Impact of Psychoactive Drugs on Delirium in ICU Patients

精神活性药物对 ICU 患者谵妄的影响

• 批准号: 7255663
• 负责人: MARGARET A PISANI
• 金额: $ 15.85万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-15 至 2009-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7255663
• 关键词: Acute; Address; Adult Respiratory Distress Syndrome; Advisory Committees; Age; American; Anti-Anxiety Agents; Anti-Cholinergics; Antidepressive Agents; Antipsychotic Agents; Biometry; Caring; Cessation of life; Characteristics; Chronic; Class; Clinical; Clinical Investigator; Clinical Research; Clinical Trials; Comorbidity; Complement; Condition; Critical Illness; Daily; Data; Delirium; Dementia; Development; Diagnosis; Dose; Drug Combinations; Drug usage; Educational Curriculum; Elderly; Environmental Risk Factor; Environmental air flow; Future; Health; Hypnotics and Sedatives; Impaired cognition; Individual; Institutionalization; Integration Host Factors; Intensive Care Units; Interruption; Intervention; Intravenous; Invasive; Knowledge; Lead; Length; Length of Stay; Literature; Mechanical ventilation; Medical; Mentally Ill Persons; Mentored Patient-Oriented Research Career Development Award; Mentors; Metabolic; Narcotics; Observational Study; Outcome; Outcome Study; Patients; Pharmaceutical Preparations; Pharmacology; Pharmacotherapy; Population; Procedures; Psychotropic Drugs; Qualifying; Recovery; Research; Research Design; Research Personnel; Research Project Grants; Research Training; Risk; Risk Factors; Sedation procedure; Sepsis; Severity of illness; Shock; Supervision; Training; United States; Validation; Work; base; clinical epidemiology; design; dosage; evidence based guidelines; experience; multidisciplinary; patient oriented research; programs; sedative; skills

DESCRIPTION (provided by applicant): The long-term objective of this Mentored Patient-Oriented Research Career Development Award is to develop the Principle Investigator's skills and knowledge in observational study design, scale development and validation and outcome studies focused on psychoactive drug use and its impact on outcomes in critically ill patients. The thrust of this research project is three-fold: 1) To determine the association of psychoactive (sedative-hypnotic, narcotic and anticholinergic) drugs with persistent delirium post-ICU discharge. Persistent delirium is defined as delirium, which is present in the ICU and is also present post-ICU discharge. We will examine the drugs individually and in combinations, examine the influence of drug class and examine the influence of cumulative dose of drug received. 2) To identify leading drugs or combinations (called HIGH RISK DRUGS) associated with the highest risk of persistent delirium. 3) Controlling for other delirium risk factors (e.g., dementia, illness severity, invasive procedures, medical comorbidities, invasive procedures, and metabolic abnormalities) we will determine the independent contribution of the HIGH RISK DRUGS to persistent delirium. The applicant will achieve the long-term objectives by completing the well-integrated specific aims under the supervision of a highly qualified mentor and guidance by an Advisory Committee with multidisciplinary ICU clinical research expertise, experience in delirium research, and assistance by expert consultants in clinical epidemiology and biostatistics. The applicant has a focused program of didactic courses, participation in research seminars and training in pharmacology that will complement her previous MPH curriculum. The research projects have been selected, in part because they will provide an excellent training vehicle for furthering the applicant's transition to an independent investigator in ICU patient-oriented research. Ultimately, we hope this work will lead to the development of specific interventions in ICU drug therapy vital to the care of more than four million critically ill patients in the United States.

描述（由申请人提供）：这一受过指导患者的研究职业发展奖的长期目标是开发主要研究者在观察研究设计，量表开发和验证和结果研究中的技能和知识，并侧重于精神活性药物使用及其对严重患者的结果的影响。该研究项目的推力是三个方面：1）确定精神活性（镇静性催眠，麻醉和抗胆碱能）药物与持续的ICU del妄排放的关联。持续的del妄定义为del妄，它存在于ICU中，也存在于ICU后排放。我们将单独检查药物并结合使用，检查药物类别的影响，并检查接受药物的累积剂量的影响。 2）确定与持续del妄风险相关的主要药物或组合（称为高风险药物）。 3）控制其他ir妄风险因素（例如痴呆，疾病严重程度，侵入性程序，医学合并症，侵入性程序和代谢异常），我们将确定高风险药物对持续妄想的独立贡献。申请人将通过在高度合格的导师和指导下完成具有多学科ICU ICU临床研究专业知识的咨询委员会的指导和指导的指导来实现长期目标，并在临床流行病学和生物统计学方面的专家顾问提供帮助。申请人有一个专注的教学课程，参与研究研讨会和药理学培训的计划，可以补充她以前的MPH课程。选择了研究项目，部分原因是它们将提供出色的培训工具，以推动申请人向ICU面向患者的研究中的独立研究者的过渡。最终，我们希望这项工作将导致制定ICU药物疗法的特定干预措施，对于美国超过400万重病患者至关重要。