Health Condition 1: J189- Pneumonia, unspecified organism
Conditions
Interventions
Control Intervention1: Nil: NIL
Sponsors
Rainbow childrens Medicare Ltd
Eligibility
Inclusion criteria
Inclusion criteria: Invasively ventilated children more than one month and up to 18 years of age shall be enrolled for the study with acute hypoxemic respiratory failure due to non-cardiogenic etiology. Acute Hypoxemic lung injury shall be defined as 1-Less than one week duration of illness 2- Unilateral or bilateral haziness on lung fields in chest X Ray not due to cardiac dysfunction or fluid overload. 3-PF Ratio below 300 or an SF ratio below 265 or OI above 4 at PEEP of 5cmH2O or more. 4-Without cardiac etiology as the cause of hypoxia.
Exclusion criteria
Exclusion criteria: • Children on NIV • Children who are hemodynamically unstable for data collection • Children who are already on High Frequency Oscillatory ventilation • Children with significant Patient Ventilator Asynchrony • Children with open chest (following surgery) • Children with air leaks, with chest Drains • Children with raised Intra cranial pressure • Children on Extracorporeal therapies (CRRT, hemodialysis), ECMO • Children in Prone position • Children with chronic lung diseases • Children with cyanotic heart diseases • For Nitrogen Wash-in washout technique, the manufacturer recommends the respiratory rates to be below 35 breathes/min and FiO2 to be below 65-70%, hence any child who doesn’t fit in to these criteria shall also be excluded automatically from the study purpose. • Children on inhaled Nitric Oxide or extracorporeal therapies (ECMO/CRRT/Hemodialysis etc) are also not recommended by the manufacturer, hence considered under exclusion criteria. • Even during the RI study, if at the PEEP of 15cmH2O, if the DP is above 15 cmH2O or the PPlat is above 28-30cmH2O, then the study will not be conducted any further and the patient shall be excluded from the study.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the recruitment-to-inflation ratio through end expiratory lung volume measurement across the traditionally tested 15 to 5 cm H2O PEEP range and in the narrower ranges of PEEP-change in three stepsTimepoint: with in 7 days of illness | — |
Secondary
| Measure | Time frame |
|---|---|
| 1.To assess respiratory mechanics like driving pressure, mechanical power, stress, strain, S/F ratio, Vd/Vt and EILV/TLC at each PEEP-step and compare with RI Index at those PEEP-steps 2.To correlate FRC at ZEEP with the volume measured by the single breath derecruitment method from PEEP of 5cmH2O to ZEEP. Timepoint: With in 7days of illness | — |
Countries
India
Contacts
Public ContactDr Latha
Rainbow childrens hospital
Outcome results
None listed