权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Reducing Sedative Exposure in Ventilated ICU Patients

减少 ICU 通气患者的镇静剂暴露

基本信息

批准号：
7558998
负责人：
Linda L Chlan
金额：
$ 42.79万
依托单位：
UNIVERSITY OF MINNESOTA
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-04-01 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7558998
关键词：
Acute Address Adult Adverse effects Affect American Analgesics Anxiety Area Biochemical Care given by nurses Caring Clinical Clinical Practice Guideline Clinical Trials Collection Critical Care Critical Illness Data Analyses Delirium Distress Dose Environment Equipment and supply inventories Evaluation Experimental Designs Exposure to Frequencies Future Goals Healed Health Hour Human Hydrocortisone Imagery Incidence Intensive Care Units Intervention Intervention Trial Intravenous Intubation Investigation Length Life Measures Mechanical ventilation Mechanics Medical Medicine Mind-Body Intervention Modality Muscle Weakness Music Music Therapy NIH Program Announcements National Institute of Nursing Research Noise Nurses Outcome Pain Participant Patients Persons Pharmaceutical Preparations Physiological Prevention Procedures Protocols documentation Quality of life Randomized Recruitment Activity Relaxation Reporting Research Research Personnel Research Priority Research Project Grants Respiratory Insufficiency Sampling Sedation procedure Self Management Severity of illness Societies Stimulus Stress Technology Testing Time Ventilator Visual analog biological adaptation to stress critical care nursing experience healing innovation mental state mind body interaction response sedative symptom management treatment as usual urinary

项目摘要

Mechanical ventilation is the most frequently used advanced, life-supportive modality in intensive care units (ICUs) to treat respiratory insufficiency from a variety of causes. To reduce anxiety, stress and promote tolerance of mechanical ventilation, nurses frequently administer sedative agents to these patients.While sedation is indicated at times, it is not without serious side effects which include muscle weakness, mental status changes, prolonged ventilatory support, and extended ICU stay. Clinical practice guidelines suggest that non-pharmacologic strategies be tried to reduce patient distress before administering sedatives. However, non-pharmacologic strategies are under-utilized and lack rigorous evaluation in clinical trials that document patient benefit. One non-pharmacologic intervention that shows promise in reducing anxiety after a single treatment but lacks rigorous evaluation on clinically salient outcomes is music. Thus, the primary aim of this clinical trial is to test a patient-directed, as desired music intervention (PDM) on reducing sedative exposure and anxiety in adult ventilated patients, and to examine attendant influences on length of ventilatory support, length of ICU stay, and stress modulation. A sample of 186 alert patients receiving acute ventilatory support will be recruited from 5 ICUs in the urban Midwest for this 3 group experimental design study with repeated measures. Subjects receiving ventilatory support will be randomized to PDM, noise- canceling headphones, or to usual care for up to 30 days. Sedative exposure (aggregate dose and dose frequency), anxiety levels (visual analog scale and State Anxiety Inventory), and 24-hour urinary cortisol samples (stress) will all be collected daily. Primary data analysis will be repeated measuresANCOVA, controlling for illness severity. Long-term objectives of this study are to positively impact important clinical outcomes and quality of life for the millions of ICU patients who experience mechanical ventilation eachyear by enhancing personal control while reducing exposure to sedative agents and their serious sideeffects.

机械通气是重症监护室最常用的先进生命支持方式（ICU）治疗各种原因引起的呼吸功能不全。减少焦虑、压力并促进由于对机械通气的耐受性，护士经常给这些患者使用镇静剂。有时需要镇静，但并非没有严重的副作用，包括肌肉无力、精神障碍状态变化、延长通气支持以及延长 ICU 停留时间。临床实践指南建议在给予镇静剂之前尝试非药物策略来减轻患者的痛苦。然而，非药物策略并未得到充分利用，并且在临床试验中缺乏严格的评估，记录患者的利益。一种非药物干预有望减少术后焦虑音乐是一种单一的治疗方法，但缺乏对临床显着结果的严格评估。因此，初级该临床试验的目的是测试以患者为导向的按需音乐干预 (PDM) 来减少镇静作用成人通气患者的暴露和焦虑，并检查随之而来的对通气时间长度的影响通气支持、ICU 停留时间和压力调节。 186 名接受急性治疗的警觉患者样本将从中西部城市的 5 个 ICU 招募通气支持，用于这 3 组实验设计反复测量研究。接受通气支持的受试者将被随机分配至 PDM、噪声组取消耳机，或进行长达 30 天的常规护理。镇静剂暴露（总剂量和剂量频率）、焦虑水平（视觉模拟量表和状态焦虑量表）和 24 小时尿皮质醇样本（压力）将每天收集。主要数据分析将重复测量ANCOVA，控制疾病的严重程度。这项研究的长期目标是对重要的临床产生积极影响每年数百万接受机械通气的 ICU 患者的结局和生活质量通过加强个人控制，同时减少接触镇静剂及其严重副作用。

项目成果

期刊论文数量（17）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Comparative analysis of clinicopathological correlations of cyclooxygenase-2 expression in resectable pancreatic cancer.

可切除胰腺癌中环氧合酶2表达的临床病理相关性的比较分析。

DOI：
10.3748/wjg.v16.i15.1879
发表时间：
2010
期刊：
World journal of gastroenterology
影响因子：
4.3
作者：
Hermanova,Marketa;Karasek,Petr;Tomasek,Jiri;Lenz,Jiri;Jarkovsky,Jiri;Dite,Petr
通讯作者：
Dite,Petr

Music preferences of mechanically ventilated patients participating in a randomized controlled trial.

参与随机对照试验的机械通气患者的音乐偏好。