Christianne Lane

Bio: Christianne Lane is an academic researcher. The author has contributed to research in topics: Data collection & Public health. The author has an hindex of 1, co-authored 2 publications receiving 29 citations.

Epidemiology and outcomes of acute respiratory distress syndrome in children according to the Berlin definition: a multicenter prospective study.

Abstract: Objectives:In 2012, a new acute respiratory distress syndrome definition was proposed for adult patients. It was later validated for infants and toddlers. Our objective was to evaluate the prevalence, outcomes, and risk factors associated with acute respiratory distress syndrome in children up to 15

621: data collection during public health emergencies: lessons learned over three influenza seasons

Abstract: Introduction/Hypothesis: Limitations in the rapid collection of patient-level data during public health emergencies remain a national strategic vulnerability. Over a 3-year period, we developed a consensus, electronic case report form (eCRF) and tested the feasibility of nationwide data collection for intensive care unit (ICU) patients with influenza. Methods: Twelve hospitals in the US implemented an observational protocol to collect data on ICU patients with laboratoryconfirmed influenza over 2-week periods. In year 1, data were collected retrospectively over hospital-identified timeframes. In years 2-3, data were collected prospectively during designated timeframes. In year 1, 80 clinical data elements were collected. In years 2-3, 151 clinical data elements were collected in a 2-tier system, with tier-1 data collected within 48-hours of admission and tier-2 data within 14 days. Descriptive statistics were calculated. Results: Over 3 years, data for 198 patients were collected across 12 sites (53% male, 91% adult). Year 1 data were retrospectively captured (n=74); year 2 (n=70) and year 3 (n=54) data were prospectively captured. 64% were mechanically ventilated, with consistency over the 3 years. 11% were on ECMO (11%, 4%, 19% by year). 90% received antiviral therapy within 48-hours (oseltamivir 98%). 87% received antibacterial drugs (93%, 82%, 85% by year). Antifungals were administered to 16% and corticosteroids to 41%. 38% were discharged home (32%, 50%, 30% by year). 21% remained in the hospital (19%, 19%, 28% by year). 16% died (20%, 9%, 20% by year). Conclusions: Data collection method and flu season timing varied over the 3-year period, but consistency of results across time suggest several lessons. A consensus eCRF for influenza has been developed that can be broadly applied with consistent data collection allowing for clinically relevant comparisons across time and location. There were important variations in treatment of lifethreatening influenza that could have affected outcomes over time; the reasons for treatment variance are not known and require study. For example, mechanical ventilation as supportive care was consistent throughout the 3-year period, while ECMO rates and treatment with corticosteroids varied. Next steps are automated data extraction and expanded data collection windows.

Definition and epidemiology of acute respiratory distress syndrome.

Abstract: Fifty years ago, Ashbaugh and colleagues defined for the first time the acute respiratory distress syndrome (ARDS), one among the most challenging clinical condition of the critical care medicine. The scientific community worked over the years to generate a unified definition of ARDS, which saw its revisited version in the Berlin definition, in 2014. Epidemiologic information about ARDS is limited in the era of the new Berlin definition, and wide differences are reported among countries all over the world. Despite decades of study in the field of lung injury, ARDS is still so far under-recognized, with 2 out of 5 cases missed by clinicians. Furthermore, although advances of ventilator strategies in the management of ARDS associated with outcome improvements—such as protective mechanical ventilation, lower driving pressure, higher PEEP levels and prone positioning—ARDS appears to be undertreated and mortality remains elevated up to 40%. In this review, we cover the history that led to the current worldwide accepted Berlin definition of ARDS and we summarize the recent data regarding ARDS epidemiology.

Mortality in Pediatric Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

Abstract: Objective:Sparse and conflicting evidence exists regarding mortality risk from pediatric acute respiratory distress syndrome (ARDS). We aimed to determine the pooled mortality in pediatric ARDS and to describe its trend over time.Data Sources and Study Selection:MEDLINE, EMBASE, and Web of Science were searched from 1960 to August 2015. Keywords or medical subject headings (MESH) terms used included “respiratory distress syndrome, adult,” “acute lung injury,” “acute respiratory insufficiency,” “acute hypoxemic respiratory failure,” “pediatrics,” and “child.” Study inclusion criteria were (1) pediatric patients aged 0 days to 18 years, (2) sufficient baseline data described in the pediatric ARDS group, and (3) mortality data. Randomized controlled trials (RCTs) and prospective observational studies were eligible.Data Extraction and Synthesis:Data on study characteristics, patient demographics, measures of oxygenation, and mortality were extracted using a standard data extraction form. Independent authors c...

Global Critical Care: Moving Forward in Resource-Limited Settings

Abstract: Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and institutional obstacles to implementation of life-saving interventions. Potential solutions include the development of common definitions for intensive care unit (ICU), intensivist, and intensive care to create a universal ICU organization framework; development of educational programs for capacity building of health care professionals working in resource-limited settings; global prioritization of epidemiologic and clinical research in resource-limited settings to conduct timely and ethical studies in response to emerging threats; adaptation of international guidelines to promote implementation of evidence-based care; and strengthening of health systems that integrates these interventions. This manuscript reviews the field of global critical care, barriers to safe high-quality care, and potential solutions to existing challenges. We also suggest a roadmap for improving the treatment of critically ill patients in resource-limited settings.

Viral Infection in the Development and Progression of Pediatric Acute Respiratory Distress Syndrome.

Abstract: Viral infections are an important cause of pediatric Acute Respiratory Distress Syndrome (ARDS). Numerous viruses, including respiratory syncytial virus (RSV) and influenza A (H1N1) virus, have been implicated in the progression of pneumonia to ARDS; yet the incidence of progression is unknown. Despite acute and chronic morbidity associated with respiratory viral infections, particularly in ‘at risk’ populations, treatment options are limited. Thus, with few exceptions, care is symptomatic. In addition, mortality rates for viral related ARDS have yet to be determined. This review outlines what is known about ARDS secondary to viral infections including the epidemiology, the pathophysiology and diagnosis. In addition, emerging treatment options to prevent infection, and to decrease disease burden will be outlined. We focused on RSV and influenza A (H1N1) viral-induced ARDS, as these are the most common viruses leading to pediatric ARDS, and have specific prophylactic and definitive treatment options.