Research Respiratory

Research

Improving the quality of life for our patients doesn’t end with treatment. It extends to clinical research.

Clinical research is necessary to uncover the root causes of conditions, determine alternative treatments, and improve patient outcomes. We take our responsibility in this area very seriously.

We are working hard to investigate innovative ways to wean patients from ventilators, identify the most effective treatment methods for patients with multiple complex medical conditions, and utilize the latest technology to ease pain.

The largest study on ventilator patients was conducted over the past decade at RML.
Research findings were recently published in JAMA, analyzing outcomes of prolonged ventilation.

 

An overview of research at RML:

 

Prolonged ventilator weaning

Research conducted at RML by Amal Jubran, MD was recently published by the Journal of the American Medical Association.

The study, Effect of Pressure Support vs Unassisted Breathing Through a Tracheostomy Collar on Weaning Duration in Patients Requiring Prolonged Mechanical Ventilation, is the largest ventilator study of its kind.

Research compared the outcomes of weaning methods for patients from prolonged mechanical ventilation (greater than 21 days on a ventilator). The study concludes that unassisted breathing through a tracheostomy, compared with pressure support, resulted in shorter time to wean off of the ventilator. Additionally, the method of weaning had no effect on patient survival at 6 and 12 months.

Why is this research significant? Patients requiring prolonged mechanical ventilation account for more than 13% of ventilated patients and 37 % of intensive care unit (ICU) costs nationally. The number of ICU patients transferred to LTACHs like RML for weaning is expected to increase substantially and will cost billions of dollars. The shorter weaning time of one technique over the other represents significant costs in terms of patients’ length of stay.

 

Ventilator weaning: quality of life

Long-Term Outcome and Functional Status of Patients Weaned from Prolonged Mechanical Ventilation (PDF)

  • Effect of Prolonged Mechanical Ventilation on Quality of Life
  • Handgrip Strength and Maximum Inspiratory Pressure in Patients Weaning from Prolonged Mechanical Ventilation
  • Determinants of Long-Term Survival in Patients Weaned from Prolonged Mechanical Ventilation
  • Is Quality of Life Worse After Weaning

 

Psycho-social aspects of weaning

Anxiety Levels in Patients Weaned from Mechanical Ventilation (PDF)

  • Do Patients Weaned from Prolonged Mechanical Ventilation Show Early Signs of PostTraumatic Stress Disorder?

 

Other weaning studies

Can Mechanically Ventilated Patients Feel Secretions in Their Airway? (PDF)
A Cohort of Ventilated Patients with West Nile Virus Infection (PDF)

 

Other clinical research

RML is currently investigating the impact removing clutter from the patient care environment has on infection rates. Through a CareFusion Foundation grant, RML will develop a system to manage clutter as well as perform environmental and surveillance cultures to determine the impact of clutter intervention.

 

Contributing to industry-wide research

In conjunction with several long-term acute care hospitals across the country, RML was a primary contributor to Post-ICU Mechanical Ventilation at Long-Term Hospitals: A Multicenter Outcomes Study. This research, sponsored by the National Association of Long-Term Hospitals, examined ventilator-dependent patients over a period of one year. Areas of study included: demographics, severity of illness, diagnoses leading to ventilator dependence, comorbitities, outcomes of weaning attempts, time to wean, length of stay, functional status, disposition, survival and quality of life data and cost of care.