LONG-TERM OUTCOMES OF SPECIFIC VENTILATOR STRATEGIES

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acute Lung Injury (ALI) is relatively common and associated with significant short term mortality. The incidence of ALI is estimated to be 75 per 100,000 persons (Ware 2000) and historically has had 40% hospital mortality (Hudson 1998; Stewart 1998; Brochard 1998; Amato 1998; Brower 1999). Evidence from the ALI Network suggests that 28-day mortality can be reduced from 40% to 31% with the use of Conventional Ventilation Lung Protection (CVLP) (ARDS Network 2001). Despite this evidence, little is known regarding the long-term mortality and outcomes in ALI subjects or whether CVLP improves these long-term outcomes. To improve the care of subjects with ALI, we need to better understand the barriers to compliance with CVLP, the long-term mortality and other outcomes associated with ALI, and the therapies that may be associated with those outcomes. This observational cohort study presents a unique opportunity to identify exposures and long-term outcomes in ALI subjects. Exposures will be determined by daily observation of subjects' therapies received in the ICU (including CVLP) and their medical course (e.g., severity of illness). Outcomes will be observed at 3, 6, 12 and 24 months after diagnosis of ALI to assess the following categories of outcomes: disorders of biologic functioning (e.g., need for hemodialysis), clinical events (e.g. repeat hospitalization), and patient reported outcomes (quality of life). Through this improved understanding, this study will add important new knowledge of ways to improve the care of subjects with ALI.