Comparison of guiding sedation level by respiratory effort versus usual care in mechanically ventilated patients: A randomized controlled trial protocol

The effect of sedation protocol guided by respiratory effort

Authors

  • Phruet Soipetkasem Division of Critical Care Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Detajin Junhasavasdikul Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Yuda Sutherasan Division of Pulmonary and Critical Care Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Sunthiti Morakul Department of Anesthesiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Vichapat Tharanon Clinical Pharmacy Section, Department of Pharmacy, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Krongtong Putthipokin Clinical Pharmacy Section, Department of Pharmacy, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400
  • Pongdhep Theerawit Division of Critical Care Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand, 10400 https://orcid.org/0000-0002-2070-8917

DOI:

https://doi.org/10.54205/ccc.v32.268690

Keywords:

Respiratory effort, Acute respiratory distress syndrome, Dynamic transpulmonary driving pressure swing, Sedation protocol

Abstract

Background: Critically ill patients relying on mechanical ventilation often require excessive sedation, aiming to address asynchrony and prevent ventilator-induced lung injury (VILI). Unintentionally, there may be more suppression of respiratory efforts. It is well-established that improper respiratory efforts during mechanical ventilation can cause unfavorable outcomes.

Methods: Researchers conducted a single-center randomized control trial, parallel 2 groups (1:1 ratio), with 164 participants. One intervention group employed the optimal respiratory effort (predicted ΔPL, P0.1), and the other control group, employed usual care to guide the adjustment of sedative levels.

Hypothesis: To compare 28-day ventilator-free day (VFD) and mortality between measuring respiratory effort as opposed to usual care and adjusting sedative level during mechanical ventilation.

Conclusions: This study will evaluate the disparity in 28-day VFD and mortality between sedative level guidance by respiratory effort and usual care.

Ethics and dissemination: The study protocol received approval from the Human Research Ethics Committee, Faculty of Medicine Ramathibodi Hospital, Mahidol University (COA No. MURA2023/642)

Trial registration: NCT06242236

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Published

2024-06-20

How to Cite

1.
Soipetkasem P, Junhasavasdikul D, Sutherasan Y, Morakul S, Tharanon V, Putthipokin K, Theerawit P. Comparison of guiding sedation level by respiratory effort versus usual care in mechanically ventilated patients: A randomized controlled trial protocol: The effect of sedation protocol guided by respiratory effort. Clin Crit Care [Internet]. 2024 Jun. 20 [cited 2024 Jul. 25];32(1):e240012. Available from: https://he02.tci-thaijo.org/index.php/ccc/article/view/268690

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Research Protocol