Impact and Sequelae of High Ventilatory Drive in Critically Ill COVID-19 Patients
Impact and Sequelae of High Ventilatory Drive in Critically Ill COVID-19 Patients With Acute Respiratory Failure Requiring High Flow Oxygen or Mechanical Ventilation: Mechanistic and Genomic Characterization Using Artificial Intelligence
Critically ill COVID-19 patients with acute respiratory failure, in the intensive care unit (ICU), often feature high respiratory drive, determining large inspiratory efforts resulting in high pressures and global and regional over-distention, leading to lung injury. SARS-CoV-2 neurotropic-penetration in control centers in medulla oblongata might contribute to dysregulation and to excessively high respiratory drive observed in these patients. These pathophysiological conditions may often lead to the development of patient-ventilator asynchronies in aptients under mechanical ventilation, again leading to high tidal volumes and increased lung injury. These phenomena can contribute to prolonged duration of mechanical ventilation and ICU length of stay, but also can result in long term adverse outcomes like emotional/psychological and cognitive sequelae. All them compromising the quality of life of critically ill survivors after ICU discharge.
The investigators will conduct a multicenter study in adult critically ill COVID-19 patients with hypoxemic respiratory failure, aiming to: 1) characterize incidence and clustering of high respiratory drive by developing algorithms, 2) apply artificial intelligence in respiratory signals to identify potentially harmful patient-ventilator interactions, 3) characterize cognitive and emotional sequelae in critically ill COVID-19 survivors after ICU discharge and 4) identify sets of genes and transcriptomic signatures whose quantified expression predisposed to asynchronies and cognitive impairment in critically ill COVID-19 patients.
研究概览
研究类型
注册 (预期的)
联系人和位置
学习地点
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Manresa、西班牙
- 招聘中
- Fundacio Althaia
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接触:
- Rafael Fernandez, PhD
- 电话号码:938 75 93 00
- 邮箱:rfernandez@althaia.cat
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副研究员:
- Montserrat Batlle, MD, PhD
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Oviedo、西班牙
- 招聘中
- Hospital Universitario Central de Asturias
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接触:
- Guilermo Muñiz-Albaiceta, PhD
- 电话号码:985 10 80 00
- 邮箱:gma@cri-lab.org
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Barcelona
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Sabadell、Barcelona、西班牙、08208
- 招聘中
- Candelaria De Haro
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接触:
- Candelaria De Haro, MD, PhD
- 电话号码:21158 0034937231010
- 邮箱:cdeharo@tauli.cat
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首席研究员:
- Josefina Lopez-Aguilar, PhD
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Adults patients with hypoxemic respiratory failure.
- Admitted to ICU.
- Mechanical ventilation or high flow nasal cannula
Exclusion Criteria:
- Neurologic patients with brainsteam affection.
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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COVID-19 Cohort
Patients with a diagnosis of moderate or severe pneumonia or ARDS secondary to COVID-19.
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Non COVID-19 Cohort
Patients with a diagnosis of moderate or severe pneumonia or ARDS not secondary to COVID-19.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Respiratory drive
大体时间:From day 1 at ICU until the day were the criteria of PaFi > 300 is met, up to 30 days
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To characterize the high respiratory drive phenomena in critically ill COVID-19 patients undergoing mechanical ventilation.
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From day 1 at ICU until the day were the criteria of PaFi > 300 is met, up to 30 days
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
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Cluster of high respiratory drive
大体时间:From day 1 of mechanical ventilation until the day of mechanical ventilation discontinuation, up to 30 days
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To describe the incidence and clustering of high respiratory drive throughout mechanical ventilation period by the development of specific algorithms.
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From day 1 of mechanical ventilation until the day of mechanical ventilation discontinuation, up to 30 days
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Artificial intelligence algorithms
大体时间:From day 1 of mechanical ventilation until the day of mechanical ventilation discontinuation, up to 30 days
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To apply artificial intelligence (machine learning, deep learning, pattern/image recognition and entropy) in physiologic respiratory signals to identify potentially harmful patient-ventilator interactions.
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From day 1 of mechanical ventilation until the day of mechanical ventilation discontinuation, up to 30 days
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Neurocognitive disorders
大体时间:1 month after ICU discharge and 1 year after ICU discharge
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To characterize cognitive and emotional sequelae in critically ill COVID-19 survivors at 1 month and 1 year after ICU discharge.
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1 month after ICU discharge and 1 year after ICU discharge
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Gene expression
大体时间:day 1 of ICU admission
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Application of massive sequencing of gene expression and circulating micro-RNA in blood samples to identify sets of genes and c-miRNA whose quantified expression is related to ventilatory asynchronies and cognitive and emotional impairment in critically ill COVID-19 patients.
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day 1 of ICU admission
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合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (预期的)
研究完成 (预期的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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