None listed
Conditions
Brief summary
Asynchronous events (AE) occur when the breathing of a patient undergoing mechanical ventilation is not synchronised with the support from the ventilator. Frequent occurrence of AEs results in poor patient-ventilator interaction, leading to an increase in work of breathing and potentially, other adverse effects. Such adverse effects include patient discomfort, increased need for sedation, increased length of mechanical ventilation, and potentially higher mortality. AEs can occur anytime during partially or fully controlled ventilation. However, it is more frequent during partially assisted modes where the patient is breathing spontaneously and the ventilator support is triggered by patient respiratory effort. AE is currently assessed retrospectively and there is a need to detect AE in real time. This study aims to investigate the quality of patient-ventilator interaction in a local hospital. Using patient specific airway pressure and flow data, we aim to develop mathematical models that can be used to detect AEs automatically in real time.
Interventions
This trial is an observational trial to recruit 60 patients in two years (30 patients per year). All patients admitted to the intensive care unit (ICU) at the IIUM Medical Centre, Malaysia during the study period will be screened for inclusion into the study.
Approval from ethical committee will be obtained. New patients will be screened for inclusion to the study. Consent from legally-accepted representative will be obtained. All patients admitted to the ICU during the study period will be scr
This trial is an observational trial to recruit 60 patients in two years (30 patients per year). All patients admitted to the intensive care unit (ICU) at the IIUM Medical Centre, Malaysia during the study period will be screened for inclusion into the study. Approval from ethical committee will be obtained. New patients will be screened for inclusion to the study. Consent from legally-accepted representative will be obtained. All patients admitted to the ICU during the study period will be screened. Data collection and clinical protocol All patients enrolled are to be ventilated using Puritan Bennett PB980 ventilator (Covidien, Boulder, CO, USA). Data collection will be performed using a CURE soft system. This system records the mechanical ventilation data from the Puritan Bennet ventilator 980. 1. The mechanical ventilator settings were not set and will vary depending on attending clinicians. 2. For each patient, the data will be collected for 72 hours. 3. After 72 hours, the data collection is stopped. The following data are collected from the patient recruited into the observational trial. 1. Patient gender, height, weight and ethnicity. 2. Patient APACHE III diagnostic code. 3. Primary patient diagnosis contributing to respiratory failure 4. Secondary patient diagnosis contributing to respiratory failure 5. Relevant past medical history e.g. smoking, medication, cardiovascular disease. 6. Chest X-ray score: Murray Index (Murray et al., 1988) if available. 7. Mechanical ventilation airway pressure and flow 8. Fraction of Inspired oxygen 9. Patient data sheet and arterial blood gases information
Sponsors
Monash University Malaysia
Eligibility
Sex/Gender
All
Age
16 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Patients requiring invasive mechanical ventilation (MV) (Intubation or tracheotomy). 2. Patients with PF [oxygen partial pressure to fraction of inspired oxygen] ratio < 300 mmHg) . 3. Arterial line in situ.
Exclusion criteria
1. Patients who are likely to be discontinued from MV within 24 hours. 2. Patients with age less or equal to 16. 3. Any medical condition associated with a clinical suspicion of raised intracranial pressure and/or a measured intracranial pressure more or equal to 20 cmH2O. 4. Patients who have a high spinal cord injury with loss of motor function and/ or have significant weakness from any neurological disease. 5. Patients who are moribund and/or not expected to survive for less than 72 hours. 6. Lack of clinical equipoise by intensive care unit (ICU) medical staff managing the patient.
Outcome results
None listed