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

描述(由申请人提供)：本意见书中包含的临床站点申请摘要是CPCCRN洛杉矶中心再次申请继续成为协作性儿科危重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)和美泰儿童医院UCLA(UCLA)--的合作伙伴。这两个网站在过去五年一直是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一直很牢固，双方都打算作为一个合并的网站参与该网络。概念应用概述本研究的目的是比较两种不同的早期肺保护性通气策略(高频振荡呼吸机和压力控制型常规呼吸机)治疗儿童急性肺损伤的效果。为了克服以前的儿科急性肺损伤试验中强调的局限性，肺损伤的非侵入性标记物将被用于改善患者登记和表征风险。已经开发的基于计算机的决策支持工具的应用将确保同等患者状态的可复制临床决策，并提高方案的遵从性。将评估急性肺损伤的神经发育和肺预后指标，以检查PICU出院后的发病率和死亡率。 公共卫生相关性：现场应用相关性：通过让两所主要大学为其目标做出贡献，CHLA-UCLA继续成为该网络的成员，提供更广泛的专业知识和更多的多种族患者群体。概念相关性：该研究试图评估早期高频振荡呼吸机与肺保护性压力控制呼吸机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.