Timing and risk factors for developing chronic respiratory failure after pediatric sepsis

ABSTRACT
Each year in the US, over 70,000 children are hospitalized with sepsis. Of the nearly 90% of children who
survive sepsis, many face physical, emotional, and cognitive morbidity following sepsis hospitalization. Indeed,
recent work by the proposed project’s research team—including through support from PI Carlton’s NCATS KL2
award—demonstrated that 1 in 20 children who survive sepsis develop new chronic respiratory failure (defined
as supplemental oxygen dependence and/or invasive or non-invasive ventilator dependence) within 6 months
of discharge. This rate of new chronic respiratory failure was nearly 2.5 times higher than in matched, non-
septic, critically ill children. The proposed project will bring novel data to address several important gaps in
understanding in order to mitigate and prevent the development of new chronic respiratory failure after sepsis.
Using national multi-payer data (commercial insurance & Medicaid), the research team will characterize the
patterns of onset of new chronic respiratory failure after sepsis. Secondly, the team will identify potentially
modifiable factors associated with onset of this new morbidity.
Specific aims include:
Aim 1: To test the extent to which new chronic respiratory failure develops in-hospital versus post-discharge
among children who survive sepsis hospitalization.
Aim 2: To establish the antecedent and sepsis-specific risk factors associated with the onset of new chronic
respiratory failure following sepsis.
No studies, to the team’s knowledge, have described the time of onset of chronic respiratory failure after sepsis
(i.e., developed during sepsis hospitalization vs. after discharge), nor assessed the explanatory risk factors for
its development. The team anticipates that findings from the proposed project will fill critical knowledge gaps
about the epidemiology and risk factors for postsepsis chronic respiratory failure that are necessary to enhance
recovery. This work will provide key preliminary data for an R01 addressing the prevention, treatment, and
management of sepsis-associated chronic respiratory failure among children.

Grant Number: 1R03TR004798-01
NIH Institute/Center: NIH
Principal Investigator: Erin Carlton