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
• 负责人: Elizabeth Y Killien
• 金额: $ 40.88万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10724042
• 关键词: Accelerometer; Acute; Acute respiratory failure; Adult; Airway Disease; Attenuated; Caregivers; Caring; Child; Childhood; Chronic; Clinical Research; Clothing; Critical Illness; Cystic Fibrosis; Data; Devices; Diameter; Eligibility Determination; Evaluation; Future; Gold; Health; Health Resources; Hospitalization; Hospitals; Impairment; International; Intervention; Intervention Trial; Laboratories; Longitudinal Studies; Longitudinal cohort study; Lung; Lung diseases; Measurement; Measures; Mechanical ventilation; Medical; Methods; Monitor; Outcome; Outcome Measure; Patient Outcomes Assessments; Patient Participation; Patient Selection; Patients; Pediatric Intensive Care Units; Persons; Physical Function; Physical activity; Physical assessment; Population; Positioning Attribute; Pulmonary Function Test/Forced Expiratory Volume 1; Pulmonary function tests; Recovery; Recovery of Function; Research; Sample Size; Spirometry; Surveys; Testing; Time; Work; Wrist; actigraphy; aged; awake; design; digital; digital technology; digital tool; disparity reduction; experience; follow-up; functional outcomes; health related quality of life; high risk; improved; novel; patient retention; prospective; pulmonary function; remote assessment; respiratory; study population; technology validation; telecoaching; telehealth; ventilation; wearable device

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.

项目总结 在危重疾病中存活下来的儿童需要长时间的机械通气，他们面临着严重和 长期后遗症，包括身体和肺功能损害以及与健康相关的损害 生活质量和恢复以前正常活动的能力。这些损害可能会得到缓解 通过在儿科重症监护病房停留期间或出院后进行有针对性的干预。有能力 由于缺乏客观量化出院后体格检查的方法，有效的检测干预措施受到阻碍 以及代表性研究人群中的肺损伤，而没有显著的自然减损。另外， 我们对不同健康状况下的轨迹恢复之间的关系理解不完全。 测量的领域和方法。这项提案的目标是验证数字技术的使用 客观测量体力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恢复轨迹与患者报告的恢复轨迹之间的关系 急性呼吸道疾病幸存儿童的结果，包括与健康相关的生活质量和参与活动 失败了。我们将对BioIntelisense BioButton进行比较，这是一款用于成人监控的谨慎可穿戴设备 体力活动和Spirobank智能肺活计，这是一款远程数字肺活量计，符合黄金标准 分别是腕式加速度计和实验室肺活量测定仪。我们还将收集患者报告 评估与健康相关的生活质量和活动参与的结果。这项提案将确定和 验证使用数字技术优化患者参与和留存的儿童远程跟踪策略 扩大患者代表性和减少临床研究参与方面的差距的技术。 此外，它将通知未来的R01提案，以测试旨在儿科急性呼吸道感染后恢复的干预措施 通过更全面地了解呼吸衰竭与呼吸衰竭的关系 身体和肺功能、与健康相关的生活质量和活动参与。