MURRAY, Utah (INTERMOUNTAIN MEDICAL CENTER) – In a new multi-site national research study, Intermountain Medical Center researchers are spearheading a project to identify complications suffered by patients who are recovering from acute lung injury, a serious condition treated in the Intensive Care Unit.
The study, which is being funded by the U.S. Department of Defense, aims to figure out what is causing medical complications and high re-admission rates among those patients.
Intermountain Medical Center/Intermountain Healthcare and Vanderbilt University Medical Center are lead sites for the study. They’ll work with Johns Hopkins University in Baltimore, Beth Israel Deaconess Medical Center in Boston, and the Veterans Affairs Medical Center in Salt Lake City. Researchers started enrolling patients this month.
Amanda Grow from Bountiful nearly died from rare complications delivering her 4th child. A condition called amniotic fluid embolism caused her lungs to fail and required 75 units of blood.
“They just kept bringing cooler after cooler of blood. There are’s pictures of my son’s birth but I don’t remember any of it,” said Amanda.
She was on life support in a medically induced coma.
“My family wasn’t sure which way it would go if I would live or die.”
Amanda narrowly survived. Then she was sent home.
It’s this dramatic and vulnerable transition in the first few weeks post-ICU Dr. Samuel Brown and others want to study.
“In the ICU, our care teams fight valiantly against life-threatening illnesses, but after the patient recovers enough to leave the ICU, we go on to the next patient in line, and a totally different care team takes over. Our former patients and their families can end up feeling abandoned,” said Samuel M. Brown, MD, director of the Center for Humanizing Critical Care at Intermountain Medical Center. “We do a great job getting people through the crisis but a pretty poor job of supporting them through the long arc of recovery.”
While about 80 percent of patients are eventually discharged alive from the ICU, they face a high risk of developing complications like PTSD (especially common if patients were on a respirator), problems with memory or strength, hospital re-admission, or even death. Evidence suggests that almost half of patients with acute lung injury and related conditions like sepsis may be re-admitted to the hospital within 3 months after discharge; some of those patients will even die in the first few months after discharge.
This three-year study, which will track patients from five different institutions across the United States, focuses on acute lung injury because it’s both common among civilians (200,000 people a year develop it and it causes 75,000 deaths annually) and because it’s of particular concern to military service members, who may suffer blast injuries in the line of duty, which can lead to acute lung injury. Acute lung injury is also common among older individuals, including military veterans.
“Acute lung injury is an especially devastating form of illness that brings you to the ICU, and people who suffer from it are at high risk of coming back to the hospital after discharge,” Dr. Brown said. “We hope that with this study, the Department of Defense can better understand what it can do to help wounded service members and simultaneously, our findings can be useful to civilians and their families. It’s a great opportunity to help a diverse array of patients.”
Dr. Brown indicated that many factors can lead to re-admission for patients with acute lung injury.
“Maybe it’s a lack of organization in that transition phase, or care plans made at discharge aren’t adequately explained or implemented. We want to know why, and whether those plans are followed in the early days and weeks after patients leave the hospital, and what happened if they do come back to the hospital,” he said.
This work was supported by the U.S. Army Medical Research and Materiel Command, Congressionally Directed Medical Research Programs, through the Peer-Reviewed Medical Research Program, under Award No. W81XWH-18-1-0813. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.
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