Nursing Care for Breathing Discomfort Among Mechanically Ventilated Patients

Dyspnea Clinical Trial

Official title:

Effect of Implementing Nursing Care on Breathing Discomfort and Its Outcomes Among Mechanically Ventilated Patients

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT04019236
• Other study ID #: Dyspnea among MV Pts
• Status: Recruiting
• Phase: N/A
• Start date: December 18, 2018
• Est. completion date: December 2020

Study information

• Verified date: July 2019
• Source: Assiut University
• Contact: Eman Mamdouh Aziz, assit.lecturer
• Phone: 01286512550
• Email: emanmamdouh[@]aun.edu.eg
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Breathing discomfort (dyspnea) during mechanical ventilation in the ICU may complicate care.

Description:

Patients on ventilators experience a variety of discomforts: symptoms (dyspnea ,fatigue , pain ) ,emotions (depression, anxiety ,panic) and feeling of lack to control .Patients may or may not express this discomfort outwardly with agitation ,restlessness ,grimacing or increase in the vital signs (heart rate ,blood pressure ,breathing frequency).The aim of the present study is to assess the prevalence of dyspnea among mechanically ventilated patients, Describe interventions that may alleviate breathing discomfort and examine its impact on clinical outcomes.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 90
• Est. completion date: December 2020
• Est. primary completion date: December 2019
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• Intubated or tracheostomized patients who were mechanically ventilated for >24 hrs.

• Age : 18-60 yrs

• Patients with Respiratory diseases

• Patients during spontaneous breathing trial

Exclusion Criteria:

• • Patients with acidosis, anemia ,drug poisoning,psychogenic disorders or neuro-muscular disorders

• (non invasive ventilation)NIV

Related Conditions & MeSH terms

• Dyspnea

Intervention

Other:
• visual analogue scale (VAS),Respiratory distress observational scale (RDOS) and other Nursing care
Distressed patient will be assessed by visual analogue scale(VAS) or respiratory distress observational scale.Nursing interventions will be done according to its causes as giving supplemental O2 therapy, pharmacologic therapy ,initiating positive pressure ventilation or change Ventilator settings (TV, PEEP, Inspiratory pressure ), Improve inspiratory muscle function by Nutrition, positioning or by minimizing use of steroids , clearing airway by Suctioning, Check O2 saturation level frequently and maintain O2 saturation between 95-100%, ,Raising the HOB (Head of the Bed), high Fowler's ,Give pain medications as prescribed or diuretics as ordered and If thick secretions increase oral fluids intake

Locations

Country	Name	City	State
Egypt	Faculty of nursing	Assiut

Sponsors (1)

Lead Sponsor	Collaborator
Assiut University

Country where clinical trial is conducted

Egypt, 

References & Publications (4)

Campbell ML. Dyspnea. Crit Care Nurs Clin North Am. 2017 Dec;29(4):461-470. doi: 10.1016/j.cnc.2017.08.006. Epub 2017 Sep 23. Review. — View Citation

Persichini R, Gay F, Schmidt M, Mayaux J, Demoule A, Morélot-Panzini C, Similowski T. Diagnostic Accuracy of Respiratory Distress Observation Scales as Surrogates of Dyspnea Self-report in Intensive Care Unit Patients. Anesthesiology. 2015 Oct;123(4):830-7. doi: 10.1097/ALN.0000000000000805. — View Citation

Puntillo K, Nelson JE, Weissman D, Curtis R, Weiss S, Frontera J, Gabriel M, Hays R, Lustbader D, Mosenthal A, Mulkerin C, Ray D, Bassett R, Boss R, Brasel K, Campbell M; Advisory Board of the Improving Palliative Care in the ICU (IPAL-ICU) Project. Palliative care in the ICU: relief of pain, dyspnea, and thirst--a report from the IPAL-ICU Advisory Board. Intensive Care Med. 2014 Feb;40(2):235-48. doi: 10.1007/s00134-013-3153-z. Epub 2013 Nov 26. Review. — View Citation

Zhuang Q, Yang GM, Neo SH, Cheung YB. Validity, Reliability, and Diagnostic Accuracy of the Respiratory Distress Observation Scale for Assessment of Dyspnea in Adult Palliative Care Patients. J Pain Symptom Manage. 2019 Feb;57(2):304-310. doi: 10.1016/j.jpainsymman.2018.10.506. Epub 2018 Nov 2. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Prevalence of breathing discomfort among Mechanically ventilated patients	visual analogue scale "VAS" for conscious patients and respiratory observational distress scale "RDOS" for unconscious patients	1year
Primary	Effect of nursing intervention on patient and ICU	Clinical outcomes "length of stay,type of discharge or other morbidities"	1year