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| ID | Type | Description | Link |
|---|---|---|---|
| 13114 | Other Identifier | REB |
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| Name | Class |
|---|---|
| Ontario Lung Association | OTHER |
| Medtronic - MITG | INDUSTRY |
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Patients requiring mechanical ventilation in the ICU will undergo three consecutive nights of polysomnography to record sleep patterns while receiving three modes of mechanical ventilation; Proportional assist ventilation (PAV), Pressure support ventilation (PSV), Assist control ventilation (ACV), applied in random order. The purpose is to determine the effect of mode of mechanical ventilation on patient-ventilator asynchrony and sleep quality.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PAV | Active Comparator | Proportional Assist Ventilation (PAV+ on PB840 ventilator) |
|
| PSV | Active Comparator | Pressure Support Ventilation (PSV on PB840 ventilator) |
|
| ACV | Active Comparator | Assist Control/ Pressure limited Ventilation (on PB840 ventilator) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PAV | Other | Proportional Assist Ventilation will be used to ventilate the patient for a 24 hour period |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sleep quality | Sleep fragmentation (number of arousals and awakenings/hr sleep), sleep architecture (% time asleep spent in Stage 1, 2, 3/4 and REM sleep) | 3 nights |
| Measure | Description | Time Frame |
|---|---|---|
| Patient-ventilator asynchrony | Incidence of patient-ventilator asynchrony (asynchrony index, % of asynchronous breaths per minute) | 3 nights |
| Measure | Description | Time Frame |
|---|---|---|
| Delirium | Positive score on a delirium screening tool (CAM-ICU or ICDSC) | 3 days |
| Comfort | Patient's assessment of their own breathing comfort and their perceived quality of sleep, indicated on a visual analogue scale |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Karen J. Bosma, MD, FRCPC | London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| London Health Sciences Centre - University Hospital | London | Ontario | N6A 5A5 | Canada |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12598213 | Background | Gabor JY, Cooper AB, Crombach SA, Lee B, Kadikar N, Bettger HE, Hanly PJ. Contribution of the intensive care unit environment to sleep disruption in mechanically ventilated patients and healthy subjects. Am J Respir Crit Care Med. 2003 Mar 1;167(5):708-15. doi: 10.1164/rccm.2201090. | |
| 15936695 | Background | Parthasarathy S. Effects of sleep on patient-ventilator interaction. Respir Care Clin N Am. 2005 Jun;11(2):295-305. doi: 10.1016/j.rcc.2005.02.004. |
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| ID | Term |
|---|---|
| D012131 | Respiratory Insufficiency |
| ID | Term |
|---|---|
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| PSV | Other | Pressure Support Ventilation will be used to ventilate the patient for a 24 hour period |
|
| ACV | Other | Assist Control Ventilation will be used to ventilate the patient for a 24 hour period |
|
| 3 days |
| Respiratory pattern | Measurement of average tidal volume, respiratory rate, minute ventilation and non-invasive measurement of respiratory muscle effort relative to maximum effort | 3 nights |
| Blood gas | measurement of paO2 and paCO2 | evening and morning |
| 10713011 | Background | Cooper AB, Thornley KS, Young GB, Slutsky AS, Stewart TE, Hanly PJ. Sleep in critically ill patients requiring mechanical ventilation. Chest. 2000 Mar;117(3):809-18. doi: 10.1378/chest.117.3.809. |
| 15510055 | Background | Parthasarathy S. Sleep during mechanical ventilation. Curr Opin Pulm Med. 2004 Nov;10(6):489-94. doi: 10.1097/01.mcp.0000143691.94442.fa. |
| 11179121 | Background | Freedman NS, Gazendam J, Levan L, Pack AI, Schwab RJ. Abnormal sleep/wake cycles and the effect of environmental noise on sleep disruption in the intensive care unit. Am J Respir Crit Care Med. 2001 Feb;163(2):451-7. doi: 10.1164/ajrccm.163.2.9912128. |
| 8621064 | Background | Irwin M, McClintick J, Costlow C, Fortner M, White J, Gillin JC. Partial night sleep deprivation reduces natural killer and cellular immune responses in humans. FASEB J. 1996 Apr;10(5):643-53. doi: 10.1096/fasebj.10.5.8621064. |
| 2802378 | Background | Chen HI, Tang YR. Sleep loss impairs inspiratory muscle endurance. Am Rev Respir Dis. 1989 Oct;140(4):907-9. doi: 10.1164/ajrccm/140.4.907. |
| 6901518 | Background | Helton MC, Gordon SH, Nunnery SL. The correlation between sleep deprivation and the intensive care unit syndrome. Heart Lung. 1980 May-Jun;9(3):464-8. No abstract available. |
| 12406837 | Background | Parthasarathy S, Tobin MJ. Effect of ventilator mode on sleep quality in critically ill patients. Am J Respir Crit Care Med. 2002 Dec 1;166(11):1423-9. doi: 10.1164/rccm.200209-999OC. Epub 2002 Sep 5. |
| 15961699 | Background | Fanfulla F, Delmastro M, Berardinelli A, Lupo ND, Nava S. Effects of different ventilator settings on sleep and inspiratory effort in patients with neuromuscular disease. Am J Respir Crit Care Med. 2005 Sep 1;172(5):619-24. doi: 10.1164/rccm.200406-694OC. Epub 2005 Jun 16. |
| 17334259 | Background | Bosma K, Ferreyra G, Ambrogio C, Pasero D, Mirabella L, Braghiroli A, Appendini L, Mascia L, Ranieri VM. Patient-ventilator interaction and sleep in mechanically ventilated patients: pressure support versus proportional assist ventilation. Crit Care Med. 2007 Apr;35(4):1048-54. doi: 10.1097/01.CCM.0000260055.64235.7C. |
| 9804601 | Background | Meza S, Mendez M, Ostrowski M, Younes M. Susceptibility to periodic breathing with assisted ventilation during sleep in normal subjects. J Appl Physiol (1985). 1998 Nov;85(5):1929-40. doi: 10.1152/jappl.1998.85.5.1929. |
| 1731573 | Background | Younes M. Proportional assist ventilation, a new approach to ventilatory support. Theory. Am Rev Respir Dis. 1992 Jan;145(1):114-20. doi: 10.1164/ajrccm/145.1.114. |