(@nhlbiforumadministrator)

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 »

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1 net vote
1 up votes
0 down votes
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(@kevinfiscella)

Goal 3: Advance Translational Research

Addressing Health Care Disparities Requires Pragmatic Research

Jumpstarting progress in eliminating health care disparities requires comparative effectiveness and implementation research (T3 and T4) regarding optimal strategies for ensuring health care equity in the real world. Ensuring minority and other socially disadvantaged groups receive and benefit from evidence-based interventions at the same rate as others requires pragmatic research that identifies and addresses barriers... more »

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6 net votes
9 up votes
3 down votes
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(@nhlbiforumadministrator)

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 »

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1 net vote
1 up votes
0 down votes
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(@k.willard)

Goal 3: Advance Translational Research

Predicting COPD exacerbations and relapse

What measures other than PFT data can be used to predict risk of 1) COPD exacerbations (e.g., hospitalization, urgent care visit, or ED visit for COPD exacerbation) or 2) relapse (e.g., re-hospitalization, urgent care visit, or ED visit) following hospital discharge after treatment of COPD exacerbations?

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14 net votes
16 up votes
2 down votes
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(@nhlbiforumadministrator)

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 »

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1 net vote
1 up votes
0 down votes
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(@greg.martin)

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 »

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-1 net votes
1 up votes
2 down votes
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(@rft2106)

Goal 2: Reduce Human Disease

What are the molecular mechanisms of lung injury, and how do they differ in children?

Both adults and children have significant morbidity and mortality due to lung injury, but have different etiologies and outcomes. It is possible that the underlying pathobiology in the two groups is different. There are no targeted therapies for lung injury, indicating that the cause is still not understood.

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4 net votes
4 up votes
0 down votes
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(@megcampbell)

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.

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1 net vote
7 up votes
6 down votes
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(@swilliams1)

Goal 3: Advance Translational Research

Best Practices for implementation of guidelines in COPD community care

How can guideline recommendations be implemented into community practice in a way that is feasible, usable, relevant, and cost-effective? (examples are use of care management, translation of chronic care model, and EMR based tools)

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9 net votes
11 up votes
2 down votes
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(@dayam0)

Goal 4: Develop Workforce and Resources

Enhancement of the Medical Home and Medical Community with the use of EMS providers

Traditionally the Health Care model has meant that patients come to HCF for their care. Hospitals are increasingly overcrowded and also not always the best place to be due to the risk for nosocomial infections. Utilizing existing community resources to enhance the health both acute and chronic deserves exploration at the national level. Training paramedics to do chronic disease monitoring as well as as remotely work with... more »

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3 net votes
4 up votes
1 down votes
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