Showing 7 ideas for tag "pediatric"

Goal 3: Advance Translational Research

Pathways for Developing Pediatric Medical Devices

There is a need to develop innovative means to attract appropriate medical device industries to develop devices for the treatment and/or diagnosis of cardiovascular, pulmonary, or blood diseases in young children.

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

Details on the impact of addressing this CQ or CC

A greater number of needed medical devices for pediatric would be developed and made clinically available for children with cardiovascular, pulmonary, or blood diseases.

Feasibility and challenges of addressing this CQ or CC

This will involve developing innovative ways of using NIH funds (e.g. RFA requiring public-private partnerships or other cost-sharing methods) to incentivize industry. These (and others) should certainly be feasible over a 5-10 year span to implement. However, this leads to the question of how NIH might facilitate such public-private partnerships and cost-sharing methods. Partnering with NICHD on this work would be appropriate.

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

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13 net votes
23 up votes
10 down votes
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Goal 1: Promote Human Health

Developmental Origins of Adult Lung, Heart and Blood Disease

It all starts in childhood. Yet it is difficult to find funding to really study these questions because the follow up timeline is long and thus very expensive but critically important. We don't even know what the "right" way to feed infants is in the first year of life to both limit cardiometabolic syndrome but also preserve neurodevelopmental outcome. We also have just started to see the tii of the iceberg in understanding... more »

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

Feasibility and challenges of addressing this CQ or CC

We need a cohort of clinical investigators that understand that what we do in early infancy affects us later. The failure of the children's long-term study should not dissuade us from the importance of this concept.

Name of idea submitter and other team members who worked on this idea Rita Ryan

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22 net votes
41 up votes
19 down votes
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Goal 2: Reduce Human Disease

Optimal hemoglobin threshold for transfusion in children with ARDS?

Do different hemoglobin transfusion thresholds alter outcomes in children with ARDS? What is the optimal *minimum* transfusion threshold for children with ARDS? What patient-centered outcomes can be affected by transfusion strategies: ventilator free days, time to organ function recovery, duration of intensive care stay, survival?

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 Society of Critical Care Medicine Executive Committee/Council

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8 net votes
9 up votes
1 down votes
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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.

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

Details on the impact of addressing this CQ or CC

Mortality rates for acute lung injury in pediatrics vary from about 10-30%. Immunosuppressed patients and those with cancer have higher rates. Morbidity following long ICU stays have social impacts on family and education, and can put patients at risk of future lung complications.

Though ECMO shows promise of improving outcomes, large clinical studies are lacking. ECMO is also fraught with signifiant risks and high costs. A molecular understanding of the pathobiology of lung injury could lead to specific therapies to improve survival and decrease morbidity.

Feasibility and challenges of addressing this CQ or CC

(1) The heterogeneity of both adults and children with lung injury hinders the applicability of clinical and translational studies. (2) Reliable animal models of pediatric lung injury are lacking.

Name of idea submitter and other team members who worked on this idea Rebecca Turcotte

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4 net votes
4 up votes
0 down votes
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Goal 2: Reduce Human Disease

Effect of obesity on recovery of lung function in pediatric survivors of critical illness

What are the determinants of persistent respiratory failure in children? Are obese children at greater risk for prolonged mechanical ventilation than non-obese children? Does BMI affect the time to recovery of lung function in obese children with ARDS? What is the pathogenesis and molecular contributors of obesity on respiratory failure in critical illness?

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 Society of Critical Care Medicine Executive Committee/Council

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1 net vote
3 up votes
2 down votes
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Goal 2: Reduce Human Disease

Redefining asthma: origins of obstructive airways disease

Can detailed longitudinal study of lung disease in infancy/early childhood improve our understanding of the origins of obstructive airways disease, and the variation seen in asthma phenotypes and severity?

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

Details on the impact of addressing this CQ or CC

Asthma is, to some extent, an umbrella term that encompasses a broadly heterogenous (in severity, symptoms, and pathophysiology) group of obstructive lung diseases. This is even more true if we examine the "wheezy infant," a population defined almost exclusively by the presence of wheeze, cough, or noisy breathing with very little understanding of disease mechanism or pathophysiology, and few evidence-based treatment options. Improving our understanding of the pathophysiology of wheeze and recurrent cough in early childhood, and how these evolve into various phenotypes of "asthma," through comprehensive longitudinal study of infants and young children may lead to better endotyping of disease and improved therapeutic options, as well as the possibility of disease prevention.

Feasibility and challenges of addressing this CQ or CC

We lack adequate biomarkers (of inflammation, structural and functional lung disease, microbiome, nutrition, etc) to investigate lung disease in infancy and early childhood. Identifying biomarkers with adequate sensitivity, and with a safety profile that allows for repeated measures in large groups of children, will be key to identifying the early childhood origins of all lung diseases.

Name of idea submitter and other team members who worked on this idea Jessica Pittman

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7 up votes
14 down votes
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Goal 2: Reduce Human Disease

Research priorities in Pediatric Cardiomyopathy and Heart Failure

If NHLBI set research priorities for pediatric cardiomyopathy and heart failure, it would help investigators better align their application with institute goals.

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

Details on the impact of addressing this CQ or CC

The most promising areas are genotype-deep phenotype studies, advances in cardiac imaging to quantify extracellular volume as a measure of fibrosis; working with industry to develop better VADS/pre-transplant devices for small children, QOL studies in heart transplant children and their families, personalized medicine, pharmacogenomics, RCTs for new heart failure interventions and also cardiac rehabilitation, leverage and expand registries to support RCTs, molecular mechanism studies including studies of restrictive physiology, using genomic findings to directly inform clinical practice.

Name of idea submitter and other team members who worked on this idea Jwilkins1953

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