Discomfort during respiratory decompensation of a patient with chronic obstructive pulmonary disease (COPD) and/or obesity with a BMI greater than 30, in intensive care and the establishment of non-invasive ventilation (NIV) is frequent and a source of failure. this therapy. Pharmacological treatments may be impossible due to the pathology, the risk of it worsening and adverse effects. In this context, hypnosis appears to be a tool that would promote comfort and thus increase tolerance of NIV.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
50
For the hypnosis group, hypnotic support is set up by a doctor/IDE previously trained and dedicated during the implementation of the NIV. The dedicated doctor/IDE will be presented before the start of the NIV setup procedure and will start the hypnosis session a few minutes before the mask is put on. The procedure for setting up the NAV may begin after agreement from the dedicated doctor/IDE.
In the control group, in order to preserve the knowledge of the evaluator, the doctor/IDE dedicated to hypnosis is present in the service but does not intervene in the care so as not to be tempted to involuntarily put hypnosis in place. The assessor will be chosen from the two other teams present in the other two modules (each module is a seven-bed unit and has no physical communication with the other two) after the start of the procedure for setting up the NIV, with or without hypnosis, in order to be certain that he had no visual contact with the patient and the caregivers present before the evaluation. The implementation of the NAV will take place as usually carried out in the service.
Rennes University Hospital
Rennes, Brittany Region, France
RECRUITINGComfort
Quantification of comfort by a Digital Verbal Comfort Scale 2 hours after initiation of NIV (from 0 to 10, 0 being the minimum comfort felt and 10 the maximum comfort felt by the patient)
Time frame: 2 hours after initiation of NIV
Anxiety
Assessment of anxiety (Numerical Verbal Scale from 0 to 10) at inclusion, 30 minutes, 2 hours and 24 hours after the implementation of the NIV
Time frame: Before and 30 minuts, 2 hours and 24 hours after the implementation of the NIV
First NIV session duration
Calculation of the number of hours of the first NIV session
Time frame: At the end of the first NIV session
Comfort
Comfort assessment at inclusion, 30 minutes and 24 hours after the implementation of the NIV (Digital Verbal Scale from 0 to 10)
Time frame: Before and 30 minuts and 24 hours after the implementation of the NIV
TcpCO2
Decrease in PaCO2: Installation of a transcutaneous sensor and measurement of TcpCO2 at inclusion, 30 minutes, 2 hours and 24 hours after the establishment of the NIV
Time frame: Before and 30 minuts, 2 hours and 24 hours after the implementation of the NIV
NIV duration
Calculation of the number of hours of NIV in the first 24 hours of treatment
Time frame: after the first 24 hours of treatment
dyspnea
Assessment of the dyspnea felt by the patient 2 hours after the setting up of the NIV: +2: significant improvement; +1 slight improvement; 0 No change; -1 slight deterioration; -2 significant deterioration.
Time frame: 2 hours after the setting up of the NIV
Intubation
Number of intubations: calculation of the number of patients intubated during the ICU stay.
Time frame: Day 28
Stay duration
Duration of stay in intensive care
Time frame: Day 28
anxiolytic treatment prescription
Record of the number of patients who had to have a prescription for anxiolytics during hospitalization in intensive care.
Time frame: Day 28
stress
Evaluation of the stress of the healthcare team by a numerical verbal scale from 0 to 10 (0 being no stress and 10 the greatest possible stress felt) at inclusion, 30 minutes and 2 hours after NIV initiation
Time frame: Before and 30 minuts and 2 hours after the implementation of the NIV
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