Clinical Trial: Variability Analysis as a Predictor of Liberation From Mechanical Ventilation

Study Status: Completed
Recruit Status: Completed
Study Type: Observational

Official Title: Variability Analysis as a Predictor of Liberation From Mechanical Ventilation in Patients Admitted to the Respiratory Special Care Unit (ReSCU)

Brief Summary: The purpose of this study is to evaluate if the variability of biological signals, such as heart rate and temperature, can predict weaning from mechanical ventilation in patients with failure to wean.

Detailed Summary:

Failure to wean is one of the most feared complications of mechanical ventilation. Prolonged mechanical ventilation occurs in 5-20% of all patients requiring MV in an intensive care unit. The published experience in the Cleveland Clinic in-hospital-weaning unit (ReSCU, Respiratory Special Care Unit) on long-term mechanical ventilation (>14 days) is that on average, 60% of the patients achieve complete ventilator independence.

The identification of factors that predict liberation from mechanical ventilation should improve outcomes and allocation of resources. Several attempts have been done to develop models to identify patients who will wean from prolonged MV; most rely on multiple measurements and their predictive ability is uncertain. Given the complexity of medical problems and the heterogeneity of the patients with prolonged MV, it is not unexpected that in order to achieve a good prediction, multiple variables are needed to encompass the whole population and relevant factors associated with the failure to wean.

Heart rate variability (HRV) is obtained from the measurement of the interval between successive heart beats; its analysis has been used extensively in cardiovascular disease. HRV is interpreted as a manifestation of the neurohumoral and autonomic system influence over the heart. Some researchers think that HRV relates to overall variability and is a manifestation of health in a complex biological system. Interpretation apart, multiple studies have demonstrated that the loss of variability reflects a poor prognosis overall. This phenomenon is seen not only in the heart, but also in breathing patterns, blood pressure, leukocyte count, electroencephalogram, gait, and recently in temperature. Limitations in interpretation and difficulty in acquisition (ventilator influence, respiratory rate influence, arrhythmi
Sponsor: The Cleveland Clinic

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Information By: The Cleveland Clinic

Dates:
Date Received: June 8, 2010
Date Started: August 2007
Date Completion:
Last Updated: June 8, 2010
Last Verified: June 2010