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通过多感官刺激降低重症监护病房接受机械通气患者的谵妄发生率:一项随机可行性研究方案

Decreasing the incidence of delirium via multi-sensory stimulation in patients receiving mechanical ventilation in the intensive care unit: A protocol for a randomized feasibility study.

作者信息

He Bin, Mo Bei-Rong, Meng Si-Ya, Yang Zheng, Liu Wen-Ting, Wang Yu-Ying, Mou Xiao-Ling, Chen Yu-Qi, Chen Yu

机构信息

Department of Intensive Care Unit, Huazhong University of Science and Technology Union Shenzhen Hospital, China.

School of Nursing, Southern Medical University, Guangzhou, 510515, China.

出版信息

Contemp Clin Trials Commun. 2024 Jan 17;38:101263. doi: 10.1016/j.conctc.2024.101263. eCollection 2024 Apr.

Abstract

INTRODUCTION

Delirium is a common acute brain dysfunction syndrome in patients admitted to intensive care units (ICUs). Family engagement strategies, based on the theory of multi-sensory stimulation to ameliorate sensory deprivation in patients, may be an effective and scalable method to reduce the burden of delirium.

METHODS

/design: This is a assessor-blinded, randomised controlled trial of the feasibility of multi-sensory stimulation (MS) in patients with delirium. A total of 72 mechanically ventilated patients (n = 24 in each group) admitted to the ICU will be randomised to routine non-pharmacological delirium care (control), family multi-sensory stimulation and nurse multi-sensory stimulation groups. All participants except the control group will receive multi-sensory stimulation, including visual, auditory, tactile and kinesthetic stimulation, for 5 days. Our primary aim is to determine the feasibility of the study procedure (recruitment, eligibility, retention and attrition rates, appropriateness of clinical outcome measures), feasibility, acceptability and safety of the intervention (adverse events, satisfaction and other). Our secondary objective is to assess the preliminary efficacy of the MS protocol in reducing the incidence, duration and severity of delirium. Sedation levels and delirium severity will be assessed twice daily. Enrolled participants will be followed in hospital until death, discharge or up to 28 days after treatment.

ETHICS AND DISSEMINATION

The current study was approved by the Ethics Review Board of Huazhong University of Science and Technology Union Shenzhen Hospital, China (KY-2023-031-01). The results of this study will be presented at scientific conferences and submitted for publication in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ChiCTR2300071457.

摘要

引言

谵妄是重症监护病房(ICU)患者中常见的急性脑功能障碍综合征。基于多感官刺激理论以改善患者感觉剥夺的家庭参与策略,可能是减轻谵妄负担的一种有效且可扩展的方法。

方法

/设计:这是一项评估者盲法、随机对照试验,旨在研究多感官刺激(MS)对谵妄患者的可行性。共有72名入住ICU的机械通气患者(每组n = 24)将被随机分为常规非药物性谵妄护理组(对照组)、家庭多感官刺激组和护士多感官刺激组。除对照组外,所有参与者将接受为期5天的多感官刺激,包括视觉、听觉、触觉和动觉刺激。我们的主要目标是确定研究程序的可行性(招募、合格性、保留率和损耗率、临床结局指标的适用性)、干预措施的可行性、可接受性和安全性(不良事件、满意度等)。我们的次要目标是评估MS方案在降低谵妄发生率、持续时间和严重程度方面的初步疗效。镇静水平和谵妄严重程度将每天评估两次。入组参与者将在医院随访至死亡、出院或治疗后28天。

伦理与传播

本研究已获得中国华中科技大学协和深圳医院伦理审查委员会批准(KY-2023-031-01)。本研究结果将在科学会议上展示,并提交至同行评审期刊发表。

试验注册号

ChiCTR2300071457。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f805/10831177/a976e19cb5f2/gr1.jpg

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