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?

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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

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Goal 2: Reduce Human Disease

Embrace and fund RCTs that enroll heterogeneous samples of patients

Critical care medicine comprises a diffuse array of diseases, syndromes, illnesses and symptoms arising from those sources requiring advanced care by highly trained teams of interdisciplinary professionals. Research is sorely needed on generating evidence that is broadly applicable to a heterogeneous group of patients. This is a major challenge for researchers who enroll critically ill patients into their clinical trials. ...more »

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

This will require a different mind-set by grant reviewers.

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

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Goal 2: Reduce Human Disease

Palliation of symptoms associated with pulmonary conditions; promotion of patient participation in symptom self-management

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 »

Submitted by (@nhlbiforumadministrator)

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

Details on the impact of addressing this CQ or CC :

Innovative symptom management strategies are needed that empower patients and their family members to engage in self-management strategies across the spectrum of illness from hospitalization through recovery.

Feasibility and challenges of addressing this CQ or CC :

Longitudinal studies with a multi-disciplinary team of investigators are needed to address the varying needs of these patients and their family members over the course of recovery or transition to death in these patients. Interventions need to be cost-effective and prevent readmission to the critical care unit.

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

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Goal 2: Reduce Human Disease

Vasopressin layered on to norepinephrine treatment for septic shock

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.

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

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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

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Goal 2: Reduce Human Disease

“Change of culture” studies

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.

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

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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

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Goal 2: Reduce Human Disease

Effect of early mobilization

Does early mobilization, i.e. as soon as mechanical ventilation begins, improve long term outcomes 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

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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

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Goal 2: Reduce Human Disease

Phenotyping patients with respiratory failure requiring mechanical ventilation

What is the most effective way to phenotype (classify) patients with respiratory failure requiring mechanical ventilation?

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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

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Goal 2: Reduce Human Disease

Postoperative respiratory failure

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 »

Submitted by (@nhlbiforumadministrator)

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

Feasibility and challenges of addressing this CQ or CC :

There is an international trial [Provilho] but no US trials.

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

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