Clinical Decision Support for Mechanical Ventilation of Patients With ARDS
Implementation of Computerized Clinical Decision Support for Mechanical Ventilation of Patients With Acute Respiratory Distress Syndrome
調査の概要
詳細な説明
A multidisciplinary team of implementation researchers and clinical effectiveness researchers has been assembled to adapt the Consolidated Framework for Implementation Research (CFIR) for this planning study. The team identified the baseline clinical care delivery for LTVV in patients with ARDS across Intermountain hospitals and identified the barriers and facilitators to this standard of care. This pilot implementation study will focus on a Pilot Solution aimed at achieving ideal clinical care delivery of LTVV for patients with ARDS.
Abbreviations for Mechanical Ventilation:
PEEP: positive end expiratory pressure FIO2: fraction of inspired oxygen CPAP: continuous positive airway pressure PS: pressure support VC: volume control VC+: hybrid mode for volume targeted ventilation on Puritan Bennett ventilators PRVC: pressure regulated volume control, hybrid mode for volume targeted ventilation on Draeger ventilators PF ratio: ratio of partial pressure of arterial oxygen (PaO2 mmHg) divided by the FIO2 expressed in liters
研究の種類
入学 (予想される)
段階
- 適用できない
連絡先と場所
研究連絡先
- 名前：Colin K Grissom, MD
- 電話番号：801-507-6554
- メール：colin.grissom@imail.org
研究場所
-
-
Utah
-
Murray、Utah、アメリカ、84107
- 募集
- Intermountain Medical Center
-
コンタクト：
- Valerie Aston
- 電話番号：801-507-4606
- メール：valerie.aston@imail.org
-
副調査官：
- Ithan Peltan, MD
-
副調査官：
- Samuel Brown, MD
-
副調査官：
- Lindsay Leither, DO
-
副調査官：
- Michael Lanspa, MD
-
副調査官：
- Joseph Bledsoe, MD
-
副調査官：
- Scott Stevens, MD
-
コンタクト：
- Carlos Barbagelata
- 電話番号：801-507-4607
- メール：carlos.barbagelata@imail.org
-
副調査官：
- Lori Carpenter
-
副調査官：
- Andrew Knighton, PhD
-
副調査官：
- Scott Narus, MD
-
副調査官：
- Rajendu Srivastava, MD
-
-
参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Invasive mechanical ventilation
- PF ratio <255
- Bilateral infiltrates on chest radiograph (adjudicated by a co-investigator)
- Presence of ≥1 risk factor for ARDS as determined by review of the HER
Exclusion Criteria:
- Age <18 years
- Pulmonary capillary wedge pressure >18 mm Hg if a right heart catheter is present
- Prisoner
- Known to be pregnant
- Death <24 hours from initial intubation
- Placed comfort care <24 hours from initial intubation
- Mechanically ventilated for >7 days prior to meeting ARDS criteria
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：ヘルスサービス研究
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
実験的：Patients with ARDS at three Intermountain tertiary hospitals
|
Implementation of processes to improve compliance with low tidal volume ventilation in patients with ARDS using a computerized protocol
|
この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
LTVV Compliance
時間枠：through study completion - 6 months
|
Defined as: % of time each patient is on a compliant tidal volume for the duration of mechanical ventilation. Measured as: VC, PRVC, or VC+ with volume set to 6.5 ml/kg or less for each patient (proportion of mechanically ventilated hours, excluding hours on appropriate CPAP/PS) |
through study completion - 6 months
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
PEEP FI02 Compliance (continuous variable)
時間枠：through study completion - 6 months
|
Defined as: % of time each patient is on a compliant FI02 and PEEP combination. Measured as: using recommended (per most recently run oxygenation protocol) PEEP-FIO2 combinations, (proportion of ventilated hours, excluding the first four hours of mechanical ventilation and excluding hours on appropriate CPAP/PS) |
through study completion - 6 months
|
|
Utilization of Ventilation Protocol (continuous)
時間枠：through study completion - 6 months
|
Defined as: % of time each patient is managed with the computerized ventilation protocol. Measured as: Running the computerized ventilation protocol whenever a ventilator check is performed and an arterial blood gas was done within the previous hour, excluding hours on appropriate CPAP/PS |
through study completion - 6 months
|
|
Utilization of Oxygenation Protocol (continuous)
時間枠：through study completion - 6 months
|
Defined as: % of time each patient is managed with the computerized oxygenation protocol. Measured as: Running the computerized oxygenation protocol at least every four hours when a ventilator check was performed, excluding hours on appropriate CPAP/PS |
through study completion - 6 months
|
|
LTVV Compliance >90% (binary)
時間枠：through study completion - 6 months
|
Defined as: meeting, or not meeting, the target LTVV compliance of >90% for each patient. Measured as: VC, PRVC, or VC+ with volume set to 6.5 ml/kg or less for 90% or more of mechanically ventilated hours, excluding hours on appropriate CPAP/PS |
through study completion - 6 months
|
|
PEEP FI02 Compliance >70% (binary)
時間枠：through study completion - 6 months
|
Defined as: meeting, or not meeting, the target PEEP FI02 compliance of >70% for each patient. Measured as: Using recommended (per most recently run oxygenation protocol) PEEP-FIO2 combinations for at least 70% of mechanically ventilated hours (excluding the first four hours of mechanical ventilation and excluding hours on appropriate CPAP/PS) |
through study completion - 6 months
|
|
Ventilator-Free Days (VFD) to Day 28
時間枠：through study completion - 6 months
|
through study completion - 6 months
|
|
|
% of Patients who do not survive to day 28
時間枠：through study completion - 6 months
|
through study completion - 6 months
|
協力者と研究者
出版物と役立つリンク
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (予想される)
研究の完了 (予想される)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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