AACN clinical issues in critical care nursing最新文献

{"title":"Evaluation of weaning parameters for weaning readiness from mechanical ventilation among elderly patients","authors":"Dujrath Somboonviboon, Nittha Oerareemitr, P. Wacharasint","doi":"10.54205/ccc.v30.259010","DOIUrl":"https://doi.org/10.54205/ccc.v30.259010","url":null,"abstract":"Background: Numbers of elderly patients with acute respiratory failure continue to rise with increasing age of the general population worldwide. Ventilatory reserve decreases substantially with age as a result of multiple interrelated physiologic changes. \u0000Objective: This study aimed to evaluate the predictive value of conventional and composite weaning parameters among elderly patients.\u0000Methods: We conducted an observational prospective study among intubated patients ≥70 years old and readied for undergoing spontaneous breathing trial (SBT). Weaning parameters were recorded [heart rate, respiratory rate, tidal volume, minute ventilation (MV)] at 1 min, 30 min, and 2 hr after beginning of SBT. Cough peak expiratory flow (CPEF) and diaphragmatic thickness (DT) were also measured at 1 min after SBT. Weaning parameters were compared between the 2 patient groups (weaning success vs. weaning failure). Primary outcome was difference in weaning parameters between the 2 groups of patients.\u0000Results: All 48 subjects were enrolled. The mean (±SD) age was 80.2 (±6) years. Altogether, 38 patients (79.2%) were in the weaning success group and 10 patients (20.8%) in the weaning failure group. All baseline characteristics did not significantly differ between the 2 groups. While no difference was observed in other isolated weaning parameters between the 2 patient groups, we found that patients in the weaning success group had significantly lower MV than patients in the weaning failure group (8.3±1.8 vs. 9.9±2.5 L/min, p=0.025). Composite weaning parameters included MV/CPEF and MV/(CPEF x DT) increased predictive values for weaning failure than isolated MV with area under the receiver operating characteristics curves of 0.78, 0.80, and 0.72 respectively. The best cutoff point to predict weaning failure were MV ≥8.4 L/min, MV/CPEF ≥0.12, and MV/(CPEF x DT) ≥0.45 cm-1 \u0000Conclusion: MV was the only parameter associated with weaning failure among the elderly. Composite parameters demonstrated better predictive value for assessing weaning readiness among elderly patients.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85137361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent profile analysis identified COVID-19 ARDS phenotypes in Thai patients: Research protocol and preliminary report","authors":"Namsai Pukiat, Y. Sutherasan, Detajin Junhasawasdikul, S. Suppadungsuk, Sanyapong Petchrompo, P. Theerawit","doi":"10.54205/ccc.v30.256078","DOIUrl":"https://doi.org/10.54205/ccc.v30.256078","url":null,"abstract":"Background: Clinical heterogeneity was observed among COVID-19 patients with acute respiratory distress syndrome (CARDS). The heterogeneity of disease was contributed to different clinical progression, responses to treatment, and mortality. \u0000\u0000Objective: We aim to study the phenotype and associated mortality of COVID-19 respiratory failure in Thai patients. \u0000\u0000Methods: We conducted a single-center, retrospective observational study. The data were collected in CARDS who received an invasive mechanical ventilator in ICU. Patient-related data were collected at admission before the onset of respiratory failure. The main features include demographics data, SOFA score, laboratory, CXR severity score, treatment during hospitalization, and the following data at the onset of respiratory failure during invasive mechanical ventilator. We also collected patients’ status at 28-day, in-hospital complications, and ventilator-free days at 28-day after intubation. The latent profile analysis was performed to identify distinct phenotypes. After identifying phenotypes, characteristics and clinical outcomes were compared between phenotypes. The primary outcome was the phenotype and associated mortality of COVID-19 respiratory. Secondary outcomes include characteristics of phenotype, ventilator-free days, response to treatment, and complications in each phenotype.