Respiratory Drive in Acute Respiratory Failure
急性呼吸衰竭中的呼吸驱动
基本信息
- 批准号:10637245
- 负责人:
- 金额:$ 75.05万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-05-01 至 2028-04-30
- 项目状态:未结题
- 来源:
- 关键词:Acute Respiratory Distress SyndromeAcute respiratory failureAdvanced DevelopmentAngiopoietin-2AnxietyAttenuatedAutomobile DrivingBiological MarkersBlood - brain barrier anatomyBreathingCarbon DioxideCarotid BodyChemoreceptorsClinicalClinical DataClinical TrialsCritical IllnessCytokine ReceptorsDataDevelopmentDisuse AtrophyElectronic Health RecordEsophagusEvaluationExhalationExhibitsFutureHeterogeneityHospitalsIL8 geneIndividualInflammationInflammatoryInjuryInjury to DiaphragmInsufflationIntensive Care UnitsInvestigationKnowledgeLightLinkLungManometryMeasuresMechanical ventilationMechanicsMechanoreceptorsMorbidity - disease rateMuscleOutcomeOxygenPainPathway interactionsPatientsPatternPhysiciansPre-Clinical ModelPreventionReceptor SignalingRefractoryReportingResearchResidual stateResolutionRespiratory DiaphragmRespiratory MechanicsRespiratory MusclesRiskSamplingSedation procedureSerumStressStructureSyndromeTestingTidal VolumeTimeTitrationsVentilatorVentilator-induced lung injuryWorkadjudicationcirculating biomarkersclinical diagnosisclinically relevantcohortcytokineelectrical impedance tomographyexperiencehigh riskinflammatory markerlung injurymortalitymortality riskmultiorgan injuryprematurepressureprospectiverespiratorysystemic inflammatory responseultrasoundventilation
项目摘要
PROJECT SUMMARY/ABSTRACT
Acute respiratory failure (ARF) requiring invasive ventilation occurs in one-third of intensive care unit (ICU)
patients and is associated with a high risk of death. Ventilation-induced lung injury (VILI) is a modifiable
determinant of ARF outcomes that develops when the at-risk lung experiences excessive global or regional
stress/strain. VILI may result from excessive forces applied by the ventilator and/or respiratory muscles.
Optimizing ventilator titration has been studied extensively, while far less is known about the contribution of
spontaneous breathing effort to VILI in ARF. High respiratory drive can cause injuriously high tidal volumes,
increasing global stress/strain either with synchronous effort or breath stacking dyssynchrony depending on
ventilator mode. High drive also causes temporally heterogeneous insufflation, increasing intra-tidal regional
strain for a given tidal volume. Both patterns of respiratory drive-related increase in stress/strain worsen lung
injury in preclinical models and have been observed in patients with ARF, but whether they contribute clinically
meaningful lung injury in patients is unclear. Extremes of drive, high or low, also may cause clinically relevant
diaphragm injury. High drive risks load-induced injury, particularly in flow-limited ventilator modes or certain
patient-ventilator dyssynchronies in which inspiratory support ends prematurely relative to patient effort. Low
drive risks diaphragm disuse atrophy, proven to occur in some patients within a few days on the ventilator.
Causes of drive heterogeneity in ARF are not well established. Chemoreceptor, mechanoreceptor, and cortical
inputs (e.g. pain, anxiety) are well established modulators of respiratory drive, but they alone do not fully
explain drive heterogeneity in ARF. Although deep sedation often suppresses respiratory drive in healthy
individuals, we recently found that sedation depth and respiratory drive are not well correlated in ARF. Many
patients exhibit high drive refractory to deep sedation, while in others even light sedation can completely
eliminate drive. Our preliminary data suggest differences in systemic inflammation might explain this drive
heterogeneity. This research will deepen understanding of mechanisms underlying drive heterogeneity and its
relationship with clinical outcomes in patients with ARF. Our overall hypothesis is that systemic inflammation is
a key determinant of respiratory drive, extremes of which cause clinically important lung and diaphragm injury.
We will assemble a prospective two-hospital, multi-ICU cohort in whom respiratory mechanics and serum
biomarkers are ascertained serially. Aim 1 evaluates circulating inflammatory markers as a potential contributor
to drive heterogeneity. Aim 2 determines mechanisms by which extremes of respiratory drive may contribute to
lung and diaphragm injury. Aim 3 evaluates the relationship between respiratory drive and time to extubation.
Findings from this work will inform development of a precision ventilation strategy, incorporating respiratory
drive to optimize lung and diaphragm protection, for evaluation in a future clinical trial.
