Aerosolized xylitol for ventilator-associated pneumonia

雾化木糖醇治疗呼吸机相关性肺炎

• 批准号: 6909404
• 负责人: LAKSHMI DURAIRAJ
• 金额: $ 12.5万
• 依托单位: UNIVERSITY OF IOWA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6909404
• 关键词: Pseudomonas; aerosols; antibacterial agents; bacterial pneumonia; bronchoscopy; clinical research; clinical trials; diagnostic respiratory lavage; disease /disorder prevention /control; drug screening /evaluation; hospital length of stay; human subject; human therapy evaluation; iatrogenic disease; inhalation drug administration; intubation; nosocomial infections; patient oriented research; respirators; respiratory therapy; spirometry; sugar alcohols

DESCRIPTION (provided by applicant): In this mentored patient-oriented research career development award, Lakshmi Durairaj seeks to gain expertise in clinical trials in the intensive care unit with particular emphasis on the prevention of ventilator associated pneumonia. This award will support the development of Dr. Durairaj into an independent researcher and an accomplished clinician-scientist. Drs. Joseph Zabner and James Torner will assume responsibility as the primary mentors to ensure a successful career development. The focus of this proposal is to study the effectiveness of a new intervention namely xylitol, a 5-carbon sugar, for the prevention of ventilator-associated pneumonia, a common nosocomial infection among ventilated patients. Dr. Durairaj has completed her didactic training in clinical epidemiology which also included classes in statistical methods and ethics and has a Master's degree in Epidemiology. Specific areas of career development include further training in statistical methods specific for clinical trials, design of various phases of interventional trials, data collection methods, statistical analysis and interpretation of results and planning future studies in the intensive care unit. Human airways are lined by a thin layer of liquid, which contains many antimicrobial peptides which are more potent in lower salt concentrations. Tracheal colonization is an important step in the pathogenesis of ventilator-associated pneumonia, which is an important cause of increased mortality, length of stay, and cost in the intensive care unit. Xylitol is a non-absorbable osmolyte which lowers the salt concentration of airway surface liquid and has the potential to decrease respiratory tract colonization and infection. For this proposal, Dr. Durairaj will assess airway retention time of xylitol, its effectiveness in decreasing tracheal colonization in a group of mechanically ventilated patients, and conduct a pilot safety study for prevention of this pneumonia in a randomized, double-blinded, controlled fashion. Near the termination of this award, she will submit a competitive R-01 proposal to study xylitol for prevention of ventilator-associated pneumonia. Dr. Durairaj will interface with experts in clinical research, immunology, pulmonary and critical care medicine and infectious diseases at her institution. This intellectually rich environment will help foster the career development, providing ample opportunity for critical review throughout the period of this award. Both the mentor and the institution are highly committed to Dr. Durairaj's academic success.

描述（由申请人提供）： 在这个以患者为导向的研究职业发展奖中，Lakshmi Durairaj 寻求获得重症监护病房临床试验的专业知识，特别强调预防呼吸机相关性肺炎。该奖项将支持 Durairaj 博士发展成为一名独立研究员和一名卓有成就的临床医生科学家。博士。约瑟夫·扎布纳 (Joseph Zabner) 和詹姆斯·托纳 (James Torner) 将承担起主要导师的责任，以确保成功的职业发展。该提案的重点是研究一种新的干预措施（即木糖醇，一种 5 碳糖）对于预防呼吸机相关性肺炎（通气患者中常见的院内感染）的有效性。 Durairaj 博士完成了临床流行病学的教学培训，其中还包括统计方法和伦理学课程，并拥有流行病学硕士学位。职业发展的具体领域包括临床试验专用统计方法的进一步培训、介入试验各阶段的设计、数据收集方法、结果的统计分析和解释以及规划重症监护病房的未来研究。 人体呼吸道内衬有一层薄薄的液体，其中含有许多抗菌肽，在较低的盐浓度下更有效。气管定植是呼吸机相关肺炎发病机制中的重要一步，是导致重症监护病房死亡率、住院时间和费用增加的重要原因。木糖醇是一种不可吸收的渗透剂，可降低气道表面液体的盐浓度，并有可能减少呼吸道定植和感染。对于这项提案，Durairaj 博士将评估木糖醇的气道滞留时间、其在一组机械通气患者中减少气管定植的有效性，并以随机、双盲、对照的方式开展一项预防这种肺炎的试点安全性研究。在该奖项即将结束时，她将提交一份竞争性 R-01 提案，研究木糖醇预防呼吸机相关性肺炎。 Durairaj 博士将与她所在机构的临床研究、免疫学、肺病和重症监护医学以及传染病专家进行交流。这种智力丰富的环境将有助于促进职业发展，并在整个奖项期间提供充足的批判性审查机会。导师和机构都高度致力于 Durairaj 博士的学术成功。