\u0000\u0000Discussion: This study aims to identify the phenotype of COVID-19SARS-CoV-2 Respiratory Failure in Thai Patients The different phenotypes may be associated with varying responses to treatment and outcomes that the result of this study may be useful for determining treatment and predicted prognosis of COVID-19 SARS-CoV-2 Respiratory Failure In Thai Patients. \u0000\u0000Ethics and dissemination: The study protocol was approved by the Institution Review Board of Ramathibodi Hospital, Mahidol University, Thailand (No. MURA2021/740). We plan to disseminate the results in peer-reviewed critical care medicine or pulmonology related journal, conferences nationally and internationally.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"257 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76186000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of hemoperfusion with a cytokine adsorbent in norepinephrine-resistant septic shock: protocol for the CLEANSE randomized clinical trial","authors":"Nattapat Wongtirawit, Phitphiboon Deawtrakulchai, Anupol Panitchote, R. Ratanarat","doi":"10.54205/ccc.v30.255033","DOIUrl":"https://doi.org/10.54205/ccc.v30.255033","url":null,"abstract":"Background: Due to the pivotal role of inflammatory cytokines in sepsis, hemoperfusion with cytokine adsorbents may lead to better outcomes. Although previous studies showed inconclusive results, proper patient selection and timing of hemoperfusion may lead to improved survival.\u0000\u0000Objectives: To examine whether patients with septic shock requiring high-dose vasopressors undergoing add-on hemoperfusion with a cytokine adsorbent have better clinical outcomes than those treated with standard treatment alone.\u0000\u0000Methods: This is a multi-center, randomized controlled study in 2 tertiary care centers. 206 patients with septic shock receiving norepinephrine of 0.2 mcg/kg/min or higher are randomized to receive either standard treatment combined with 3-hour sessions of hemoperfusion with cytokine adsorbent for two consecutive days (HP group) or standard treatment alone (ST group). The primary outcome is 28-day mortality. Secondary outcomes include hospital and ICU mortality, shock reversal, vasoactive-inotropic score (VIS), organ support-free days, interleukin-6 levels, as well as safety data.\u0000\u0000Conclusions: This study will provide information to guide the use of hemoperfusion with a cytokine adsorbent in patients with septic shock.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89651337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of milrinone versus placebo on hemodynamic in patients with septic shock: A randomize control trial","authors":"Suratee Chobngam, S. Tongyoo","doi":"10.54205/ccc.v30.255002","DOIUrl":"https://doi.org/10.54205/ccc.v30.255002","url":null,"abstract":"Background: Sepsis is one of the most serious healthcare problems worldwide, which is associated with high mortality and financial burdens. The common causes of death are refractory shock and multi-organ failure. Myocardial dysfunction, a relatively common complication of septic shock, causes a significantly decrease in stroke volume and cardiac output. This results in insufficient blood supply to the organs, creates multi-organ failure and finally, leading to death. The Surviving Sepsis Campaign Guidelines 2016 also recommended using dobutamine in septic shock patients who had been resuscitated until achieving normal blood pressure target of mean arterial pressure 65 mmHg or more, but still had evidence of inadequate tissue perfusion. Milrinone action via an alternative pathway from the sympathetic inotropic agents, makes the milrinone to be used as an option for improve cardiac function among sepsis patients. However, there are few studies of milrinone in patients with septic shock. \u0000\u0000Methods: We plan to conduct a double blind randomized controlled trial, enrolling patients at Siriraj hospital and Hat-Yai hospital. The adults with the diagnosis of septic shock according to definition of SEPSIS III will be screened. Patients who receive fluid resuscitation at least 30 mL/kg, mean arterial pressure (MAP) ≥ 65 mmHg, with a clinical sign of poor tissue perfusion, or evidence of impaired left ventricular systolic function (left ventricular ejection fraction (LVEF) < 40%) will be enrolled. The patients were randomly assigned in a 1:1 ratio by their sequential number to receive either milrinone (intervention group) or placebo (control group). The physician performs an echocardiogram for assessing cardiac function, before the starting of the study drug and after the 6 and 24 hours. The monitoring of vital signs, urine output, and lactate at 6 and 24 hours after milrinone or placebo commencement is recorded. \u0000\u0000Conclusion: This study will evaluate the efficacy of milrinone in improving cardiac output among adult patients with septic shock who is resuscitated to achieve target blood pressure but still have signs of poor tissue perfusion.