项目总结/文摘
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
数据更新时间:{{ journalArticles.updateTime }}
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
数据更新时间:{{ journalArticles.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ monograph.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ sciAawards.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ conferencePapers.updateTime }}
{{ item.title }}
- 作者:
{{ item.author }}
数据更新时间:{{ patent.updateTime }}
Jeremy R. Beitler其他文献
Monitoring esophageal pressure
- DOI:
10.1007/s00134-024-07401-y - 发表时间:
2024-04-11 - 期刊:
- 影响因子:21.200
- 作者:
Lise Piquilloud;Jeremy R. Beitler;François M. Beloncle - 通讯作者:
François M. Beloncle
Inhaled sedation versus propofol in respiratory failure in the ICU (INSPiRE-ICU2): study protocol for a multicenter randomized controlled trial
- DOI:
10.1186/s13063-025-08791-0 - 发表时间:
2025-03-31 - 期刊:
- 影响因子:2.000
- 作者:
Brian O’Gara;Alexis L. Serra;Joshua A. Englert;Alisha Sachdev;Robert L. Owens;Steven Y. Chang;Pauline K. Park;Daniel Talmor;Ida Sverud;Peter Sackey;Jeremy R. Beitler - 通讯作者:
Jeremy R. Beitler
Volatile anesthetics for ICU sedation: the future of critical care or niche therapy?
- DOI:
10.1007/s00134-022-06842-7 - 发表时间:
2022-09-03 - 期刊:
- 影响因子:21.200
- 作者:
Jeremy R. Beitler;Daniel Talmor - 通讯作者:
Daniel Talmor
Respiratory drive in the acute respiratory distress syndrome: pathophysiology, monitoring, and therapeutic interventions
- DOI:
10.1007/s00134-020-05942-6 - 发表时间:
2020-02-03 - 期刊:
- 影响因子:21.200
- 作者:
Elena Spinelli;Tommaso Mauri;Jeremy R. Beitler;Antonio Pesenti;Daniel Brodie - 通讯作者:
Daniel Brodie
Lung-protective sedation: moving toward a new paradigm of precision sedation
- DOI:
10.1007/s00134-022-06901-z - 发表时间:
2022-10-14 - 期刊:
- 影响因子:21.200
- 作者:
Elias Baedorf Kassis;Jeremy R. Beitler;Daniel Talmor - 通讯作者:
Daniel Talmor
Jeremy R. Beitler的其他文献
{{
item.title }}
{{ item.translation_title }}
- DOI:
{{ item.doi }} - 发表时间:
{{ item.publish_year }} - 期刊:
- 影响因子:{{ item.factor }}
- 作者:
{{ item.authors }} - 通讯作者:
{{ item.author }}
{{ truncateString('Jeremy R. Beitler', 18)}}的其他基金
1/2: PREcision VENTilation to attenuate Ventilation-Induced Lung Injury (PREVENT VILI)
1/2:精确通气以减轻通气引起的肺损伤(预防 VILI)
- 批准号:
10738958 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Measuring lung stress to identify occult ventilation-induced lung injury in ARDS
测量肺应激以识别 ARDS 患者隐匿性通气引起的肺损伤
- 批准号:
9918972 - 财政年份:2019
- 资助金额:
$ 75.05万 - 项目类别:
相似海外基金
Novel Digital Methods to Evaluate Functional and Pulmonary Outcomes following Pediatric Acute Respiratory Failure
评估小儿急性呼吸衰竭后功能和肺部结果的新型数字方法
- 批准号:
10724042 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Optimizing Time-Limited Trials of Mechanical Ventilation in Acute Respiratory Failure: A Mixed Methods Observational Study
优化急性呼吸衰竭机械通气的限时试验:混合方法观察研究
- 批准号:
10633823 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Use of Inter-Hospital Transfer Services in Critical Illness and Acute Respiratory Failure
在危重疾病和急性呼吸衰竭中使用医院间转运服务
- 批准号:
10739060 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Strengthening implementation science in Acute Respiratory Failure using multilevel analysis of existing data
利用现有数据的多级分析加强急性呼吸衰竭的实施科学
- 批准号:
10731311 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Identifying patient subgroups and processes of care that cause outcome differences following ICU vs. ward triage among patients with acute respiratory failure and sepsis
确定急性呼吸衰竭和脓毒症患者在 ICU 与病房分诊后导致结局差异的患者亚组和护理流程
- 批准号:
10734357 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Health expectations after acute respiratory failure in survivor-care partner dyads
幸存者护理伙伴二人组急性呼吸衰竭后的健康期望
- 批准号:
10732929 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Temporal trends in quality indicators of palliative care for patients with chronic illness hospitalized with acute respiratory failure
因急性呼吸衰竭住院的慢性病患者姑息治疗质量指标的时间趋势
- 批准号:
10622756 - 财政年份:2023
- 资助金额:
$ 75.05万 - 项目类别:
Association of patient characteristics and antibiotic timing with the development of acute respiratory failure in hospital-acquired sepsis
患者特征和抗生素使用时机与医院获得性脓毒症急性呼吸衰竭发展的关系
- 批准号:
10313769 - 财政年份:2022
- 资助金额:
$ 75.05万 - 项目类别:
Financial Hardship among Patients with Acute Respiratory Failure and their Family Member Caregivers: Understanding the Impact on Patient- and Family- Centered Outcomes
急性呼吸衰竭患者及其家庭成员护理人员的经济困难:了解对以患者和家庭为中心的结果的影响
- 批准号:
10413457 - 财政年份:2022
- 资助金额:
$ 75.05万 - 项目类别:
Racial disparities in shared decision making for patients with acute respiratory failure
急性呼吸衰竭患者共同决策的种族差异
- 批准号:
10506137 - 财政年份:2022
- 资助金额:
$ 75.05万 - 项目类别: