title: Contributors to fatigue in patients receiving mechanical ventilatory support: A descriptive correlational study.
abstract: OBJECTIVE
  To describe levels of fatigue and explore clinical factors that might contribute to fatigue in critically ill patients receiving mechanical ventilation.
  
  
  METHODS
  Descriptive, correlational design. Sample was a sub-set of patients enrolled in a randomised clinical trial testing patient-directed music for anxiety self-management. Clinical factors included age, gender, length of ICU stay, length of ventilatory support, illness severity (APACHE III), and sedative exposure (sedation intensity and frequency). Descriptive statistics and mixed models were used to address the study objectives.
  
  
  METHODS
  Medical and surgical intensive care units in the Midwestern United States.
  
  
  METHODS
  Fatigue was measured daily via a 100-mm Visual Analogue Scale, up to 25 days.
  
  
  RESULTS
  A sample of 80 patients (50% female) receiving ventilatory support for a median 7.9 days (range 1-46) with a mean age of 61.2 years (SD 14.8) provided daily fatigue ratings. ICU admission APACHE III was 61.5 (SD 19.8). Baseline mean fatigue ratings were 60.7 (SD 27.9), with fluctuations over time indicating a general trend upward. Mixed models analysis implicated illness severity (β(se(β))=.27(.12)) and sedation frequency (β(se(β))=1.2(.52)) as significant contributors to fatigue ratings.
  
  
  CONCLUSIONS
  Illness severity and more frequent sedative administration were related to higher fatigue ratings in these mechanically ventilated patients.
authors.affiliation: Symptom Management, College of Nursing, The Ohio State University, 1585 Neil Avenue, Columbus, OH 43210, United States. Electronic address: chlan.1@osu.edu.
authors.forename: Linda L
authors.initials: LL
authors.lastname: Chlan
authors.affiliation: School of Nursing, University of Minnesota, 5-160 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, United States. Electronic address: savik001@umn.edu.
authors.forename: Kay
authors.initials: K
authors.lastname: Savik
mesh_terms: D018806:APACHE; D000368:Aged; D001007:Anxiety / Q000628:therapy; D016638:Critical Illness; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009147:Music Therapy / Q000379:methods; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000628:therapy*; D012307:Risk Factors; D012648:Self Care / Q000379:methods; D012720:Severity of Illness Index; D064232:Visual Analog Scale
chemical_list: D006993:Hypnotics and Sedatives
keywords: Fatigue; Intensive care unit; Mechanical ventilation; Symptoms