Showing 3 ideas for tag "support"

Goal 2: Reduce Human Disease

Understanding Right Ventricular Function and Failure

There is a need for understanding of right heart failure (RHF) and its consequences following left ventricular assist device (LVAD) support, as well as to develop devices to optimally support the right ventricle.

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

Details on the impact of addressing this CQ or CC

Understanding the pathophysiology and risk factors of right heart failure in the context of LVAD use might lead to preventative and therapeutic options for these patients.

Feasibility and challenges of addressing this CQ or CC

Current resources in terms of a National Registry for VADS (INTERMACS) exists and can be leveraged.
While we have a substantial understanding of the risk factors associated with poor outcomes of patients with heart failure and left ventricular dysfunction, much less is known about the syndrome of heart failure and right ventricular (RV) dysfunction. Right-sided heart failure occurs in approximately 20% of patients receiving LVAD support. Investigation into the pathophysiology of right ventricular failure and its consequences following LVAD support, including identification of risk factors and treatment strategies, remains a high priority according to the Joint NHLBI-American Association for Thoracic Surgery (AATS) Working Group convened in 2011 (http://aats.org/CME/2011-AATS-NHLBI-Symposium.cgi). Development of new devices designed to optimally support the RV are warranted.

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

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19 net votes
31 up votes
12 down votes
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Goal 2: Reduce Human Disease

Optimal Use of mechanical circulatory support devices to Minimize Pump Thrombosis & AEs

There is a need for the development of a collaborative observational study that leverages off of existing registries, such as INTERMACS and STS, that will follow mechanical circulatory support devices (mechanical circulatory support device) patients prospectively and collect process-of-care data to identify 1) optimal approaches for the management of patients and 2) pumps to minimize the occurrence of adverse hemodynamic... more »

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

Details on the impact of addressing this CQ or CC

Completion of the proposed observational study would optimize mechanical circulatory support device/left ventricular assist device use and minimize serious adverse events such as pump thrombosis.

Feasibility and challenges of addressing this CQ or CC

Use of mechanical circulatory support is expanding to less sick populations, so optimal and safe use of these devices is critical.
Mechanical circulatory support devices (mechanical circulatory support device) have become important therapeutic options for patients with advanced heart failure. Considerable efforts are underway to develop newer generations of devices that are smaller, more durable and reliable, with fewer adverse events. However, mechanical circulatory support devices that are currently being used continue to have considerable risks and hemodynamic complications associated with them including bleeding, stroke, and intra-pump thrombus formation. Many factors influence the occurrence of these adverse events in patients receiving mechanical circulatory support devices, including patient selection, patient management such as the anticoagulation regimen used, pump selection, surgical placement and implantation of the pump, and mechanical aspects of the pump including pump speed and pulsatility, among other factors. The existence of multiple factors and complexities influencing and contributing to these adverse event outcomes preclude a standard clinical trial approach.

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

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4 net votes
15 up votes
11 down votes
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Goal 2: Reduce Human Disease

Linking Clinics and schools to improve asthma control and reduce health disparities

How can we improve communication between schools and clinicians in order to develop support systems for children with severe asthma with health disparities?

 

How can we eliminate inefficiency in medical communication to better serve children with severe asthma?

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

Details on the impact of addressing this CQ or CC

Children with asthma, especially severe asthma, are compromised by school absence and sleep disturbance. School scan play a significant role in identifying these children, assisting in monitoring their adherence to therapy and supporting the clinician's management plan. However, steps must be taken to improve communication systems that link clinics to schools and allow schools to communicate effectively with clinicians. While systems are in place for some schools that have active asthma management programs, there are many schools that do not have these resources or infrastructure. Model systems can be developed to assist these schools and improve the overall care of asthma in the United States.

Feasibility and challenges of addressing this CQ or CC

Challenges that must be overcome is standardization of communication forms and harmonization of approach to asthma care, as well resolving barriers that exist due to confidentiality barriers in sharing medical information.

Name of idea submitter and other team members who worked on this idea Stanley Szefler, MD

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6 net votes
12 up votes
6 down votes
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