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

描述（由申请人提供）：本提交资料中包含的临床研究中心申请摘要是CPCCRN洛杉矶中心继续成为协作儿科重症监护研究网络成员的重新申请。该中心是洛杉矶地区两所主要大学洛杉矶儿童医院（USC）和美泰儿童医院UCLA（UCLA）之间的合作伙伴关系。这两家研究中心在过去五年中一直是CPCCRN的成员，并一直参与CPCCRN下的临床研究。这两个网站之间的伙伴关系继续保持牢固，双方都打算作为一个合并网站参加该网络。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）用于急性肺损伤儿童。为了克服既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改善患者入组和表征风险。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的患者状态的可复制的临床决策，并提高协议的遵守。将评价急性肺损伤的神经发育和肺部结局指标，以检查PICU出院后的发病率和死亡率。 公共卫生相关性：临床试验机构应用相关性：CHLA-UCLA在网络中的持续成员资格提供了更广泛的专业知识和更大的多种族患者群体，有两所主要大学为其目标做出贡献。概念相关性：本研究旨在评价早期高频振荡通气与肺保护性压力控制通气相比对短期和长期发病率和死亡率的影响。

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.