Predictors of Upper Airway Function and Sleep-disordered Breathing in the Critically Ill
Determining Predictors of Adequate Upper Airway Function in Ventilated Patients
This is part 2 of the #NCT01618240 under the same IRB protocol #2010P001919. The primary objective of this study is to examine factors that are related to sleep-disordered breathing and upper airway patency in critically ill patients who have been recently mechanically ventilated. Our primary hypothesize is that sedatives and neuromuscular blocking agents given in the ICU prior to extubation and during the first night following extubation are associated with sleep-disordered breathing. The secondary hypotheses are that duration of mechanical ventilation, BMI, and muscle strength are associated with sleep-disordered breathing during the night after extubation.
The secondary objective is to evaluate if sleep-disordered breathing in the ICU can be predicted by standard pulmonary function testing in the ICU.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Contacts and Locations
Study Contact
Study Contact
- Name: Matthias Eikermann, MD, PhD
- Phone Number: 617-643-4408
- Email: MEIKERMANN@PARTNERS.ORG
Study Locations
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Massachusetts
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Boston, Massachusetts, United States, 02114
- Recruiting
- Massachusetts General Hospital
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Contact:
- Matthias Eikermann, MD, PhD
- Phone Number: 617-643-4408
- Email: MEIKERMANN@PARTNERS.ORG
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Principal Investigator:
- Matthias Eikermann, MD, PhD
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients admitted to the SICU
- Age over 18 years.
- Ventilated patients with an endotracheal tube for at least 24 hours.
Exclusion Criteria:
- Decreased level of consciousness as defined by a Richmond Agitation Sedation Scale (RASS) of 0.
- Non-cooperative patient, CAM score positive for risk of delirium.
- For women: pregnancy.
Study Plan
How is the study designed?
Design Details
- Observational Models: Cohort
- Time Perspectives: Prospective
Number of groups / cohorts
Cohorts and Interventions
Group / CohortGroup / Cohort |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Ventilated patients
Patients who have been extubated within 24 hours and have been mechanically ventilated for at least 24 hours.
Alice PDx, pulmonary function tests, muscle strength tests, grip strength measurements, ventilator, Sedatives and muscle relaxants given in the ICU
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Mechanical ventilator used to replace or assist spontaneous breathing.
Alice PDx is a polysomnography monitor used to study stages of sleep and detect sleep-disordered breathing.
The device monitors PO2, airflow, EEG, EOG and abdominal wall movements to detect sleep apnea.
The pulmonary function tests are used to study upper airway patency.
MRC score (0-60) is a clinical assessment of muscle power on abduction of the arm, flexion of the forearm, extension of the wrist, flexion of the leg, extension of the knee and dorsal flexion of the foot with the score of (0-5) on each measurement
Grip strength has been shown to be an accurate means of assessing muscle function in the critically ill.
Muscle weakness may have an impact on upper airway patency.
Patients in the ICU are administered sedatives, anesthetics, opiods, anti-pyschotics and neuromuscular blocking agents as part of routine care.
We hypothesize that the use of these drugs is associated with sleep-disordered breathing following extubation.
We will collect the drug doses from the patient's chart.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Apnea-hypopnea index (AHI)
Time Frame: 1 Night after extubation
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The apnea-hypopnea index (AHI) is calculated the night after extubation via a polysomnography device.
An AHI ≥ 5 indicates sleep-disordered breathing and obstructive sleep apnea (OSA).
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1 Night after extubation
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Matthias Eikermann, MD, PhD, Massachusetts General Hospital
Publications and helpful links
General Publications
- Mirzakhani H, Williams JN, Mello J, Joseph S, Meyer MJ, Waak K, Schmidt U, Kelly E, Eikermann M. Muscle weakness predicts pharyngeal dysfunction and symptomatic aspiration in long-term ventilated patients. Anesthesiology. 2013 Aug;119(2):389-97. doi: 10.1097/ALN.0b013e31829373fe.
- Timm FP, Zaremba S, Grabitz SD, Farhan HN, Zaremba S, Siliski E, Shin CH, Muse S, Friedrich S, Mojica JE, Kurth T, Ramachandran SK, Eikermann M. Effects of Opioids Given to Facilitate Mechanical Ventilation on Sleep Apnea After Extubation in the Intensive Care Unit. Sleep. 2018 Jan 1;41(1). doi: 10.1093/sleep/zsx191.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Nervous System Diseases
- Respiratory Tract Diseases
- Apnea
- Respiration Disorders
- Sleep Disorders, Intrinsic
- Dyssomnias
- Sleep Wake Disorders
- Disease Attributes
- Sleep Apnea Syndromes
- Sleep Apnea, Obstructive
- Critical Illness
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Hypnotics and Sedatives
Other Study ID Numbers
Other Study ID Numbers
- 2010P001919B
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