Manifestation & Effect of Patient-Ventilator Dysynchrony

描述（由申请人提供）：患者-呼吸机同步对于实现最佳氧合和通气至关重要。然而，呼吸机同步性难以量化。护士经常使用非经验性方法评估患者-呼吸机同步不良（PVD），并且同步不良的临床表现不标准化。确定有效的生物行为措施，这种现象将有助于临床医生减少机械通气的并发症。因此，本研究的具体目的是：1）识别患者-呼吸机不同步的生物行为标志物（生理稳定性、激动和患者行为）; 2）检查患者呼吸机不同步对镇静剂使用的影响。将使用24小时内连续获得的气道压力波形变化来识别患者呼吸机不同步。本研究中评价的患者-呼吸机不同步的生物行为标志物包括生理不稳定性（心率、SaO 2、呼吸频率）、躁动（体动记录）和直接观察患者行为以及镇静剂用量。描述PVD将有助于临床医生早期和准确地检测不同步，这可能会导致与机械通气和镇静相关的风险降低。

DESCRIPTION (provided by applicant): Patient-ventilator synchrony is critical in achieving optimal oxygenation and ventilation. However, ventilator synchrony is difficult to quantify. Nurses often asses patient-ventilator dysnchrony (PVD) using a non-empirical approach, and clinical manifestations of dysychrony are not standardized. Identifying valid biobehavioral measures of this phenomenon will assist clinicians to reduce the complications of mechanical ventilation. Thus, the specific aims of this fellowship are to: 1) Identify biobehavioral markers (physiologic stability, agitation and patient behavior) of patient-ventilator dysnchrony and 2) Examine the effect of patient ventilator dysynchrony on the use of sedation. Patient ventilator dysynchrony will be identified using changes in airway pressure waveforms that will be obtained continuously over a 24-hour period. The bio-behavioral markers of patient-ventilator dysynchrony to be evaluated in this study will include physiologic instability (heart rate, SaO2, respiratory rate), agitation (actigraphy) and direct observation of patient behaviors as well as amount of sedation use. Describing PVD will assist clinicians in early and accurate detection of dysynchrony, which may lead to reduction in risks associated with mechanical ventilation and sedation.