Mari Armstrong-Hough, MPH, PhD, has been awarded a $3.8 million, five-year grant (R01HL181102) from the National Heart, Lung, and Blood Institute to improve outcomes among people experiencing respiratory failure. The funding will support Reducing Excess Sedation to Optimize Recovery (RESTORE), led by Dr. Armstrong-Hough and co-principal investigator Dr. Thomas Valley of the University of Michigan.
Roughly one million Americans die each year from respiratory failure, a serious condition in which the lungs cannot get enough oxygen into the blood or cannot remove enough carbon dioxide. People hospitalized with respiratory failure are often treated in the intensive care unit (ICU), where medication and oxygen are administered, with more severe cases requiring a ventilator to support breathing.
Notably, nearly 90 percent of ventilated patients with respiratory failure in the US are sedated more deeply than guidelines recommend. While sedation can keep ventilated patients comfortable and calm, studies show that deep sedation is linked to worse outcomes, including disability and death.
“There is an urgent need to de-implement this common but harmful practice,” said Dr. Armstrong-Hough. “Our goal is to improve survival and quality of life for patients with respiratory failure by promoting best practices for sedation in critical care.”
The RESTORE study will build upon earlier NHLBI-funded research by Drs. Armstrong-Hough and Valley examining disparities in respiratory failure outcomes and barriers that lead hospitals to overuse deep sedation. The grant will support additional research into the factors that contribute to the use of deep sedation and optimization of a package of tools to help ICUs limit its use in respiratory failure.
The researchers will then conduct a cluster-randomized trial at 12 hospitals to test whether systematically reducing the use of deep sedation in ICUs will improve survival and quality of life for patients with respiratory failure.