Sleep Quality in Mechanically Ventilated Patients

NCT ID: NCT01410149

Last Updated: 2012-08-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

13 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-04-30

Study Completion Date

2011-12-31

Brief Summary

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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.

Detailed Description

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Conditions

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Respiratory Failure

Keywords

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PAV (proportional assist ventilation); sleep; polysomnography; mechanical ventilation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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PAV

Proportional Assist Ventilation (PAV+ on PB840 ventilator)

Group Type ACTIVE_COMPARATOR

PAV

Intervention Type OTHER

Proportional Assist Ventilation will be used to ventilate the patient for a 24 hour period

PSV

Pressure Support Ventilation (PSV on PB840 ventilator)

Group Type ACTIVE_COMPARATOR

PSV

Intervention Type OTHER

Pressure Support Ventilation will be used to ventilate the patient for a 24 hour period

ACV

Assist Control/ Pressure limited Ventilation (on PB840 ventilator)

Group Type ACTIVE_COMPARATOR

ACV

Intervention Type OTHER

Assist Control Ventilation will be used to ventilate the patient for a 24 hour period

Interventions

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PAV

Proportional Assist Ventilation will be used to ventilate the patient for a 24 hour period

Intervention Type OTHER

PSV

Pressure Support Ventilation will be used to ventilate the patient for a 24 hour period

Intervention Type OTHER

ACV

Assist Control Ventilation will be used to ventilate the patient for a 24 hour period

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18-75
* received mechanical ventilation \>72 hours
* glasgow coma scale \>10
* acute physiology score \<13
* ready for partial ventilatory support: intact respiratory drive, PaO2/FiO2 ratio \>200 on positive end expiratory pressure (PEEP) less than or equal to 5 cmH2O, and PH of 7.35 to 7.45
* sedation: analgesia at dose not higher than 0.01 mg/kg/hr morphine equivalent x 48 hours, sedation at dose not higher than 0.01 mg/kg/hr lorazepam equivalent x 72 hours.
* anticipate ongoing need for partial ventilatory support for the following 72 hours

Exclusion Criteria

* Successful completion of spontaneous breathing trial
* Neurological injury, encephalopathy or abnormal EEG
* History of central sleep apnea
* General anaesthesia within 72 hours from study entry
* Requiring haloperidol \>10 mg/24 hours
* hemodynamically unstable
* sepsis
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ontario Lung Association

OTHER

Sponsor Role collaborator

Medtronic - MITG

INDUSTRY

Sponsor Role collaborator

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

OTHER

Sponsor Role lead

Responsible Party

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Karen Bosma

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Karen J. Bosma, MD, FRCPC

Role: PRINCIPAL_INVESTIGATOR

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's

Locations

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London Health Sciences Centre - University Hospital

London, Ontario, Canada

Site Status

Countries

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Canada

References

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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.

Reference Type BACKGROUND
PMID: 12598213 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15936695 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 10713011 (View on PubMed)

Parthasarathy S. Sleep during mechanical ventilation. Curr Opin Pulm Med. 2004 Nov;10(6):489-94. doi: 10.1097/01.mcp.0000143691.94442.fa.

Reference Type BACKGROUND
PMID: 15510055 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 11179121 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 8621064 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 2802378 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 6901518 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 12406837 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15961699 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 17334259 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 9804601 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 1731573 (View on PubMed)

Other Identifiers

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13114

Identifier Type: OTHER

Identifier Source: secondary_id

R-07-106

Identifier Type: -

Identifier Source: org_study_id