Novel Digital Methods to Evaluate Functional and Pulmonary Outcomes following Pediatric Acute Respiratory Failure

评估小儿急性呼吸衰竭后功能和肺部结果的新型数字方法

• 批准号: 10724042
• 负责人: Elizabeth Y Killien
• 金额: $ 40.88万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10724042
• 关键词: Accelerometer; Acute; Acute respiratory failure; Adult; Airway Disease; Attenuated; Caregivers; Caring; Child; Childhood; Chronic; Clinical Research; Clothing; Critical Illness; Cystic Fibrosis; Data; Devices; Diameter; Eligibility Determination; Evaluation; Future; Gold; Health; Health Resources; Hospitalization; Hospitals; Impairment; International; Intervention; Intervention Trial; Laboratories; Longitudinal Studies; Longitudinal cohort study; Lung; Lung diseases; Measurement; Measures; Mechanical ventilation; Medical; Methods; Monitor; Outcome; Outcome Measure; Patient Outcomes Assessments; Patient Participation; Patient Selection; Patients; Pediatric Intensive Care Units; Persons; Physical Function; Physical activity; Physical assessment; Population; Positioning Attribute; Pulmonary Function Test/Forced Expiratory Volume 1; Pulmonary function tests; Recovery; Recovery of Function; Research; Sample Size; Spirometry; Surveys; Testing; Time; Work; Wrist; actigraphy; aged; awake; design; digital; digital technology; digital tool; disparity reduction; experience; follow-up; functional outcomes; health related quality of life; high risk; improved; novel; patient retention; prospective; pulmonary function; remote assessment; respiratory; study population; technology validation; telecoaching; telehealth; ventilation; wearable device

PROJECT SUMMARY Children who survive critical illness requiring prolonged mechanical ventilation are at high risk of significant and long-lasting sequelae including physical and pulmonary function impairments and impairments in health-related quality of life and the ability to return to previously normal activities. These impairments may be mitigated through targeted interventions during the pediatric intensive care unit stay or after discharge. The ability to effectively test interventions is hindered by insufficient methods to objectively quantify post-discharge physical and pulmonary impairments across representative study populations without significant attrition. Additionally, we have an incomplete understanding of the relationship between trajectory recoveries across different health domains and methods of measurement. The objective of this proposal is to validate the use of digital technologies to objectively measure physical activity and pulmonary function and evaluate the relationship between recovery trajectories of objectively measured physical and pulmonary functioning and patient-reported outcomes including health-related quality of life and activity participation in children surviving acute respiratory failure. We will compare the BioIntellisense BioButton, a discreet wearable device used in adults to monitor physical activity and the Spirobank Smart Spirometer, a remote digital spirometer, against the gold standards of wrist-worn accelerometry and laboratory spirometry, respectively. We will also collect patient-reported outcomes evaluating health-related quality of life and activity participation. This proposal will identify and validate strategies for remote follow-up of children that optimize patient participation and retention using digital technologies to expand patient representation and reduce disparities in clinical research participation. Additionally, it will inform a future R01 proposal to test an intervention aimed at recovery after pediatric acute respiratory failure by providing a more comprehensive understanding of the associations between recovery of physical and pulmonary functioning, health-related quality of life, and activity participation.

项目摘要 在需要延长机械通气的危重疾病中幸存的儿童具有重大意义的高风险和 长期后遗症，包括身体和肺功能障碍和与健康有关的损害 生活质量和返回以前正常活动的能力。这些障碍可能会缓解 通过小儿重症监护病房期间或出院后的针对性干预措施。能力 有效地测试干预措施受到了不足的方法来客观地量化病后物理 以及代表性研究人群之间的肺部障碍，没有大量损耗。此外， 我们对不同健康的轨迹回收率之间的关系有不完全的了解 域和测量方法。该提案的目的是验证数字的使用 能够客观地衡量身体活动和肺功能并评估关系的技术 在客观测量的身体和肺功能的恢复轨迹之间以及患者报告 结果包括与健康相关的生活质量和活动参与急性呼吸系统的儿童 失败。我们将比较Biointellisense Biobutton，这是一种用于监视的成人的谨慎可穿戴设备 体育锻炼和Spirobank智能螺旋仪，一种远程数字螺旋计，符合黄金标准 分别是腕部加速度测定法和实验室肺活量测定法。我们还将收集患者报告 评估与健康相关的生活质量和活动参与的结果。该建议将确定并 验证远程跟踪儿童的策略 扩大患者代表性并减少临床研究参与中的差异的技术。 此外，它将为未来的R01提案提供旨在测试旨在恢复小儿急性后恢复的干预措施的建议 通过对恢复之间的关联有更全面的了解，呼吸衰竭 身体和肺部功能，与健康相关的生活质量以及活动参与。