The National Institute of Child Health and Human Development (NICHD) has awarded a two-year, $450,000 grant to Dr. Elizabeth Killien for a study to assess whether oscillometry can identify and characterize recovery of pulmonary function for pediatric ICU patients surviving acute respiratory failure. The study could make it possible for doctors to better track lung function after ICU discharge, and to provide more targeted follow-up care to a larger number of patients.
"Acute respiratory failure is the most common cause of critical illness among children in the U.S., and the prevalence has been increasing over the last several decades," Killien said. "More children are surviving, which is great news, but that means it's important for us to have a good way to assess their lung function as they recover and manage any lasting impacts."
Spirometry, a test where a patient breathes as hard and fast as possible on cue while using a breath sensor, is currently the primary method for testing pulmonary function. But this type of testing isn't feasible for children under age 6, or those who can't follow complex instructions. At Seattle Children's, about 70 percent of children who are admitted to the pediatric ICU with acute respiratory failure fall into those categories. This study will be the first to evaluate pulmonary function in children surviving acute respiratory failure who can't participate in spirometry.
Oscillometry is a method that's just starting to be used for chronic lung disease, but hasn't been assessed for acute lung disease. It's a passive test and can be done with small portable devices, so it's more accessible for a larger population. The grant will allow Killien and collaborators to figure out whether oscillometry can deliver similar results to spirometry, expanding the toolkit for doctors treating pediatric patients in the ICU and enabling them to more closely observe any long-term effects.
The study will take place at three sites: Seattle Children's, Children's Hospital Colorado, and Centre Hospitalier Universitaire Sainte-Justine, in Montreal. The researchers will track patients for three months after discharge from the pediatric ICU for acute respiratory illness. They plan to enroll 150 participants across the three sites.
"We're hopeful that this study will allow us to identify patients who could benefit from follow-up care and might have previously been excluded from pulmonary function screening," Killien said.
Dr. Killien is an Assistant Professor with the UW Medicine Department of Pediatrics and an attending physician in the Seattle Children’s pediatric ICU. Read more about the work of her division: Critical Care Medicine.