Ventilator Settings Can Substantially Impact Patients’ Comfort

Fortis, Spyridon; Florindez, Jorge; Balasingham, Shiva; Aguirre, Manuel De; Amoateng-Adjepong, Yaw; Manthous, Constantine A.

doi:10.1177/0885066613519574

Cited by 3 publications

(15 citation statements)

References 21 publications

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“…Thirteen quantitative studies used observational methods, including multi-centre observational cohort study (n = 1) [ 39 ], multi-centre prospective cohort studies (n = 3) [ 6 , 31 , 34 ], single-centre cohort observational study (n = 2 [ 30 , 33 ], multi-centre cross-sectional observational Study(n = 1) [ 38 ], single-centre cross sectional observational study (n = 1) [ 27 ] and single-centre cross sectional observational study (n = 5) [ 26 , 28 , 32 , 36 , 40 ]. The remaining five quantitative studies used an interventional design; a single-centre randomised controlled trial (RCT) (n = 2) [ 29 , 35 ], multi-centre RCT (n = 1) [ 37 ] and single-centre crossover RCT (n = 2) [ 41 , 42 ] each testing a different intervention.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining five quantitative studies used an interventional design; a single-centre randomised controlled trial (RCT) (n = 2) [ 29 , 35 ], multi-centre RCT (n = 1) [ 37 ] and single-centre crossover RCT (n = 2) [ 41 , 42 ] each testing a different intervention.…”

Section: Resultsmentioning

confidence: 99%

“…The multi-centre randomised controlled trial [ 37 ] comparing neurally adjusted ventilatory assist, (NAVA) ventilation to usual care using pressure support ventilation, (PSV) in the early weaning phase in mechanically ventilated adults had a robust design including an adequately powered sample size, was rigorously conducted, controlled for confounding variables, and reported according to CONSORT [ 44 ]. The single-centre randomised controlled trials [ 29 , 35 , 41 , 42 ] had limitations including a small sample size, lack of clarity in relation to recruitment, selection, randomisation, and usual care provided. The staff delivering the intervention also undertook the outcome assessments risking reporting bias [ 29 ] and were not comprehensively reported according to CONSORT [ 29 , 35 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

“…The single-centre randomised controlled trials [ 29 , 35 , 41 , 42 ] had limitations including a small sample size, lack of clarity in relation to recruitment, selection, randomisation, and usual care provided. The staff delivering the intervention also undertook the outcome assessments risking reporting bias [ 29 ] and were not comprehensively reported according to CONSORT [ 29 , 35 , 41 , 42 ].…”

Section: Resultsmentioning

confidence: 99%

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Breathlessness assessment, management and impact in the intensive care unit: a rapid review and narrative synthesis

Richardson,

Decavèle,

Demoule

et al. 2024

Ann. Intensive Care

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Background Adults in the intensive care unit (ICU) commonly experience distressing symptoms and other concerns such as pain, delirium, and breathlessness. Breathlessness management is not supported by any ICU guidelines, unlike other symptoms. Aim To review the literature relating to (i) prevalence, intensity, assessment, and management of breathlessness in critically ill adults in the ICU receiving invasive and non-invasive mechanical ventilation (NIV) and high-flow oxygen therapy, (HFOT), (ii) the impact of breathlessness on ICU patients with regard to engagement with rehabilitation. Methods A rapid review and narrative synthesis using the Cochrane Methods Group Recommendations was conducted and reported in accordance with PRISMA. All study designs investigating breathlessness in adult ICU patients receiving either invasive mechanical ventilation (IMV), NIV or HFOT were eligible. PubMed, MEDLINE, The Cochrane Library and CINAHL databased were searched from June 2013 to June 2023. Studies were quality appraised. Results 19 studies representing 2822 ICU patients were included (participants mean age 48 years to 71 years; proportion of males 43–100%). The weighted mean prevalence of breathlessness in ICU patients receiving IMV was 49% (range 34–66%). The proportion of patients receiving NIV self-reporting moderate to severe dyspnoea was 55% prior to initiation. Breathlessness assessment tools included visual analogue scale, (VAS), numerical rating scale, (NRS) and modified BORG scale, (mBORG). In patients receiving NIV the highest reported median (interquartile range [IQR]) VAS, NRS and mBORG scores were 6.2cm (0–10 cm), 5 (2–7) and 6 (2.3–7) respectively (moderate to severe breathlessness). In patients receiving either NIV or HFOT the highest reported median (IQR) VAS, NRS and mBORG scores were 3 cm (0–6 cm), 8 (5–10) and 4 (3–5) respectively. Conclusion Breathlessness in adults receiving IMV, NIV or HFOT in the ICU is prevalent and clinically important with median intensity ratings indicating the presence of moderate to severe symptoms.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Breathlessness assessment, management and impact in the intensive care unit: a rapid review and narrative synthesis

Richardson,

Decavèle,

Demoule

et al. 2024

Ann. Intensive Care

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“…These techniques and strategies have been associated with some of the most relevant clinical outcomes including a decrease in discomfort, ventilator-associated pneumonia, length of MV, and ICU and hospital length of stay. [23] Interestingly, extremely few well-conducted sedative versus sedative trials show improvements in these hard clinical outcomes.…”

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confidence: 99%

Moving away from benzodiazepine as a primary sedative in the intensive care unit; is clonidine a viable alternative?

Szumita¹,

Reardon²

2014

Indian Journal of Critical Care Medicine

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Comfort and learnability assessment of a new soft robotic manipulator for minimally invasive surgery

Shafti

Andorno

Marchese

et al. 2015

2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC)

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Laparoscopic surgeons perform precise and time consuming procedures while holding awkward poses in their upper body and arms. There is an ongoing effort to produce robotic tools for laparoscopic surgery that will simplify these tasks and reduce risk of errors to help both the surgeon and the patient. STIFF-FLOP is an ongoing EU FP7 project focusing on this by creating a stiffness controllable soft robotic manipulator. This paper reports on a study to test the soft manipulator's learnability and the effort associated with its use. The tests involved a limited prototype of the manipulator with a custom built test rig and EMG acquisition system. Task times and video recordings along with EMG waveforms from the forearm muscles of participants (n=25) were measured for objective assessment. A questionnaire was also provided to the participants for subjective assessment. The data shows that in average EMG levels were 25.9% less in RMS when using the STIFF-FLOP arm than when conventional laparoscopic tools were used. In terms of learnability, from the first to the second attempt on the STIFF-FLOP manipulator, elapsed time was reduced by an average of 32.1%. Further details and analysis of the EMG signals as well as time and questionnaire results is presented in the paper.

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Ventilator Settings Can Substantially Impact Patients’ Comfort

Abstract: Ventilator parameters may impact patients' comfort substantially. Future studies may help identify evidence-based methodology for gauging comfort following changes in ventilator settings and the settings that are most likely to positively impact various groups of patients.

Cited by 3 publications

References 21 publications

Breathlessness assessment, management and impact in the intensive care unit: a rapid review and narrative synthesis

Breathlessness assessment, management and impact in the intensive care unit: a rapid review and narrative synthesis

Moving away from benzodiazepine as a primary sedative in the intensive care unit; is clonidine a viable alternative?

Comfort and learnability assessment of a new soft robotic manipulator for minimally invasive surgery

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