Five Year Outcomes from Acute Lung Injury

急性肺损伤的五年结果

• 批准号: 8126292
• 负责人: Peter J. Pronovost
• 金额: $ 19.57万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-11 至 2014-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8126292
• 关键词: Acute; Acute Lung Injury; Adrenal Cortex Hormones; Adult Respiratory Distress Syndrome; Anxiety; Blood capillaries; Caring; Cessation of life; Clinical Research; Cohort Studies; Critical Illness; Death Rate; Delirium; Diffuse; Epidemiology; Frequencies; Funding; Future; Goals; Grant; HIV Infections; Hypoxia; Incidence; Instruction; Intensive Care; Intensive Care Units; Intervention; Intervention Studies; Knowledge; Lead; Learning; Left; Longitudinal Studies; Lung; Mechanical ventilation; Medical; Mental Depression; Mental Health; Mental disorders; Mentors; Mid-Career Clinical Scientist Award (K24); Morbidity - disease rate; Muscle Weakness; Outcome; Patients; Persons; Physical Function; Post-Traumatic Stress Disorders; Prevalence; Psyche structure; Public Health; Quality of life; Recovery; Research; Research Design; Research Infrastructure; Research Proposals; Respiratory Failure; Risk Factors; Sampling; Sepsis; Severities; Survivors; Symptoms; Syndrome; United States National Institutes of Health; capillary; cohort; design; epidemiology study; experience; follow-up; functional status; improved; malignant breast neoplasm; mortality; nutrition; patient oriented research; physical conditioning; prospective; randomized trial; research study

DESCRIPTION (provided by applicant): Acute Lung Injury (ALI) is a syndrome characterized by acute, diffuse pulmonary capillary leak resulting in hypoxic respiratory failure. ALI imposes a significant public health burden with an incidence of 86 per 100,000 person years and a total number of deaths similar to breast cancer or HIV infection. Due to advances in medical care, the mortality rate for ALI has decreased from -70% to -40%. Patients who previously may have died now survive ALI; however, their recovery is often long and complicated. Research studying the long-term outcomes of these ALI survivors has become increasingly important. The present application is a third submission for a K24 award. The PI is a leader is patient -oriented research in critically ill patients especially those with ALI, and has an outstanding record of mentoring trainees. The goal of this proposal is to learn how existing ICU therapies can be used to minimize long-term physical and mental health morbidities and improve patients' functional status and quality of life after ALI. We propose to extend our existing NIH funded cohort study, which follows patients for 2 years after ALI, to allow 5-year follow-up. Specifically, we will study the epidemiology of muscle weakness, and symptoms of anxiety, depression and post-traumatic stress disorder at up to 5 years after ALI [Aims 1a and 2a] and the association of these sequelae with limitations in patients' physical function and quality of life. We will then determine the association of nutrition and corticosteroids in the ICU with long-term muscle weakness[Aim 1b]. We also will determine the association of delirium and corticosteroids in the ICU with long-term symptoms of post-traumatic stress disorder [Aim 2b]. A number of research opportunities exist for trainees. This research proposal describes a new cohort study of ALI patients who will be followed for 5 years. This research will provide new knowledge regarding the frequency of morbidities after ALI, their consequences for patients, and how nutrition, corticosteroids and delirium in the ICU may reduce or exacerbate these morbidities up to 5 years after ALI. The study will add to our infrastructure for trainees to participate in clinical research and to design future studies, including intervention studies, to improve outcomes in ALI patients. RELEVANCE (See instructions): Acute lung injury is a significant public health problem that can lead to death or long-term physical and mental illnesses. While death rates have been decreased by advances in medical care, the recovery period from ALI is long and patients are left with significant morbidity. This grant would research existing ICU therapies that could improve recovery and reduce long-term physical and mental health morbidities from ALI.

描述（由申请人提供）：急性肺损伤（ALI）是一种综合征，其特征是急性，弥漫性肺毛细管泄漏，导致低氧呼吸衰竭。阿里施加了重大的公共卫生负担，每100,000人的发生率为86，与乳腺癌或艾滋病毒感染相似的死亡人数总数为86。由于医疗保健的进步，ALI的死亡率已从-70％降至-40％。以前可能已经死亡的患者现在幸存下来。但是，他们的恢复通常很长而复杂。研究这些ALI幸存者的长期结果的研究变得越来越重要。本申请是K24奖励的第三份提交。 PI是领导者，是针对危重患者尤其是患有ALI的患者的患者研究，并且具有出色的指导学员记录。该建议的目的是了解如何使用现有的ICU疗法来最大程度地减少长期身心健康的病态，并改善患者在ALI之后的功能状况和生活质量。我们建议扩展我们现有的NIH资助的队列研究，该研究跟随患者在ALI之后2年，以进行5年的随访。具体而言，我们将研究肌肉无力的流行病学，以及在ALI后5年的焦虑，抑郁和创伤后应激障碍的症状[AIMS 1A和2A]，以及这些后遗症与患者身体功能和生活质量的限制之间的关联。然后，我们将确定ICU中的营养和皮质类固醇与长期肌肉无力的关联[AIM 1B]。我们还将确定ICU中del妄和皮质类固醇与创伤后应激障碍的长期症状的关联[AIM 2B]。学员存在许多研究机会。这项研究建议描述了一项新的队列研究，对ALI患者进行了5年的追踪。这项研究将提供有关ALI后病原体的频率，对患者的后果以及ICU中​​的营养，皮质类固醇和del妄如何减少或加剧这些病态后5年后的营养，皮质类固醇和ir妄，最多可在ALI后5年减少或加剧这些病态。这项研究将增加我们的基础设施，以供受训者参与临床研究并设计包括干预研究在内的未来研究，以改善ALI患者的预后。相关性（请参阅说明）：急性肺损伤是一个重大的公共卫生问题，可能导致死亡或长期的身体和精神疾病。尽管医疗保健的进展降低了死亡率，但阿里的恢复期很长，患者的发病率很高。这项赠款将研究现有的ICU疗法，这些疗法可以改善恢复并减少ALI的长期身心健康。