| Autor: |
Semler MW; Division of Allergy, Pulmonary and Critical Care Medicine and., Bernard GR; Division of Allergy, Pulmonary and Critical Care Medicine and., Aaron SD; Division of Respirology, University of Ottawa, Ottawa, Ontario, Canada., Angus DC; Department of Critical Care Medicine and., Biros MH; Department of Emergency Medicine, University of Minnesota, Minneapolis, Minnesota., Brower RG; Division of Pulmonary and Critical Care Medicine and., Calfee CS; Department of Medicine and.; Department of Anesthesia, University of California, San Francisco, San Francisco, California., Colantuoni EA; Department of Biostatistics, Johns Hopkins University, Baltimore, Maryland., Ferguson ND; Interdepartmental Division of Critical Care Medicine.; Department of Medicine.; Department of Physiology, and.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Gong MN; Department of Epidemiology.; Department of Population Health, and.; Department of Medicine, Montefiore Medical Center, Bronx, New York., Hopkins RO; Department of Psychology, Brigham Young University, Provo, Utah.; Pulmonary and Critical Care Division, Intermountain Medical Center, Murray, Utah., Hough CL; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington., Iwashyna TJ; Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan., Levy BD; Pulmonary and Critical Care Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Martin TR; Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington., Matthay MA; Department of Medicine and.; Department of Anesthesia, University of California, San Francisco, San Francisco, California., Mizgerd JP; Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts., Moss M; Division of Pulmonary Sciences & Critical Care, University of Colorado, Denver, Colorado., Needham DM; Division of Pulmonary and Critical Care Medicine and., Self WH; Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Seymour CW; Department of Critical Care Medicine and.; Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania., Stapleton RD; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Vermont, Burlington, Vermont., Thompson BT; Division of Pulmonary and Critical Care Medicine, Harvard University, Boston, Massachusetts., Wunderink RG; Division of Pulmonary and Critical Care, Northwestern University Feinberg School of Medicine, Chicago, Illinois; and., Aggarwal NR; Division of Lung Diseases, NHLBI, Bethesda, Maryland., Reineck LA; Division of Lung Diseases, NHLBI, Bethesda, Maryland. |
| Abstrakt: |
Preventing, treating, and promoting recovery from critical illness due to pulmonary disease are foundational goals of the critical care community and the NHLBI. Decades of clinical research in acute respiratory distress syndrome, acute respiratory failure, pneumonia, and sepsis have yielded improvements in supportive care, which have translated into improved patient outcomes. Novel therapeutics have largely failed to translate from promising preclinical findings into improved patient outcomes in late-phase clinical trials. Recent advances in personalized medicine, "big data," causal inference using observational data, novel clinical trial designs, preclinical disease modeling, and understanding of recovery from acute illness promise to transform the methods of pulmonary and critical care clinical research. To assess the current state of, research priorities for, and future directions in adult pulmonary and critical care research, the NHLBI assembled a multidisciplinary working group of investigators. This working group identified recommendations for future research, including 1 ) focusing on understanding the clinical, physiological, and biological underpinnings of heterogeneity in syndromes, diseases, and treatment response with the goal of developing targeted, personalized interventions; 2 ) optimizing preclinical models by incorporating comorbidities, cointerventions, and organ support; 3 ) developing and applying novel clinical trial designs; and 4 ) advancing mechanistic understanding of injury and recovery to develop and test interventions targeted at achieving long-term improvements in the lives of patients and families. Specific areas of research are highlighted as especially promising for making advances in pneumonia, acute hypoxemic respiratory failure, and acute respiratory distress syndrome. |
