Exhaled Biomarkers of Pulmonary Infection in the Critically Ill

描述（由申请人提供）：候选人提出了职业发展途径独立奖，以进一步发展生物行为临床研究领域的研究技能。该提案的每一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，包括一个详细的传播计划。候选人的最终职业目标是成为一名独立的科学家，专注于改善机械通气重症患者的护理和结果。呼吸机相关性肺炎（VAP）是一种急性护理并发症，发病率和死亡率高，增加了住院时间和医疗资源的使用。拟定的K99研究项目旨在评价机械通气人群的呼出气生物标志物和护理因素，以更好地了解机械通气危重症人群的肺部感染。主要目的是评估危重MV患者呼出生物标志物、全身生物标志物和肺部感染的关系。次要目的是检查这些患者的护理因素（体位和肺部卫生）以及这些因素与呼出气成分、呼出生物标志物和肺部感染之间的关系。将从气管内插管的成人中采集血浆和呼出气样本，用于生物标志物分析，将评估生物标志物分析与肺部感染评分的一致性和相关性。此外，将收集护理因素（体位和肺部卫生）数据，并评估其与呼出生物标志物和肺部感染评分的相关性。本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志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患者肺部健康结果的研究计划。此外，通过了解护士指导的护理对机械通气患者呼出生物标志物和肺部感染的影响，本研究将为这些治疗的病理意义提供基础性见解，并可能产生未来的临床相关研究假设。 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。测试呼吸可以允许早期诊断感染和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会导致干预措施，以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.