Novel Digital Methods to Evaluate Functional and Pulmonary Outcomes following Pediatric Acute Respiratory Failure

项目摘要 在需要长时间机械通气的危重疾病中存活的儿童， 长期后遗症，包括身体和肺功能损害以及健康相关损害 生活质量和恢复以前正常活动的能力。这些损害可以减轻 在儿科重症监护病房住院期间或出院后进行有针对性的干预。的能力 缺乏客观量化出院后身体状况的方法， 和肺损伤，而没有显著的损耗。此外，本发明还 我们对不同健康状况下的轨迹恢复之间的关系没有完全的了解， 领域和测量方法。本提案的目的是验证数字化的使用 客观测量身体活动和肺功能并评估其关系的技术 客观测量的身体和肺功能的恢复轨迹与患者报告的 结果包括急性呼吸道疾病存活儿童的健康相关生活质量和活动参与 失败我们将比较BioIntellisense BioButton，这是一种用于成人的可穿戴设备， 身体活动和Spirobank智能肺活量计，一种远程数字肺活量计， 腕戴式加速度计和实验室肺功能测定法。我们还将收集患者报告的 评估健康相关生活质量和活动参与的结果。该提案将确定和 验证儿童远程随访的策略，使用数字化技术优化患者参与和保留 扩大患者代表性和减少临床研究参与差异的技术。 此外，它将为未来的R01提案提供信息，以测试旨在儿科急性 呼吸衰竭，通过提供更全面的了解恢复之间的关联， 身体和肺功能、健康相关的生活质量和活动参与。

PROJECT SUMMARY Children who survive critical illness requiring prolonged mechanical ventilation are at high risk of significant and long-lasting sequelae including physical and pulmonary function impairments and impairments in health-related quality of life and the ability to return to previously normal activities. These impairments may be mitigated through targeted interventions during the pediatric intensive care unit stay or after discharge. The ability to effectively test interventions is hindered by insufficient methods to objectively quantify post-discharge physical and pulmonary impairments across representative study populations without significant attrition. Additionally, we have an incomplete understanding of the relationship between trajectory recoveries across different health domains and methods of measurement. The objective of this proposal is to validate the use of digital technologies to objectively measure physical activity and pulmonary function and evaluate the relationship between recovery trajectories of objectively measured physical and pulmonary functioning and patient-reported outcomes including health-related quality of life and activity participation in children surviving acute respiratory failure. We will compare the BioIntellisense BioButton, a discreet wearable device used in adults to monitor physical activity and the Spirobank Smart Spirometer, a remote digital spirometer, against the gold standards of wrist-worn accelerometry and laboratory spirometry, respectively. We will also collect patient-reported outcomes evaluating health-related quality of life and activity participation. This proposal will identify and validate strategies for remote follow-up of children that optimize patient participation and retention using digital technologies to expand patient representation and reduce disparities in clinical research participation. Additionally, it will inform a future R01 proposal to test an intervention aimed at recovery after pediatric acute respiratory failure by providing a more comprehensive understanding of the associations between recovery of physical and pulmonary functioning, health-related quality of life, and activity participation.