Exhaled Biomarkers of Pulmonary Infection in the Critically Ill

描述(由申请者提供)：应聘者提出职业发展途径独立奖，以进一步发展在生物行为临床研究领域的研究技能。该提案的每个目标都得到教学课程、研究培训经验、科学会议和研讨会的支持，包括详细的传播计划。候选人的最终职业目标是成为一名独立科学家，专注于改善机械通气危重患者的护理和预后。呼吸机相关肺炎(VAP)是一种发病率和死亡率高的急性护理并发症，增加了住院时间和医疗资源的使用。建议的K99研究项目的目的是评估机械通气人群中呼出的生物标志物和护理因素，以更好地了解机械通气危重患者中的肺部感染。主要目的是评估呼气生物标记物、全身生物标记物与危重MV患者肺部感染的关系。第二个目的是检查这些患者的护理因素(位置和肺部卫生)，以及这些因素与呼气成分、呼气生物标志物和肺部感染的关系。血浆和呼气样本将从气管内插管的成人身上收集，用于生物标志物分析，以评估其与肺部感染评分的一致性和相关性。此外，还将收集护理因素(定位和肺部卫生)数据，并评估其与呼气生物标记物和肺部感染评分的相关性。这项研究提案的总体目标是为候选人提供与肺部感染相关的生物标记物分析和护理因素知识的基础，并推进候选人旨在改善危重病患者肺健康结局的研究计划。此外，通过了解护士指导护理对机械通气患者呼气生物标志物和肺部感染的影响，这项研究将为这些疗法的病理意义提供基础性的见解，并可能产生未来临床相关的研究假设。 公共卫生相关性：呼吸机相关性肺炎是机械通气危重患者的严重并发症。检测呼吸可以更早地诊断感染，更好地了解呼吸机相关性肺炎。此外，检查机械通气患者的护理效果可能导致采取干预措施降低呼吸机相关性肺炎的风险。

DESCRIPTION (provided by applicant): The candidate proposes a career development Pathways to Independence award to further develop research skills in the area of biobehavioral clinical research. Each aim of the proposal is supported by didactic coursework, research training experiences, scientific meetings and seminars including a detailed dissemination plan. The candidate's ultimate career goal is to become an independent scientist focused on improving care and outcomes of the mechanically ventilated critically ill. Ventilator-associated pneumonia (VAP) is an acute care complication with high morbidity and mortality, which increases length of stay and health care resources used. The purpose of the proposed K99 research project is to evaluate exhaled biomarkers and nursing care factors in the mechanically ventilated population to obtain a better understanding of pulmonary infection in the mechanically ventilated critically ill population. The primary aim is to evaluate relationships of exhaled biomarkers, systemic biomarkers and pulmonary infection in critically ill MV patients. The secondary aim is to examine nursing care factors (positioning and pulmonary hygiene) in these patients and the relationship between those factors and exhaled breath composition, exhaled biomarkers and pulmonary infection. Plasma and exhaled breath samples will be collected from endotracheally intubated adults for biomarker analysis which will be assessed for agreement and association with pulmonary infection scores. Additionally, nursing care factor (positioning and pulmonary hygiene) data will be collected and assessed for association with exhaled biomarkers and pulmonary infections scores. The overall goal of this research proposal is to provide the candidate with a foundation in biomarker analysis and knowledge of nursing care factors that are associated with pulmonary infection and advance the candidate's research program aimed at improving pulmonary health outcomes of the critically ill. Additionally, by understanding the effect of nurse-directed care on exhaled biomarkers and pulmonary infection in mechanically ventilated patients, this study will provide foundational insight into the pathological significance of these therapies and may generate future clinically relevant research hypotheses. PUBLIC HEALTH RELEVANCE: Ventilator-associated pneumonia is a serious complication in mechanically ventilated critically ill patients. Testing the breath could allow for earlier diagnosis of infection and better understanding of ventilator- associated pneumonia. Additionally, examining the effect nursing care of mechanically ventilated patients may lead to interventions to reduce the risk of ventilator-associated pneumonia.