Sleep Quality in Mechanically Ventilated Patients

London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's13 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Respiratory Failure

Interventions

PAVOTHER

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

PSVOTHER

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

ACVOTHER

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

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

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

Locations (1)

London Health Sciences Centre - University Hospital

London, Ontario, Canada

Outcomes

Primary Outcomes

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)

Time frame: 3 nights

Secondary Outcomes

Patient-ventilator asynchrony

Incidence of patient-ventilator asynchrony (asynchrony index, % of asynchronous breaths per minute)

Time frame: 3 nights

Data from ClinicalTrials.gov

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