Pacific Northwest Clinical Center for the NHLBI PETAL Network

描述（申请人提供）：预防和早期治疗急性肺损伤（PETAL）网络的目标是开发和进行高质量的随机对照临床试验，以预防，治疗和/或改善急性呼吸窘迫综合征（ARDS）患者或有急性呼吸窘迫综合征（ARDS）风险的患者的结局，采用多学科和协作方法，并收集确定疾病发病机理的分子表型、对治疗的反应和恢复所必需的生物样品和临床数据。太平洋西北临床中心的具体目标是参与这个临床网络，以扩大我们自1994年以来通过前两个ARDS临床试验网络所做的工作。 ARDS是一种常见的低氧性呼吸衰竭，通常是致命的，并伴有严重的后遗症，对幸存者的健康和生活质量产生长期影响。虽然以前的药物试验未能降低ARDS患者的死亡率，但前两个NHLBI ARDS网络已经证明，呼吸机和液体管理的变化可以大大改善患者的预后。自2000年具有里程碑意义的低潮气量通气研究发表以来，急性呼吸窘迫综合征（ARDS）的病死率稳步下降。 之前的NHLBI ARDS网络证明了这样一个假设，即由临床和研究中心组成的由医生指导的网络可以设计和进行研究，从而改善ARDS患者的结局。通过将重点扩大到重症监护室以外，这个新的网络有可能更加深远。拟议的太平洋西北临床中心体现了经验丰富，多样化，协作和多学科的方法，将导致PETAL的成功。我们是一个团队的学术和社区医院;重症监护，创伤/外科和急诊医学专家;和临床试验，基础 科学家;流行病学家，临床医生和研究协调员，在西雅图，华盛顿和波特兰，俄勒冈州。我们相信，改善重症患者的护理以及短期和长期结果的机会掌握在这个新的PETAL网络手中。在这个应用程序中，我们将证明为什么太平洋西北临床中心将是这个新网络的成功的重要组成部分。

DESCRIPTION (provided by applicant): The goal of the Prevention and Early Treatment of Acute Lung Injury (PETAL) Network is to develop and conduct high-quality randomized, controlled clinical trials to prevent, treat and/or improve outcomes of patients with or at risk fo acute respiratory distress syndrome (ARDS) using a multidisciplinary and collaborative approach, and to collect biologic samples and clinical data necessary to determine the molecular phenotype of disease pathogenesis, response to therapy, and recovery. The specific objective of the Pacific Northwest Clinical Center is to participate in this clinical network in orer to expand upon the work we have done through the two previous ARDS Clinical Trials Networks since 1994. ARDS is a form of hypoxemic respiratory failure that is common, often fatal, and associated with significant sequelae that have a long lasting impact on the health and quality of life of its survivors. While previous trials of pharmacologic agents have failed to decrease mortality of patients with ARDS, the first two NHLBI ARDS Networks have demonstrated that changes in ventilator and fluid management can profoundly improve patient outcome. Since the publication of the landmark study of low tidal volume ventilation in 2000, there has been a steady drop in the case fatality of ARDS. The preceding NHLBI ARDS Networks proved the hypothesis that an investigator-directed network of clinical and research centers can design and conduct investigations that would improve outcomes for patients with ARDS. By expanding the focus beyond the ICU, this new network has the potential to be even more far- reaching. The proposed Pacific Northwest Clinical Center embodies the experienced, diverse, collaborative and multidisciplinary approach that will lead to PETAL's success. We are a team of academic and community hospitals; of critical care, trauma/surgical and emergency medicine specialists; and of clinical trialists, basic scientists; epidemiologists, clinicians, and research coordinators, in both Seattle, Washington and Portland, Oregon. We believe that the opportunity to improve care and both short and long-term outcomes of critically ill patients is in the hands of this new PETAL Network. In this application, we will demonstrate why the Pacific Northwest Clinical Center will be an important part of this new Network's success.