# Psychological support based on positive suggestions in acute respiratory failure patients

> **NIH NIH K23** · MAYO CLINIC ROCHESTER · 2024 · $185,760

## Abstract

PROJECT SUMMARY/ABSTRACT
Up to two thirds of those who survive acute respiratory failure (ARF) requiring mechanical ventilation suffer
from symptoms of anxiety, depression, or post-traumatic stress disorder (PTSD) after leaving the intensive
care unit (ICU). Memories of frightening and delusional experiences in the ICU appear to be the strongest
potentially modifiable risk factor. Research on the formation of fear and associated memories shows that if
mitigating information about a traumatic event is introduced during the time between memory formation and its
recall, the emotional experience of the memory can be modified in a positive manner. This means that in order
to prevent mental health problems in ARF patients, psychological support needs to take place in parallel with
medical treatment in the ICU. Previously, application of Psychological Support Based on Positive Suggestions
(PSBPS) resulted in shorter duration of mechanical ventilation and decreased need for sedatives. We
hypothesize that PSBPS can also mitigate mental health morbidity in ARF survivors. However, providing
reliable PSBPS intervention is a challenge for busy ICU clinicians. Doulas, trained lay health care providers
who provide emotional support to women in labor have been identified as a reliable yet affordable alternative.
Given common elements of their services and our intervention, doulas are in an ideal position to administer
PSBPS. The objective of this project is to refine and test a behavioral intervention to be administered in
parallel with medical treatment in the ICU. This will be accomplished through two specific aims, which are: 1)
to complete the pilot PSBPS with trained doulas and to refine the intervention based on stakeholder feedback
and 2) to conduct a randomized controlled trial to evaluate the potential efficacy of PSBPS vs usual care in
ARF patients on mental health morbidity and cognitive outcomes. In AIM 1, PSBPS will be performed on 30
ARF patients with subsequent semi-structured interviews of all involved stakeholders; patients will also
complete anxiety, depression, acute stress/PTSD, and cognitive function evaluation as measured by validated
instruments. For AIM 2, we will conduct a randomized, controlled trial to test the effectiveness of PSBPS. We
hypothesize that ARF patients who receive standardized EPSCI will have fewer symptoms of anxiety,
depression and acute stress/PTSD at ICU discharge and at 6-month follow-up, and better cognitive function.
The proposed Career Development Award supports the NHLBI mission by striving to improve outcomes in
ARF patients while training a junior investigator in essential skills to become an independent researcher.

## Key facts

- **NIH application ID:** 10745975
- **Project number:** 5K23HL146741-05
- **Recipient organization:** MAYO CLINIC ROCHESTER
- **Principal Investigator:** Lioudmila Karnatovskaia
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $185,760
- **Award type:** 5
- **Project period:** 2019-12-24 → 2025-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10745975

## Citation

> US National Institutes of Health, RePORTER application 10745975, Psychological support based on positive suggestions in acute respiratory failure patients (5K23HL146741-05). Retrieved via AI Analytics 2026-06-14 from https://api.ai-analytics.org/grant/nih/10745975. Licensed CC0.

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