- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT00638339
Effects Of Invasive And Noninvasive Mechanical Ventilation On Sleep In The Intensive Care Unit (ICU)
Effects Of Invasive And Noninvasive Mechanical Ventilation On Sleep In The Icu
Studieoversikt
Status
Detaljert beskrivelse
Sleep in critically-ill patients is commonly severely fragmented, and sleep architecture is altered as compared to a healthy person. This abnormal sleep may cause some important adverse psychological and physiological consequences. Noise, light, patient-care activities, pain, or medications are some of the contributing factors to sleep disruption in the ICU. Recent evidence also suggests that invasive mechanical ventilation (IMV) itself may lead to sleep fragmentation in the ICU. Noninvasive ventilation (NIV) is a well-established, relatively new form of ventilation which improves sleep quality or gas exchange in some patients with chronic hypoventilatory disorders. Although sleep may be disrupted due to discomfort from the mask or air leaking during NIV use; intermittent use of NIV may result in better sleep quality between NIV sessions. The effects of NIV on sleep in the acute care setting have not yet been studied.
The purpose of the study is to describe the sleep architecture of a cohort of critically-ill patients using NIV, comparing findings to a reference group of patients using (IMV).
Studietype
Registrering (Faktiske)
Kontakter og plasseringer
Studiesteder
-
-
Massachusetts
-
Boston, Massachusetts, Forente stater, 02111
- Tufts-New England Medical Center Medical ICU and Coronary Care Unit
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Prøvetakingsmetode
Studiepopulasjon
Beskrivelse
Inclusion Criteria:
- Age > 18 yrs
- Receiving invasive or noninvasive mechanical ventilation
- Anticipated further ventilation of at least 24-hour duration for IMV and 8 hours/ 24 hours for NIV
Exclusion Criteria:
- Pre-morbid diseases that could interfere with interpretation of sleep monitoring including CNS disorders (strokes, encephalopathic states), dementia, and known sleep disorders
- On home BiPAP or CPAP
- Depressed sensorium as evidence by Glasgow Coma Score < 10, need for continuous sedation with Riker Score < 2 and inability to follow verbal commands for sustained 3 hours
- Presence of head trauma, psychiatric illness (including use of antidepressant medication), anoxic brain injury, drug overdose or uncontrolled seizure disorder
- Severe hemodynamic instability (BP< 90 mmHg despite vasopressor therapy) and sepsis
- Recalcitrant hypoxemia (inability to sustain SaO2 > 88%)
- Considered as unstable by ICU team (hemodynamic instability, acute uncontrolled GI bleeding, acute cardiac ischemia or arrhythmias)
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Observasjonsmodeller: Case-Control
- Tidsperspektiver: Potensielle
Kohorter og intervensjoner
Gruppe / Kohort |
---|
1
critically ill patients undergoing invasive mechanical ventilation in medical ICU and CCU
|
2
critically ill patients undergoing noninvasive mechanical ventilation in medical ICU and CCU
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tidsramme |
---|---|
To define sleep characteristics in critically-ill patients receiving mechanical ventilation in medical ICU and coronary care unit (CCU)
Tidsramme: During 24-hour monitorization period (after recruitment into the study)
|
During 24-hour monitorization period (after recruitment into the study)
|
Sekundære resultatmål
Resultatmål |
Tidsramme |
---|---|
To compare total sleep time and differences in sleep architecture including time spent in different sleep stages and arousals in critically-ill patients receiving mechanical ventilation in medical ICU and CCU
Tidsramme: During 24-hour monitorization
|
During 24-hour monitorization
|
To determine sleep patterns during NIV use, correlating sleep with periods of use and air leaking
Tidsramme: During 24-hour monitorization
|
During 24-hour monitorization
|
To monitor environmental factors including noise, light and patient care activities, and to associate these with sleep patterns
Tidsramme: During 24-hour monitorization
|
During 24-hour monitorization
|
To assess associations of severity of illness and sedation usage with sleep patterns
Tidsramme: During 24-hour monitorization period
|
During 24-hour monitorization period
|
Samarbeidspartnere og etterforskere
Sponsor
Etterforskere
- Studieleder: Aylin Ozsancak, MD, Research Fellow
- Hovedetterforsker: Nicholas S Hill, MD, Chair of Pulmonary, Critical Care and Sleep Medicine Division
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Faktiske)
Studiet fullført (Faktiske)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Anslag)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Nøkkelord
Ytterligere relevante MeSH-vilkår
Andre studie-ID-numre
- IRB-8053
Plan for individuelle deltakerdata (IPD)
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