Controlled Trial of Two Lung Protective Ventilation Modes in Acute Lung Injury

描述（由申请人提供）：临床站点申请摘要包含在此提交的是CPCCRN洛杉矶中心再次申请继续成为合作儿科重症护理研究网络的成员。该中心是洛杉矶地区两所主要大学，洛杉矶儿童医院（USC）和加州大学洛杉矶分校美泰儿童医院（UCLA）之间的合作伙伴关系。这两家医院在过去五年中都是CPCCRN的成员，并一直参与CPCCRN的临床研究。这两个网站之间的伙伴关系一直很牢固，双方都打算作为一个合并的网站参与这个网络。本研究的目的是比较两种不同的早期肺保护性通气策略（高频振荡通气与压力控制常规通气）对急性肺损伤儿童的影响。为了克服以往儿科急性肺损伤试验中突出的局限性，将使用非侵入性肺损伤标志物来提高患者入组率和表征风险。已经开发的基于计算机的决策支持工具的应用将确保相同患者状态的可复制临床决策，并提高协议的依从性。急性肺损伤的神经发育和肺预后指标将被评估，以检查PICU出院后的发病率和死亡率。

DESCRIPTION (provided by applicant): Clinical Site Application Summary Contained in this submission is the CPCCRN Los Angeles Center's reapplication for continued membership in the Collaborative Pediatric Critical Care Research Network. The center is a partnership between the two major universities within the Los Angeles area, the Children's Hospital of Los Angeles (USC) and Mattel Children's Hospital UCLA (UCLA). Both sites have been members of the CPCCRN for the last five years and have been participating in conducting clinical studies under the CPCCRN. The partnership has continued to be strong between the two sites and it is the intention of both to participate in the network as a combined site. Concept Application Summary The purpose of this study is to compare two different early lung protective ventilation strategies (high frequency oscillatory ventilation versus pressure controlled conventional ventilation) for children with acute lung injury. In order to overcome limitations highlighted in previous trials on pediatric Acute Lung Injury, non-invasive markers of lung injury will be used to both improve patient enrollment and characterize risk. Application of already developed computer-based decision support tools will ensure replicable clinical decisions for equivalent patient states and improve protocol adherence. Neurodevelopmental and pulmonary outcome measures from Acute Lung Injury will be evaluated to examine morbidity and mortality beyond the PICU discharge. PUBLIC HEALTH RELEVANCE: Site Application Relevance: Continued membership of CHLA-UCLA in the network provides a broader range of expertise and larger multi-ethnic patient population by having two major universities contributing to its goals. Concept Relevance: The study seeks to evaluate the effects of early high frequency oscillatory ventilation compared to lung protective pressure control ventilation on short and long term morbidity and mortality.