1/2 – Pediatric Prehospital Airway Resuscitation Trial
1/2 — 儿科院前气道复苏试验
基本信息
- 批准号:10738581
- 负责人:
- 金额:$ 190.27万
- 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:2023-09-01 至 2024-08-31
- 项目状态:已结题
- 来源:
- 关键词:AccountingAddressAdverse eventAgeAgreementApplied ResearchBayesian AnalysisBenefits and RisksBrainCaringCategoriesChildChild CareChild HealthChildhoodClinicalClinical Trials NetworkCommunitiesComplementComplexConsensusCritical CareCritical IllnessCritically ill childrenDatabasesDedicationsDevicesDiseaseDoseEmergency CareEmergency researchEnsureEventGelGuidelinesHeartHeart ArrestHospitalsInformed ConsentInstitutional Review BoardsInternationalInterviewIntratracheal IntubationKnowledgeLaryngeal MasksLarynxLifeLungManualsMasksOutcomeOxygenParamedical PersonnelPatientsPediatric HospitalsPhasePhysician ExecutivesPre-hospitalization careProtocols documentationPublic HealthRecommendationResourcesRespiratory FailureResuscitationSafetySecureSeizuresSurvival RateTechniquesTestingTrainingTraumaTraumatic injuryTubeUnited States Agency for Healthcare Research and QualityUnited States Health Resources and Services AdministrationVariantclinical carecommunity consultationcompare effectivenessdesignevidence baseexperienceimprovedinnovationmultidisciplinarynoveloperationout-of-hospital cardiac arrestpediatric emergencypreventrelative effectivenessskillssynergismtrial designtrial enrollmentventilation
项目摘要
PROJECT SUMMARY
We aim to answer the signature question of paramedic care; “What is the best way to manage the
prehospital airway in critically ill children?” Cardiac arrest, respiratory failure, and major trauma are
devastating critical conditions in children. Resuscitation from critical illness requires skillful airway
management to optimize delivery of oxygen to the lungs, preventing irreparable damage to the brain and
heart. As the first to provide critical care, prehospital paramedics often perform life-saving airway management
on critically ill children. The most common prehospital airway management techniques (bag-valve-mask
ventilation (BVM), endotracheal intubation (ETI), and supraglottic airway insertion (SGA) have important trade-
offs between risks and benefits; the best approach is unknown.
We propose the novel Pediatric Prehospital Airway Resuscitation Trial (Pedi-PART) to determine
the best strategies for prehospital airway management in critically ill children. Pedi-PART will
immediately influence paramedic practices and have a lasting impact upon the health of children
internationally. We will determine the relative effectiveness of three airway strategies ([BVM-only], [BVM+ETI],
[BVM+SGA]), accounting for variations across disease (cardiac arrest, trauma, respiratory failure) and age
categories, and we will apply adaptive techniques to minimize the required number of patients. Our aims are:
AIM I: Prepare the Pediatric Emergency Care Applied Research Network (PECARN) to execute the
innovative Pedi-PART trial. PECARN is the nation’s premier pediatric emergencies research network. We
have assembled an alliance of over 60 EMS agencies from 10 communities associated with PECARN and their
ongoing Pediatric Dose Optimization for Seizures in EMS trial (PediDOSE - U01-NS114042).
AIM II: Compare the effectiveness of prehospital BVM, SGA, and ETI airway management strategies
upon pediatric cardiac arrest, major trauma, and respiratory failure outcomes. We will execute the trial in
two sequential stages. Stage I: Determine if [BVM-only] or [BVM followed by SGA] results in better ICU-free
survival in critically ill children with cardiac arrest, major trauma, or respiratory failure. Stage II: Determine if
[winner of Stage I] or [BVM followed by ETI] results in better ICU-free survival.
AIM III: Compare the safety of prehospital BVM, SGA, and ETI airway management strategies in
pediatric cardiac arrest, major trauma, and respiratory failure. In Stage I, we will determine if [BVM+SGA]
results in fewer prehospital and hospital adverse events compared with [BVM-only] in critically ill children with
cardiac arrest, major trauma, or respiratory failure. In Stage II, we will determine if the winner of Stage I results
in fewer adverse events compared with [BVM+ETI].
项目概要
我们的目标是回答护理人员护理的标志性问题; “最好的管理方式是什么?