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80999304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory variation of central vein diameter in upper body as a surrogate of pulse pressure variation","authors":"Nichaphat Phancharoenkit, Pusit Feungfoo","doi":"10.54205/ccc.v30.255038","DOIUrl":"https://doi.org/10.54205/ccc.v30.255038","url":null,"abstract":"Background: Cyclical change in central vein diameter during respiratory cycle can be used for fluid-responsiveness assessment. The purpose of this study is to assess variations in the diameter of central veins in upper body region, specifically internal jugular vein (IJV), subclavian vein (SCV), and brachiocephalic vein (BCV), in mechanically ventilated patients. We hypothesized that variations in the diameter of these veins caused by passive ventilation would be strongly concordant with pulse pressure variation (PPV).\u0000\u0000Methods: The study was conducted in mechanically ventilated, critically ill surgical and medical patients. The PPV values were automatically calculated and were recorded. The diameters of the study veins such as the IJV, SCV, and BCV were measured bedside using the ultrasound. Then respiratory variations of venous diameter were calculated into distensibility index, collapsibility index and variability index. The relationships between PPV and ultrasound-derived parameters were assessed. Patients were separated into two groups according to their PPV values (>13 and <10). The test performance and proper cut-off values of ultrasound-derived parameters to distinguish between these two groups were generated by receiver operating characteristic (ROC) curves.\u0000\u0000Results: A total of 44 patients were assessed. There were substantial correlations between PPV and ultrasound parameter namely IJV-DI (r=0.652, p<0.001), IJV-VI (r=0.655, p<0.001), SCV-CI (r=0.618, p<0.001), and SCV-VI (r=0.626, p<0.001). While PPV and BCV-CI show moderate correlation (r=0.531, p=0.008). The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI values were significantly greater in PPV>13 group than PPV<10 group. All these parameters were effective in distinguishing between PPV>13 from PPV<10 group with AUC 0.983, 0.983, 0.928, 0.928 and 0.826, respectively. The IJV-DI, IJV-VI, SCV-CI, SCV-VI and BCV-VI analysis demonstrated appropriate cut-off values for separating patients with PPV>13 from those with PPV<10 as 16.19% (sensitivity 92%, specificity 96%), 14.98 % (sensitivity 92%, specificity 96%), 9.74% (sensitivity of 93%, specificity of 91%), 12.33% (sensitivity of 87%, specificity of 100%) and 13.71% (sensitivity of 73%, specificity of 100%), respectively.\u0000\u0000Conclusions: In critically ill patients, all ultrasound-derived measures such as IJV-DI, IJV-VI, SCV-CI, SCV-VI, and BCV-VI revealed significant correlation with PPV value.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85661622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous intestinal perforation in critical COVID: A case report","authors":"P. Fuengfoo, Amorn Jongstapongpan, Poonnapong Hansiriphan, N. Srisawat, Pitaks Detporntewan, Ratchamon Pinyoteppratarn, Panu Boontoterm, Nichaphat Phancharoenkit, A. Palwatwichai","doi":"10.54205/ccc.v30.256874","DOIUrl":"https://doi.org/10.54205/ccc.v30.256874","url":null,"abstract":"Spontaneous intestinal perforation is a rare extrapulmonary manifestations of critical COVID-19 case. The pathogenesis of viral etiology is still unclear and association to some essential therapeutic treatment such as steroid or interleukin-9 antagonist is also inconclusive. Surgery is not mandatory If source control and sepsis can be accomplished with available interventions reported in current literatures. This uncommon complication develops either at time of presentation or after hospital admission, both upper and lower gastrointestinal tract1 We reported an ARDS patient experienced cardiac thrombus without valvular defect or arrhythmia who was diagnosed of spontaneous intestinal perforation from acute necrotizing ileitis necessitated damage control surgery.