EPISYNC study: predictors of patient-ventilator asynchrony in a prospective cohort of patients under invasive mechanical ventilation - study protocol

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art_SOUSA_EPISYNC_study_predictors_of_patientventilator_asynchrony_in_a_2019.PDF (1.02 MB)
Citações na Scopus
4
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article
Data de publicação
2019
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BMJ PUBLISHING GROUP
DOI
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Scopus
Web of Science
PubMed
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MAGRANS, Rudys
BLANCH, Lluis
KACMAREK, R. M.
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Citação
BMJ OPEN, v.9, n.5, article ID e028601, 6p, 2019
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Introduction Patient-ventilator asynchrony is common during the entire period of invasive mechanical ventilation (MV) and is associated with worse clinical outcomes. However, risk factors associated with asynchrony are not completely understood. The main objectives of this study are to estimate the incidence of asynchrony during invasive MV and its association with respiratory mechanics and other baseline patient characteristics. Methods and analysis We designed a prospective cohort study of patients admitted to the intensive care unit (ICU) of a university hospital. Inclusion criteria are adult patients under invasive MV initiated for less than 72 hours, and with expectation of remaining under MV for more than 24 hours. Exclusion criteria are high flow bronchopleural fistula, inability to measure respiratory mechanics and previous tracheostomy. Baseline assessment includes clinical characteristics of patients at ICU admission, including severity of illness, reason for initiation of MV, and measurement of static mechanics of the respiratory system. We will capture ventilator waveforms during the entire MV period that will be analysed with dedicated software (Better Care, Barcelona, Spain), which automatically identifies several types of asynchrony and calculates the asynchrony index (AI). We will use a linear regression model to identify risk factors associated with AI. To assess the relationship between survival and AI we will use Kaplan-Meier curves, log rank tests and Cox regression. The calculated sample size is 103 patients. The statistical analysis will be performed by the software R Programming (www.R-project.org) and will be considered statistically significant if the p value is less than 0.05. Ethics and dissemination The study was approved by the Ethics Committee of Instituto do Coracao, School of Medicine, University of Sao Paulo, Brazil, and informed consent was waived due to the observational nature of the study. We aim to disseminate the study findings through peer-reviewed publications and national and international conference presentations.
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https://observatorio.fm.usp.br/handle/OPI/33248
Referências
  1. Azevedo LCP, 2013, CRIT CARE, V17, DOI 10.1186/cc12594
  2. Blanch L, 2015, INTENS CARE MED, V41, P633, DOI 10.1007/s00134-015-3692-6
  3. Blanch L, 2012, INTENS CARE MED, V38, P772, DOI 10.1007/s00134-012-2493-4
  4. Branson RD, 2013, RESP CARE, V58, P973, DOI 10.4187/respcare.02507
  5. Chacon E, 2012, AM J CRIT CARE, V21, pE89, DOI 10.4037/ajcc2012108
  6. Chao DC, 1997, CHEST, V112, P1592, DOI 10.1378/chest.112.6.1592
  7. Colombo D, 2011, CRIT CARE MED, V39, P2452, DOI 10.1097/CCM.0b013e318225753c
  8. de Haro C, 2018, CRIT CARE MED, V46, P1385, DOI 10.1097/CCM.0000000000003256
  9. de Wit M, 2009, CRIT CARE MED, V37, P2740, DOI 10.1097/CCM.0b013e3181a98a05
  10. Ferreira JC, 2017, BMC PULM MED, V17, DOI 10.1186/s12890-017-0484-5
  11. Harris PA, 2009, J BIOMED INFORM, V42, P377, DOI 10.1016/j.jbi.2008.08.010
  12. Jolliet P, 2006, CRIT CARE, V10, DOI 10.1186/cc5073
  13. Leung P, 1997, AM J RESP CRIT CARE, V155, P1940, DOI 10.1164/ajrccm.155.6.9196100
  14. Murias G, 2016, CRIT CARE, V20, DOI 10.1186/s13054-016-1436-9
  15. Nava S, 1997, EUR RESPIR J, V10, P177, DOI 10.1183/09031936.97.10010177
  16. Parthasarathy S, 1998, AM J RESP CRIT CARE, V158, P1471, DOI 10.1164/ajrccm.158.5.9802014
  17. Pierson DJ, 2011, RESP CARE, V56, P214, DOI 10.4187/respcare.01115
  18. Ramirez II, 2017, RESP CARE, V62, P144, DOI 10.4187/respcare.04750
  19. Sassoon C S, 2001, Curr Opin Crit Care, V7, P28, DOI 10.1097/00075198-200102000-00005
  20. Thille AW, 2006, INTENS CARE MED, V32, P1515, DOI 10.1007/s00134-006-0301-8
  21. Thille AW, 2007, CLIN PULM MED, V14, P350
  22. Vaporidi K, 2017, INTENS CARE MED, V43, P184, DOI 10.1007/s00134-016-4593-z
  23. von Elm E, 2008, J CLIN EPIDEMIOL, V61, P344, DOI 10.1016/j.jclinepi.2007.11.008

Coleções
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/09