR. Yet, this cohort has never been systematically studied in terms of the effect of specific ventilatory patterns on postoperative outcomes. Data ...more »
1. Does pulmonary rehabilitation (PR) reduce mortality risk? 2. Does PR in the post-hospitalization period reduce subsequent health care utilization? 3. Can the principles of PR be applied more broadly across the disease spectrum to reduce morbidity, mortality, and health care expenditures in patients with COPD? 4. Does early PR following hospitalization for acute exacerbation reduce mortality and readmission rates ...more »
How can we increase physical activity in our COPD patients?
Does a collaborative self management plan for COPD reduce or increase mortality risk? (based on two conflicting VA studies)
Early detection and treatment of COPD
a. Best tests to detect
b. Impact of early treatment
c. Impact of early treatment on disease progression
a. Enhance our understanding of the behavioral issues that lead to smoking addiction
b. Explore effective behavioral and pharmacological and non-pharmacological mechanisms to reverse smoking addiction
Challenge the unspoken of high cost, high risk and unclear benefits of current COPD care a. PRCT of lung transplantation vs. optimized medical care b. Noninvasive ventilation for treatment of chronic severe respiratory failure c. Chronic combined vs. de-escalation of chronic bronchodilator therapy to as needed for GOLD stages III-IV d. Self management programs in COPD e. Telemedicine in outpatient management of severe ...more »