# Functional Outcomes after Prolonged Mechanical Ventilation in Children

> **NIH NIH K23** · UNIVERSITY OF COLORADO DENVER · 2020 · $161,795

## Abstract

Project Summary
Every year, more than 100,000 children in the United States require admission to a Pediatric Intensive Care
Unit (PICU) with mechanical ventilation support. Of these, one in ten have significant acute lung injury referred
to as Pediatric Acute Respiratory Distress Syndrome (PARDS). The majority of these children survive their
arduous PICU course, but little is known about their long-term functional outcomes. Adult survivors of
mechanical ventilation and ARDS are known to suffer from long-term significant impairments including
decreased exercise tolerance, inability to return to work, and low health-related quality of life (HRQOL). There
remains a significant knowledge gap in the understanding of long-term outcomes in children who survive
prolonged mechanical ventilation and PARDS. In this proposal, we will employ two methods to evaluate the
long-term physical functioning of children who survive mechanical ventilation and PARDS. First, we will link
detailed data from the inpatient electronic health record to post-discharge outpatient insurance claims data to
identify natural clusters of functional outcome phenotypes and the predictive patient and hospitalization
characteristics in a large retrospective cohort of children admitted to our PICU who require > 3 days of
mechanical ventilation (Aim 1). Second, we will establish a prospective cohort of critically-ill mechanically
ventilated children to evaluate post-discharge HRQOL, functional status, and physical activity (Aim 2). We will
use accelerometry, a novel, objective measure of physical activity to build upon the currently used, subjective
measures of physical functioning. We hypothesize that we will be able to identfy and validate functional
outcome phenotypes and predictors of phenotype clusters (Aim 1). Additionally, we hypothesize that severity of
PARDS as well as a threshold of duration of mechanical ventilation, a metric of exposure to PICU-related
therapies, will be associated with worse functional outcomes including impaired functional recovery and
decreased physical activity (Aim 2). The results of this proposal will identify a cohort of critically ill children who
are at high risk of poor functional recovery and most likely to benefit from targeted interventions to improve
long-term outcomes. These studies will lay the groundwork for Dr. Maddux to obtain the necessary expertise in
pediatric critical care outcomes research to employ accurate, clinically-meaningful long-term outcome
measures to evaluate targeted in-hospital and post-discharge therapies in clinical trials with the goal to improve
the long-term physical functioning of critically ill children. Addditionally, a well orchestrated career development
plan will provide the necessary training for Dr. Maddux to become an independent investigator focused on
long-term outcomes after critical illness with the skills to evaluate large databases and perform prospective
cohort follow-up.

## Key facts

- **NIH application ID:** 9986853
- **Project number:** 5K23HD096018-02
- **Recipient organization:** UNIVERSITY OF COLORADO DENVER
- **Principal Investigator:** Aline Bernard Maddux
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $161,795
- **Award type:** 5
- **Project period:** 2019-08-01 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9986853

## Citation

> US National Institutes of Health, RePORTER application 9986853, Functional Outcomes after Prolonged Mechanical Ventilation in Children (5K23HD096018-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9986853. Licensed CC0.

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