Pacific Northwest Clinical Center for the NHLBI PETAL Network

描述(申请人提供)：急性肺损伤(PEAL)预防和早期治疗网络的目标是开发和进行高质量的随机对照临床试验，以使用多学科和协作的方法预防、治疗和/或改善急性呼吸窘迫综合征(ARDS)风险患者的预后，并收集必要的生物样本和临床数据，以确定疾病的发病机制、治疗反应和康复的分子表型。太平洋西北临床中心的具体目标是参与ERER的这个临床网络，以扩展我们自1994年以来通过前两个ARDS临床试验网络所做的工作。 ARDS是一种常见的低氧性呼吸衰竭，通常是致命的，并与严重的后遗症相关，对其幸存者的健康和生活质量有长期的影响。虽然之前的药理药物试验未能降低ARDS患者的死亡率，但前两个NHLBI ARDS网络已经证明，改变呼吸机和液体管理可以显著改善患者的预后。自2000年发表具有里程碑意义的低潮气量呼吸机研究以来，ARDS的病死率一直在稳步下降。 之前的NHLBI ARDS网络证明了这样一个假设，即由临床和研究中心组成的研究人员指导的网络可以设计和进行研究，从而改善ARDS患者的预后。通过将重点扩展到ICU之外，这个新的网络有可能更加深远。拟建的太平洋西北临床中心体现了经验丰富、多样化、协作和多学科的方法，这将导致Petal的成功。我们是一支由学术和社区医院组成的团队；由重症护理、创伤/外科和急救医学专家组成的团队；以及由临床试验人员组成的团队，基本 来自华盛顿州西雅图和俄勒冈州波特兰的科学家、流行病学家、临床医生和研究协调员。我们相信，改善危重病人护理和短期和长期结果的机会掌握在这个新的花瓣网络手中。在这一应用中，我们将展示为什么太平洋西北临床中心将是这一新网络成功的重要组成部分。

DESCRIPTION (provided by applicant): The goal of the Prevention and Early Treatment of Acute Lung Injury (PETAL) Network is to develop and conduct high-quality randomized, controlled clinical trials to prevent, treat and/or improve outcomes of patients with or at risk fo acute respiratory distress syndrome (ARDS) using a multidisciplinary and collaborative approach, and to collect biologic samples and clinical data necessary to determine the molecular phenotype of disease pathogenesis, response to therapy, and recovery. The specific objective of the Pacific Northwest Clinical Center is to participate in this clinical network in orer to expand upon the work we have done through the two previous ARDS Clinical Trials Networks since 1994. ARDS is a form of hypoxemic respiratory failure that is common, often fatal, and associated with significant sequelae that have a long lasting impact on the health and quality of life of its survivors. While previous trials of pharmacologic agents have failed to decrease mortality of patients with ARDS, the first two NHLBI ARDS Networks have demonstrated that changes in ventilator and fluid management can profoundly improve patient outcome. Since the publication of the landmark study of low tidal volume ventilation in 2000, there has been a steady drop in the case fatality of ARDS. The preceding NHLBI ARDS Networks proved the hypothesis that an investigator-directed network of clinical and research centers can design and conduct investigations that would improve outcomes for patients with ARDS. By expanding the focus beyond the ICU, this new network has the potential to be even more far- reaching. The proposed Pacific Northwest Clinical Center embodies the experienced, diverse, collaborative and multidisciplinary approach that will lead to PETAL's success. We are a team of academic and community hospitals; of critical care, trauma/surgical and emergency medicine specialists; and of clinical trialists, basic scientists; epidemiologists, clinicians, and research coordinators, in both Seattle, Washington and Portland, Oregon. We believe that the opportunity to improve care and both short and long-term outcomes of critically ill patients is in the hands of this new PETAL Network. In this application, we will demonstrate why the Pacific Northwest Clinical Center will be an important part of this new Network's success.