危重儿童院前气道?心脏骤停、呼吸衰竭和严重外伤
儿童的毁灭性危急状况。危重病复苏需要熟练的气道
优化向肺部输送氧气的管理,防止对大脑造成不可挽回的损害
心。作为第一个提供重症监护的人员,院前护理人员经常进行挽救生命的气道管理
对危重儿童。最常见的院前气道管理技术(球袋-阀门-面罩)
通气 (BVM)、气管插管 (ETI) 和声门上气道插入 (SGA) 具有重要的权衡
风险与收益之间的偏差;最好的方法尚不清楚。
我们提出新颖的儿科院前气道复苏试验 (Pedi-PART) 来确定
危重儿童院前气道管理的最佳策略。 Pedi-PART 将
立即影响护理人员的做法并对儿童的健康产生持久的影响
国际上。我们将确定三种气道策略的相对有效性([仅 BVM]、[BVM+ETI]、
[BVM+SGA]),考虑了疾病(心脏骤停、创伤、呼吸衰竭)和年龄的变化
类别,我们将应用适应性技术来尽量减少所需的患者数量。我们的目标是:
目标 I:准备儿科紧急护理应用研究网络 (PECARN) 以执行
创新的 Pedi-PART 试验。 PECARN 是美国首屈一指的儿科紧急情况研究网络。我们
组建了一个由来自 10 个与 PECARN 相关社区的 60 多个 EMS 机构组成的联盟及其
正在进行的 EMS 试验中针对癫痫发作的儿科剂量优化 (PediDOSE - U01-NS114042)。
AIM II:比较院前 BVM、SGA 和 ETI 气道管理策略的有效性
儿童心脏骤停、重大创伤和呼吸衰竭结果。我们将在
两个连续的阶段。第一阶段:确定[仅使用 BVM] 或 [BVM 后加 SGA] 是否会带来更好的免 ICU 效果
心脏骤停、严重创伤或呼吸衰竭的危重儿童的生存率。第二阶段:确定是否
[第一阶段的获胜者]或[BVM,随后是ETI]可带来更好的无ICU生存率。
目标 III:比较院前 BVM、SGA 和 ETI 气道管理策略的安全性
小儿心脏骤停、重大创伤和呼吸衰竭。在第一阶段,我们将确定是否[BVM+SGA]
与[仅 BVM] 相比,对于患有以下疾病的危重儿童,院前和院内不良事件较少
心脏骤停、重大创伤或呼吸衰竭。在第二阶段,我们将决定第一阶段的获胜者是否取得成绩
与 [BVM+ETI] 相比,不良事件更少。
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)
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Henry E. Wang其他文献
Managing the airway during cardiac arrest.
心脏骤停期间管理气道。
- DOI:
- 发表时间:
2013 - 期刊:
- 影响因子:0
- 作者:
Henry E. Wang;D. Yealy - 通讯作者:
D. Yealy
Prehospital endotracheal intubation: the controversy continues (Conference Proceedings).
院前气管插管:争议仍在继续(会议记录)。
- DOI:
- 发表时间:
2009 - 期刊:
- 影响因子:3.6
- 作者:
J. Strote;R. Roth;D. Cone;Henry E. Wang - 通讯作者:
Henry E. Wang
The challenge of defining the "science" of airway management--what is the right outcome measure?
定义气道管理“科学”的挑战——正确的结果衡量标准是什么?
- DOI:
- 发表时间:
2003 - 期刊:
- 影响因子:4.4
- 作者:
Henry E. Wang;D. Yealy - 通讯作者:
D. Yealy
The in vitro effect of N-acetylcysteine on prothrombin time in plasma samples from healthy subjects.
N-乙酰半胱氨酸对健康受试者血浆样本中凝血酶原时间的体外影响。
- DOI:
- 发表时间:
2011 - 期刊:
- 影响因子:4.4
- 作者:
A. Pizon;D. Jang;Henry E. Wang - 通讯作者:
Henry E. Wang
Carpometacarpal Dislocation of the Thumb
- DOI:
10.1016/j.jemermed.2007.10.083 - 发表时间:
2010-04-01 - 期刊:
- 影响因子:
- 作者:
Anthony F. Pizon;Henry E. Wang - 通讯作者:
Henry E. Wang
Henry E. Wang的其他文献
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{{ truncateString('Henry E. Wang', 18)}}的其他基金
Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac Arrest
院外心脏骤停气道管理的实用试验
- 批准号:
8793277 - 财政年份:2014
- 资助金额:
$ 190.27万 - 项目类别:
Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac Arrest
院外心脏骤停气道管理的实用试验
- 批准号:
8930251 - 财政年份:2014
- 资助金额:
$ 190.27万 - 项目类别:
Pragmatic Trial of Airway Management in Out-of-Hospital Cardiac Arrest
院外心脏骤停气道管理的实用试验
- 批准号:
9116937 - 财政年份:2014
- 资助金额:
$ 190.27万 - 项目类别:
Effect of Paramedic Airway Experience on Patient Outcomes
护理人员气道经验对患者预后的影响
- 批准号:
7824725 - 财政年份:2009
- 资助金额:
$ 190.27万 - 项目类别:
Effect of Paramedic Airway Experience on Patient Outcomes
护理人员气道经验对患者预后的影响
- 批准号:
7740956 - 财政年份:2006
- 资助金额:
$ 190.27万 - 项目类别:
Effect of Paramedic Airway Experience on Patient Outcomes
护理人员气道经验对患者结果的影响
- 批准号:
7197718 - 财政年份:2006
- 资助金额:
$ 190.27万 - 项目类别:
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