LONG-TERM OUTCOMES OF SPECIFIC VENTILATOR STRATEGIES

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心机构，不一定为研究者机构。急性肺损伤（ALI）是相对常见的，并与显着的短期死亡率。 据估计，ALI的发病率为75/100，000人（Ware 2000），历史上有40%的住院死亡率（哈德逊1998; Stewart 1998; Brochard 1998; Amato 1998; Brower 1999）。来自ALI网络的证据表明，使用常规通气肺保护（CVLP）可将28天死亡率从40%降至31%（ARDS网络2001）。尽管有这些证据，但关于ALI受试者的长期死亡率和结局以及CVLP是否改善这些长期结局的了解甚少。为了改善对ALI受试者的护理，我们需要更好地了解CVLP依从性的障碍、长期死亡率和与ALI相关的其他结局，以及可能与这些结局相关的治疗。这项观察性队列研究为确定ALI受试者的暴露和长期结局提供了独特的机会。将通过每日观察受试者在ICU接受的治疗（包括CVLP）及其病程（例如，疾病的严重性）。将在诊断为ALI后3、6、12和24个月观察结局，以评估以下类别的结局：生物功能障碍（例如，需要血液透析）、临床事件（例如，重复住院）和患者报告的结局（生活质量）。 通过这种改进的理解，本研究将增加重要的新知识，以改善对ALI受试者的护理。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Acute Lung Injury (ALI) is relatively common and associated with significant short term mortality. The incidence of ALI is estimated to be 75 per 100,000 persons (Ware 2000) and historically has had 40% hospital mortality (Hudson 1998; Stewart 1998; Brochard 1998; Amato 1998; Brower 1999). Evidence from the ALI Network suggests that 28-day mortality can be reduced from 40% to 31% with the use of Conventional Ventilation Lung Protection (CVLP) (ARDS Network 2001). Despite this evidence, little is known regarding the long-term mortality and outcomes in ALI subjects or whether CVLP improves these long-term outcomes. To improve the care of subjects with ALI, we need to better understand the barriers to compliance with CVLP, the long-term mortality and other outcomes associated with ALI, and the therapies that may be associated with those outcomes. This observational cohort study presents a unique opportunity to identify exposures and long-term outcomes in ALI subjects. Exposures will be determined by daily observation of subjects' therapies received in the ICU (including CVLP) and their medical course (e.g., severity of illness). Outcomes will be observed at 3, 6, 12 and 24 months after diagnosis of ALI to assess the following categories of outcomes: disorders of biologic functioning (e.g., need for hemodialysis), clinical events (e.g. repeat hospitalization), and patient reported outcomes (quality of life). Through this improved understanding, this study will add important new knowledge of ways to improve the care of subjects with ALI.