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87420986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of inhaled sevoflurane to treat post-operative intractable cerebral edema in neurosurgical intensive care unit.","authors":"Panu Boontoterm, Boonchot Kiangkitiwan, S. Sakoolnamarka, Wiriya Homhuan, P. Fuengfoo","doi":"10.54205/ccc.v30.256435","DOIUrl":"https://doi.org/10.54205/ccc.v30.256435","url":null,"abstract":"Background: Burst suppression are widely used in case of refractory increased intracranial pressure for deep state of brain inactivation. Inhaled sevoflurane via the anesthetic conserving device could be useful for the sedation of patients in the intensive care unit (ICU), but prospective studies have been small study. \u0000\u0000Case report: A 53-year-old male patient with confusion, not follow to\u0000command and status epilepticus had been hospitalized and \u0000diagnosed glioblastoma multiforme at left temporal lobe. By the time \u0000initial therapy had begun with dexamethasone and anti-epileptic \u0000drug, the symptoms had improved. The patient was performed \u0000craniotomy with tumor removal during intra-operative found \u0000intractable cerebral edema and changed operation to \u0000decompressive craniectomy, in post-operative period after increased \u0000dosage of propofol and midazolam to control intracranial pressure, \u0000patient developed hypotension, then norepinephrine was titrated to \u0000maintain mean arterial pressure more than 65 mmHg and used \u0000inhaled sevoflurane to decrease dose propofol for maintain \u0000hemodynamics then during 5 day usage inhaled sevoflurane, \u0000norepinephrine could wean off and Glasgow coma scale was \u0000improve. Follow up brain EEG at 1st week showed no epileptiform \u0000discharge, antiepileptic drug could de-escalated and CT scan \u0000showed no refractory cerebral edema or hemorrhage. Ventilator was \u0000weaned off and the patient was transfer to step down ward.\u0000\u0000Conclusion: When managing intractable cerebral edema patient \u0000with inhaled sevoflurane showed that lower opioid dose intensity, \u0000promote resolving from seizures or status epilepticus, decrease \u0000dose of vasopressor to maintain hemodynamics and no adverse \u0000events supported the use of inhaled sevoflurane via the anesthetic \u0000conserving device in this patient who have clinical need for burst \u0000suppression.","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90434589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Left ventricular diastolic function compared to inferior vena cava diameter variation as predictor of fluid responsiveness in mechanical ventilated patients with shock: The research protocol","authors":"Anutr Thitayanapong, S. Tongyoo","doi":"10.54205/ccc.v30.254873","DOIUrl":"https://doi.org/10.54205/ccc.v30.254873","url":null,"abstract":"Background: Fluid responsiveness, defined as an increase in cardiac output by 15% after a fluid challenge, is recommended to be evaluated in-patients with shock. Left ventricular (LV) diastolic dysfunction is associated with a lower increment of cardiac output after fluid challenge. Despite being a non-invasive test, the echocardiographic evaluation of the left ventricular diastolic function was rarely studied for the prediction of fluid responsiveness. The objective of this study is to evaluate the efficacy of LV diastolic function in predicting fluid responsiveness, comparing with inferior vena cava (IVC) diameter variation method, among shock patients who required mechanical ventilation.\u0000\u0000Methods: We plan to enroll adult patients with shock admitted to the intensive care unit (ICU). The echocardiographic hemodynamic parameters include IVC diameter variation, peak velocity of early diastolic filling of mitral valve inflow (E wave), peak early diastolic velocity of the mitral valve annulus (Ea), mitral E/Ea ratio, left ventricular ejection fraction (LVEF) and transaortic cardiac output (CO), all at baseline and after fluid therapy are measured. A fluid challenge with an infusion of 300 ml of acetate Ringer’s solution within 15 minutes will be given. Patients who have an increase in systolic blood pressure of at least 10 mmHg, mean arterial pressure of at least 5 mmHg or cardiac output of at least 15% are defined as fluid responders. The primary outcome of this study is the efficacy of the mitral E/Ea ratio comparing with IVC diameter variation in predicting fluid responsiveness. The secondary outcomes include the rate of fluid responsiveness in mechanically ventilated patients and LVEF and CO in patients with shock in the intensive care units.