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?
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.
How can we ensure that patients with serious heart, lung, or blood diseases fully understand their prognosis, treatment options, and the risks and benefits of those options and help them make decisions that fully incorporate their own personal values, goals, and treatment preferneces?
Does early cognitive rehabilitation (while on vent) improve long term cognitive function in ALI survivors?
Does palliative care and/or hospice care as practiced across communities improve end-of-life care for COPD – specifically, does it reduce the burden of symptoms, improve HRQoL and satisfaction, reduce utilization in last 6 months of life (i.e. hospital visits, cost, invasive ventilation use, etc), improve the end-of-life experience, and increase the concordance of place of death to expressed patient preferences?
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 »
Can novel therapeutics including cell-based therapy be tested in patients with severe acute lung injury (P/F <200) and shock (need for vasopressors) since these are the patients with the highest mortality (> 30%) based on NHLBI ARDS Network data?
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 »
How should providers coordinate management strategies and treatment goals in patients with COPD and other co-existing chronic diseases?
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?
What can be done in primary care settings to increase appropriate provider assessment of the need for oxygen and prescription of LTOT?
Would an NIH trans-IC office of critical care research improve coordination and strategic planning across?