Collaborative Pediatric Research Critical Care Network(U10)

描述（由申请人提供）：儿科重症监护医学结合多学科的方法来解决最脆弱的人群的重症III和受伤儿童的医疗需求。幸运的是，在过去的几十年里，护理的改善影响了所有PICU患者的死亡率，目前大多数学术三级护理中心的年死亡率低于5%。然而，某些疾病过程，特别是急性肺损伤和败血症，仍然与显著较高的死亡率相关，并消耗大量的卫生保健资源。尽管如此，这些最具挑战性的疾病在任何一个中心发生的频率都不够高，无法进行有效的单点研究，从而提高我们对这些疾病的理解和管理。考虑到这一现实，尤尼斯·肯尼迪·施莱弗国家儿童健康与人类发展研究所（NICHD）在资助基础设施以满足创建多中心研究网络的需求方面表现出了极大的智慧，即儿科重症护理合作研究网络（CPCCRN）。我们在密歇根大学快速发展的项目在建立当地基础设施方面取得了巨大进展，使我们能够积极参与一些基于网络的研究。除了拥有这种基础设施能力外，我们还相信我们有一个研究团队，他们可以为这个网络做出重要的科学和领导贡献。因此，我们正在申请成为CPCCRN的参与站点，以协助执行对病危或受伤儿童的病理生物学，管理策略以及治疗的安全性和有效性的调查。作为该申请的一部分，我们提交了一份概念提案，该提案反映了我们的基础设施和智力能力，以富有成效的方式为CPCCRN做出贡献。我们假设，对危重疾病晚期与宿主免疫功能障碍相关的基因表达调控机制的进一步了解，将为进一步改善预后确定新的治疗靶点。

DESCRIPTION (provided by applicant): Pediatric Critical Care Medicine Incorporates a multidisciplinary approach to address the medical needs of the most fragile population of critically III and Injured children. Fortunately, improvements in care over the past decades have impacted mortality for all PICU patients such that current annual rates at most academic, tertiary care centers are below 5%. However, certain disease processes notably acute lung injury and sepsis, remain associated with significantly higher mortality rates as well as consume substantial health care resources. Despite this, the occurrences of these most challenging diseases do not occur sufficiently often at any one center to enable an effective, single-site study that will advance both our understanding and management of these diseases. Mindful of this reality, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) showed great wisdom in funding an infrastructure to address the need to create a multi-center research network, the Collaborative Pediatric Critical Care Research Network (CPCCRN). Our rapidly evolving program at the University of Michigan has made great strides in establishing a local Infrastructure to allow us to actively participate in a number of network-base studies. In addition to possessing this infrastructure capacity, we also believe we have a team of investigators who can make important scientific and leadership contributions to this network. As a result, we are applying to become a participating site within CPCCRN to assistant in executing investigations of pathobiology, management strategies, and the safety and efficacy of treatments for critically ill or injured children. As part of this application, we have submitted a Concept Proposal which reflects both our Infrastructure and Intellectual capacity to contribute in a productive manner to CPCCRN. We hypothesize that an Improved understanding of the mechanisms regulating gene expression associated with host Immune dysfunction In the late phase of critical Illnesses will identify novel therapeutic targets for further improving outcomes.