\u0000\u0000Conclusion: This study will evaluate the efficacy of left ventricular diastolic function measured by the echocardiography (Mitral E/Ea ratio) in predicting fluid responsiveness among mechanical ventilated patients with shock.\u0000\u0000Trial registrations: Clinicaltrials.gov NCT05066256, registered on January 10th, 2021","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75019859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of near-infrared spectroscopy in mortality and organ dysfunction in patients recovery from septic shock: The research protocol","authors":"Gunthiga Laplertsakul, P. Theerawit, Y. Sutherasan, Detajin Junhasavasdikul","doi":"10.54205/ccc.v30.254767","DOIUrl":"https://doi.org/10.54205/ccc.v30.254767","url":null,"abstract":"Background: Sepsis or septic shock results in the alteration of blood flow at the microcirculatory level, affecting tissue oxygenation and organ function and associated with death. This study aimed to use near-infrared spectroscopy (NIRS) in conjunction with vascular occlusion test (VOT) to assess the association of microcirculatory dysfunction after recovered from septic shock and in-hospital mortality.\u0000Methods: We conducted a prospective observational study in patients who recovered from septic shock. We performed NIRS with VOT within 24 hours of hospitalization in medical and anesthetic ICU (T0), then at the time of recovery from septic shock (D0), at day 3 (D3), day 5 (D5), and day 7 (D7) after recovery from septic shock. We recorded the de-oxygenation (DeO2) slope, the re-oxygenation (ReO2) slope, and the area under the hyperemic response curve (the reperfusion area). We focused on parameters of microcirculation dysfunction, in-hospital mortality, and in-hospital complications.\u0000Hypothesis: We hypothesize that NIRS with vascular occlusion test parameters are associated with in-hospital mortality and hospital complications\u0000Ethic: The study protocol has been approved by the Institution Review Board of Ramathibodi Hospital, Mahidol University, Thailand (No. MURA2020/147). \u0000Trial registration: TCTR20220413001","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82114852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characteristics of the continuously-recorded mechanical power and its associated clinical outcomes in medical patients with respiratory failure (CORE POWER) study: The protocol of prospective observation study.","authors":"Akarawut Kasemchaiyanun, Detajin Junhasavasdikul, P. Theerawit","doi":"10.54205/ccc.v30.254872","DOIUrl":"https://doi.org/10.54205/ccc.v30.254872","url":null,"abstract":"Background: The amount of energy delivered from the ventilator applied to the lungs within a given timeframe, is defined as mechanical power (MP). Recently, low MP is one of the new concepts in lung-protective ventilation strategies that may associate with survival benefit. However, measuring MP requires additional calculations not being carried-out in usual clinical care and the reports about MP were mostly a cross-sectional data. The real-time changes or dynamic data of MP was scarcely reported. Our objective is to investgate the association between the dynamic changes of MP and clinical outcomes in critically ill patients. \u0000\u0000Methods: This will be a prospective, observational study performed in a single center. Adult patients admitted to medical intermediate and intensive care units who requiring invasive mechanical ventilation will be consecutively enrolled. The patients’ ventilators will be connected to the specific investigator’s computer system for continuously real-time data recording for at least 24 hours. The primary outcome is in-hospital mortality. \u0000\u0000Hypothesis: We hypothesize that excessive mechanical power during mechanical ventilation contributes to ventilator-induced lung injury, thus real-time continuously mechanical power monitoring may reduce adverse events associated with mechanical ventilation.\u0000\u0000Ethic: The study protocol has been approved by the Institution Review Board of Ramathibodi Hospital, Mahidol University, Thailand (No. MURA2021/680). \u0000\u0000Trial registration: TCTR20220202010","PeriodicalId":76963,"journal":{"name":"AACN clinical issues in critical care nursing","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87393408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}