How to shorten duration of mechanical ventilation in children admitted to Pediatric Intensive Care Units?

$84
Raised of $3,000 Goal
3%
Ended on 1/22/17
Campaign Ended
  • $84
    pledged
  • 3%
    funded
  • Finished
    on 1/22/17

About This Project

Most of patients admitted in Pediatric Intensive Care Unit require mechanical ventilation. Because it may lead to severe complications, it is important that mechanical ventilation be discontinued as soon as the patient is capable of sustaining spontaneous breathing. We are studying a new and noninvasive tool to assess the patient's respiratory effort in order to optimize the timing to remove the previously inserted endotracheal tube.

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What is the context of this research?

Every year, more than 300,000 children are hospitalized in Pediatric Intensive Care Unit in North America (Odetola, 2005), and a majority of them require mechanical ventilation, regardless the reason of admission. Mechanical ventilation may lead to severe complications (secondary lung injury, diaphragm dysfunction, etc) that is why it should be discontinued as soon as possible. However, criteria to diagnose extubation readiness are lacking. The monitoring of work of breathing during the weaning phase of ventilation allows us to determine the capacity of the patient to assume the ventilation. Therefore, work of breathing monitoring has the potential to be an important tool to accelerate the extubation process. However, its assessment is not easy in clinical practice.

What is the significance of this project?

Pediatric studies regarding the management of mechanical ventilation are lacking. In particular, the assessment of the patient’s respiratory effort during mechanical ventilation is actually scarcely reported. Such information is necessary to guide the adaptation of the settings in children. This original project aims to fulfill the lack of data in this field. We expect that the Indirect Calorimetry-based less invasive method will provide an accurate estimation of work of breathing. Once validated, this tool could be rapidly used to optimize the timing of extubation, and future trial will study its potential aiming to reduce the duration of ventilation, the length of stay in Pediatric Intensive Care Unit and mortality.

What are the goals of the project?

The primary objective of this study is to validate the reliability of a new method (Indirect Calorimetry) to assess the ability of patients to breath spontaneously and efficiently. We will compare this technology with 2 other methods (esophageal pressure measurement and Electrical Activity of the diaphragm, already known as good surrogates to assess work of breathing) during a routine extubation readiness test. Our final goal is to earlier identify patients able to be extubated and patients in whom extubation is unsafe.

Budget

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The budget will go towards paying an assistant who will meet the parents before inclusion, to explain them the study and to require their consent. In addition, although the Indirect Calorimeter is already available, we need to buy some equipment (specific catheters) to perform the measurements in children.

Endorsed by

Respiratory failure is the major reason for children to be admitted in intensive care unit. With this project, Guillaume wants to identify new strategies that will permit to personnalize the ventilator support to the needs of each individual child ! With this optimized support, we hope that children will leave faster the hospital !

Meet the Team

Guillaume Mortamet
Guillaume Mortamet
MD, PhD student

Affiliates

Université de Montréal and Université de Paris Est
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Team Bio

The team of the Paediatric Intensive Care Unit of CHU Sainte-Justine is internationally recognized in the field of pediatric mechanical ventilation, and in particular in pediatric acute respiratory distress syndrome. We played an important role as organizers and experts of the recent international Consensus Conference on Pediatric Acute Lung Injury (PALICC).

Guillaume Mortamet

As a young clinical investigator, I have a strong background in pediatric critical care medicine, with specific expertise in respiratory research.

I completed several degrees in both pediatric and adult critical care and I worked as a fellow in Necker Children's Hospital, Paris.

As a result of these previous experiences, and with the closed supervision of my research supervisor Dr Guillaume Emeriaud MD PhD, I am able to lead such a project and I am aware of the different issues I could meet. I know the importance of constructing a realistic research plan, timeline, and budget in order to accomplish the project.

To conduct this study, I work in close collaboration with 3 internationally recognized experts in the field of pediatric mechanical ventilation (G Emeriaud, P Jouvet, B Fauroux), including non invasive and invasive support.


Lab Notes

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Project Backers

  • 5Backers
  • 3%Funded
  • $84Total Donations
  • $16.80Average Donation
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