This subproject is one of many research subprojects utilizing theresources provided by a Center grant funded by NIH/NCRR. The subproject andinvestigator (PI) may have received primary funding from another NIH source,and thus could be represented in other CRISP entries. The institution listed isfor the Center, which is not necessarily the institution for the investigator.Acute hypoxemic respiratory failure complicates and contributes significantly to the morbidity and mortality of critically ill children with diverse underlying diseases. Despite aggressive treatment, mortality associated with Acute Hypoxemic Respiratory Failure (AHRF) remains between 40 - 60% (1, 2). High mortality is associated with progressive and sustained impairment in oxygenation in children with ARDS. Although multiorgan failure and the primary diagnosis associated with AHRF contribute to mortality, progressive deterioration of lung disease complicates the clinical course of patients with AHRF. Ventilatory strategies which result in alveolar over-distention and cyclic reopening of collapsed alveoli may contribute to progressive lung injury (6, 7). Adjunctive therapies that improve oxygenation and protect the lung from progressive injury may contribute to lower morbidity and improved clinical courses (8, 9, 10, 11). Inhaled nitric oxide therapy has been shown to acutely lower PAP and improve gas exchange in neonates, children, and adults with AHRF (12, 13, 14). The proposed study is a prospective, multi-center, randomized, placebo-controlled trial comparing the effects of nitric oxide for inhalation in the treatment of AHRF in pediatric patients admitted to the PICU requiring intubation. Nitric oxide will be delivered at 5 ppm continuously into the inspiratory limb of the ventilator circuit in mechanically ventilated patients using a blinded version of the INOvent delivery system. The hypothesis to be tested is that the combination of a protective ventilator strategy to recruit the lung and iNO can slow the progression of lung disease in AHRF. Study endpoints are discharge from the PICU, day 28, or death. The primary outcome measures are length of ventilation and PICU stay. 330 subjects will be enrolled.

Agency
National Institute of Health (NIH)
Institute
National Center for Research Resources (NCRR)
Type
General Clinical Research Centers Program (M01)
Project #
5M01RR000069-45
Application #
7605057
Study Section
Special Emphasis Panel (ZRR1-CR-9 (01))
Project Start
2007-03-01
Project End
2008-02-29
Budget Start
2007-03-01
Budget End
2008-02-29
Support Year
45
Fiscal Year
2007
Total Cost
$2,160
Indirect Cost
Name
University of Colorado Denver
Department
Pediatrics
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Young, Kendra A; Maturu, Amita; Lorenzo, Carlos et al. (2018) The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio as a predictor of insulin resistance, ?-cell function, and diabetes in Hispanics and African Americans. J Diabetes Complications :
Kelsey, Megan M; Braffett, Barbara H; Geffner, Mitchell E et al. (2018) Menstrual Dysfunction in Girls From the Treatment Options for Type 2 Diabetes in Adolescents and Youth (TODAY) Study. J Clin Endocrinol Metab 103:2309-2318
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Arslanian, Silva; El Ghormli, Laure; Kim, Joon Young et al. (2018) The Shape of the Glucose Response Curve During an Oral Glucose Tolerance Test: Forerunner of Heightened Glycemic Failure Rates and Accelerated Decline in ?-Cell Function in TODAY. Diabetes Care :
Kriska, Andrea; El Ghormli, Laure; Copeland, Kenneth C et al. (2018) Impact of lifestyle behavior change on glycemic control in youth with type 2 diabetes. Pediatr Diabetes 19:36-44
Venditti, E M; Tan, K; Chang, N et al. (2018) Barriers and strategies for oral medication adherence among children and adolescents with Type 2 diabetes. Diabetes Res Clin Pract 139:24-31
Gidding, Samuel S; Bacha, Fida; Bjornstad, Petter et al. (2018) Cardiac Biomarkers in Youth with Type 2 Diabetes Mellitus: Results from the TODAY Study. J Pediatr 192:86-92.e5
Jacobson, Denise L; Lindsey, Jane C; Coull, Brent A et al. (2018) The Association of Fat and Lean Tissue With Whole Body and Spine Bone Mineral Density Is Modified by HIV Status and Sex in Children and Youth. Pediatr Infect Dis J 37:71-77
Arslanian, Silva; El Ghormli, Laure; Bacha, Fida et al. (2017) Adiponectin, Insulin Sensitivity, ?-Cell Function, and Racial/Ethnic Disparity in Treatment Failure Rates in TODAY. Diabetes Care 40:85-93

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