ICU mechanical ventilation-induced lung injury
Conditions
Interventions
Experimental group:Sedation with remifentanil, titrated within the range of 0 to 3 mg/kg/h.
Control group:Sedation with propofol, titrated within the range of 0 to 12 mg/kg/h.
Sponsors
Tianjin Nankai Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 84 Years
Inclusion criteria
Inclusion criteria: (1) Aged 18 to 84 years, of any gender; (2) Patients in the ICU undergoing invasive mechanical ventilation with a Lung Injury Prediction Score (LIPS) = 4; (3) Patients requiring light to moderate sedation (RASS score 0 to -3); (4) Voluntary participation with signed informed consent.
Exclusion criteria
Exclusion criteria: (1) Acute severe intracranial or spinal neurologic disease due to vascular causes, infection, or intracranial injury; (2) Severe bradycardia (HR<50 beats/min); (3) Atrioventricular block II-III (unless a pacemaker is installed); (4) Known allergy to any study drug or any excipient of the study drug; (5) Patients receiving sedative therapy for treatment indications (e.g., seizures) rather than for ventilator tolerance; (6) Patients unlikely to require ongoing sedation during mechanical ventilation (e.g., Guillain-Barré syndrome); (7) Patients unlikely to be weaned off the ventilator: e.g., irreversible diseases requiring long-term ventilatory support that primarily affects respiratory organ neuromuscular function, high-level spinal cord injuries, or advanced amyotrophic lateral sclerosis; (8) Distal tetraplegia; (9) Positive pregnancy test or currently breastfeeding; (10) Received any investigational drug within the past 30 days; (11) Concurrent participation in any other interventional study (patients allocated to different treatments in any study group and/or non-routine diagnostic or monitoring procedures).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Transpulmonary driving pressure;Electrical Impedance Tomography; | — |
Secondary
| Measure | Time frame |
|---|---|
| ANG-2;Endocan;KL-6;Fib;CRP; Lactic acid;IL-6;IL-8; BIS;Mechanical ventilation time;Murray lung injury score;Administration of neuromuscular blocking agents;ICU monitoring duration;Blood gas analysis indicators;Total length of hospital stay;Total dose of sedative drugs;Total amount of analgesic drug use;30-day mortality rate;Hemodynamics; | — |
Countries
China
Contacts
Public ContactYu Jianbo
Tianjin Nankai Hospital
Outcome results
None listed