Reducing Reintubation Risk in High-Risk Cardiac Surgery Patients with High-Flow Nasal Cannula -the "I-CAN" study

项目摘要 候选人：罗伯特·E. Freundlich，MD，MS是范德比尔特大学医学院的助理教授 中心（VUMC）。Freundlich博士在临床信息学方面有很强的背景， 作为范德比尔特麻醉学的副医学主任， 围手术期信息学研究部（VAPIR）。他的长期职业规划是成为一名医生- 科学家能够利用先进的信息学工具进行高质量的实用临床试验， 重症监护室和围手术期护理。为了实现这一目标，他将获得实用临床试验方面的专业知识 设计，广泛使用商业电子健康记录（EHR）的先进使用，行政领导 开发和临床信息学委员会认证。 研究项目：美国每年有50多万成年患者接受心脏手术。 美国，其中5-10%的人将经历重新插管。心脏手术后再次插管与 短期和长期死亡率较高，成本增加，住院时间较长。当病人接受 心脏外科手术的年龄越来越大，合并症负担越来越重，并且接受越来越复杂的心脏外科手术 因此，在手术过程中，努力确定可以有效防止重新插管的策略至关重要。 职业发展：Freundlich博士的职业发展计划将正式的课程与 与他的导师和合作者进行个性化培训，以1）加强他在 进行务实的比较有效性试验; 2）发展实施EHR的专业知识- 嵌入式临床试验设计; 3）先进的统计建模技术，以改善风险预测;以及4） 加强他作为多学科研究团队领导者的技能。 环境：VUMC是生物统计学，围手术期信息学和实用临床的公认领导者 试验设计和实施。这是一个理想的环境，以促进弗罗因德利希博士的发展成为一个国家， 领导在他的领域。Freundlich博士已经确定了VUMC的专家，每个人都是他或她所在领域的领导者 并将帮助指导弗罗因德利希博士实现其研究独立的目标。范德比尔特的临床和 转化科学奖（CTSA）资助“学习医疗保健系统”，旨在促进研究， 使用新颖的方法将临床研究整合到临床护理中，将有助于Freundlich博士在研究 提出研究和职业发展计划。

PROJECT SUMMARY Candidate: Dr. Robert E. Freundlich, MD, MS is an Assistant Professor at Vanderbilt University Medical Center (VUMC). Dr. Freundlich has a strong background in clinical informatics, gained through his research fellowship and ongoing work as the Associate Medical Director of the Vanderbilt Anesthesiology and Perioperative Informatics Research Division (VAPIR). His long-term career plan is to become a physician- scientist capable of leveraging advanced informatics tools to conduct high quality pragmatic clinical trials in the intensive care unit and perioperative care. To achieve this, he will gain expertise in pragmatic clinical trial design, advanced use of a widely-available commercial electronic health record (EHR), executive leadership development, and board certification in clinical informatics. Research Project: More than half a million adult patients undergo cardiac surgery each year in the United States, 5-10% of whom will experience reintubation. Reintubation after cardiac surgery is associated with higher short- and long-term mortality, increased cost, and longer lengths of stay. As patients undergoing cardiac surgery are increasing in age, comorbidity burden, and receive increasingly complex cardiac surgical procedures, efforts to identify strategies that can effectively prevent reintubation are of critical importance. Career Development: Dr. Freundlich's career development plan integrates formal coursework with personalized training with his mentors and collaborators to 1) strengthen his methodologic foundation in the conduct of pragmatic comparative effectiveness trials; 2) develop expertise in the implementation of EHR- embedded clinical trial design; 3) advanced statistical modeling techniques to improve risk prediction; and 4) bolster his skills as a leader of a multi-disciplinary research team. Environment: VUMC is an established leader in biostatistics, perioperative informatics, and pragmatic clinical trial design and conduct. It is the ideal environment to foster Dr. Freundlich's development into a national leader in his field. Dr. Freundlich has identified experts at VUMC, each of whom is a leader in his or her field and will help mentor Dr. Freundlich towards his goal of research independence. Vanderbilt's Clinical and Translational Science Award (CTSA) funded “Learning Healthcare System”, intended to facilitate research that uses novel methods to integrate clinical research into clinical care, will help Dr. Freundlich as he works on the proposed research and career development plans.