Patient-ventilator synchrony is critical in achieving optimal oxygenation and ventilation. However, ventilator synchrony is difficult to quantify. Nurses often asses patient-ventilator dysnchrony (PVD) using a non-empirical approach, and clinical manifestations of dysychrony are not standardized. Identifying valid biobehavioral measures of this phenomenon will assist clinicians to reduce the complications of mechanical ventilation. Thus, the specific aims of this fellowship are to: 1) Identify biobehavioral markers (physiologic stability, agitation and patient behavior) of patient-ventilator dysnchrony and 2) Examine the effect of patient ventilator dysynchrony on the use of sedation. Patient ventilator dysynchrony will be identified using changes in airway pressure waveforms that will be obtained continuously over a 24-hour period. The bio-behavioral markers of patient-ventilator dysynchrony to be evaluated in this study will include physiologic instability (heart rate, SaO2, respiratory rate), agitation (actigraphy) and direct observation of patient behaviors as well as amount of sedation use. Describing PVD will assist clinicians in early and accurate detection of dysynchrony, which may lead to reduction in risks associated with mechanical ventilation and sedation. ? ? ?
| Mellott, Karen G; Grap, Mary Jo; Munro, Cindy L et al. (2014) Patient ventilator asynchrony in critically ill adults: frequency and types. Heart Lung 43:231-43 |
| Mellott, Karen G; Grap, Mary Jo; Munro, Cindy L et al. (2009) Patient-ventilator dyssynchrony: clinical significance and implications for practice. Crit Care Nurse 29:41-55 quiz 1 p following 55 |
| Unoki, Takeshi; Grap, Mary Jo; Sessler, Curtis N et al. (2009) Autonomic nervous system function and depth of sedation in adults receiving mechanical ventilation. Am J Crit Care 18:42-50; quiz 51 |
| Mellott, Karen G; Sharp, Pamela B; Anderson, Lynn M (2008) Biobehavioral measures in a critical-care healing environment. J Holist Nurs 26:128-35;quiz 136-8 |
