Showing 30 ideas for tag "critical"
(@greg.martin)

Goal 2: Reduce Human Disease

Novel methods to diagnose and treat microvascular ischemia

Microvascular ischemia is common, particularly in the setting of critical illness. We need better ways to evaluate, diagnose and treat these conditions, whether they relate to microvascular myocardial ischemia, as a primary diagnosis of complication of other acute illness, or non-myocardial ischemia during the course of surgery, injury, infection or acute illness.

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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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(@nhlbiforumadministrator)

Goal 3: Advance Translational Research

Novel therapeutics for patients with severe acute lung injury

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?

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(@greg.martin)

Goal 2: Reduce Human Disease

Pathogenesis and treatment of cardiovascular disease in survivors of critical illness.

Acute cardiovascular complications are frequent in critical illness and injury, occurring on a spectrum that includes troponin leak or demand ischemia to acute occlusive coronary events and lethal arrhythmias. They arise in the course of similar acute illnesses but they epidemiology, pathogenesis, treatment and long-term consequences are unknown. Are they the result of a generalized inflammatory state that persists... more »

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(@greg.martin)

Goal 2: Reduce Human Disease

National ARDS Registry

ARDS remains one of the most common and lethal forms of respiratory failure in critically ill patients. Improvements in understanding the pathogenesis has not led to effective treatments, and heterogeneity of the condition precludes major advances. A national registry would serve to improve understanding of epidemiology, disease characterization (for definitions) and can identify incidence, outcome, disparities, treatment... more »

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(@nhlbiforumadministrator)

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.

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(@greg.martin)

Goal 2: Reduce Human Disease

National network to study the pathobiology of sepsis

Sepsis is the leading cause of death in hospitalized patients, the 3rd leading cause of death in all people in the US, the most common condition leading to widespread vascular collapse, among the most common causes of respiratory failure, and a frequent cause of acute cardiac dysfunction.

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(@greg.martin)

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?

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(@greg.martin)

Goal 3: Advance Translational Research

Durable gene activity map at the individual level

A durable gene activity map of the individual to understand when certain gene sets are on vs off or dysfunctional over an individual’s lifetime as one way of guiding the precision of medicine for that patient. It would need to be person portable and universally exportable and interpretable across all of the EHRs.

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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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(@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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(@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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