Nursing Care for Breathing Discomfort Among Mechanically Ventilated Patients

Study Overview
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Brief Summary
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Breathing discomfort (dyspnea) during mechanical ventilation in the ICU may complicate care.

Detailed Description
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Patients on ventilators experience a variety of discomforts: symptoms (dyspnea ,fatigue , pain ) ,emotions (depression, anxiety ,panic) and feeling of lack to control .Patients may or may not express this discomfort outwardly with agitation ,restlessness ,grimacing or increase in the vital signs (heart rate ,blood pressure ,breathing frequency).The aim of the present study is to assess the prevalence of dyspnea among mechanically ventilated patients, Describe interventions that may alleviate breathing discomfort and examine its impact on clinical outcomes.

Official Title
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Effect of Implementing Nursing Care on Breathing Discomfort and Its Outcomes Among Mechanically Ventilated Patients

Conditions
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Dyspnea

Intervention / Treatment
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* Other: visual analogue scale (VAS),Respiratory distress observational scale (RDOS) and other Nursing care


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Intubated or tracheostomized patients who were mechanically ventilated for >24 hrs. Age : 18-60 yrs Patients with Respiratory diseases Patients during spontaneous breathing trial Exclusion Criteria: • Patients with acidosis, anemia ,drug poisoning,psychogenic disorders or neuro-muscular disorders (non invasive ventilation)NIV

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: Researcher will provide patients with suitable care for relieving dyspnea and record the outcomes
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other:  interventional <br>New other than Routine nursing care will be used. | Other: visual analogue scale (VAS),Respiratory distress observational scale (RDOS) and other Nursing care<br>* Distressed patient will be assessed by visual analogue scale(VAS) or respiratory distress observational scale.Nursing interventions will be done according to its causes as giving supplemental O2 therapy, pharmacologic therapy ,initiating positive pressure ventilation or change Ventilator settings (TV, PEEP, Inspiratory pressure ), Improve inspiratory muscle function by Nutrition, positioning or by minimizing use of steroids , clearing airway by Suctioning, Check O2 saturation level frequently and maintain O2 saturation between 95-100%, ,Raising the HOB (Head of the Bed), high Fowler's ,Give pain medications as prescribed or diuretics as ordered and If thick secretions increase oral fluids intake<br>|
| No Intervention:  Control group <br>Routine care only will be done for this group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of breathing discomfort among Mechanically ventilated patients | visual analogue scale VAS for conscious patients and respiratory observational distress scale RDOS for unconscious patients | 1year | 
| Effect of nursing intervention on patient and ICU | Clinical outcomes length of stay,type of discharge or other morbidities | 1year |