Acute hypoxemic respiratory failure. Acute respiratory failure
Conditions
Interventions
Intervention 1: Intervention group: APRV: Patients change from previous volume ventilation mode to APRV mode. P-high is adjusted to create VT = 6ml / kg and does not exceed 30cmH2O. From 60%, produce
Sponsors
Tehran University of Medical Sciences
Eligibility
Sex/Gender
All
Age
16 Years to 85 Years
Inclusion criteria
Inclusion criteria: Intubated patients with acute respiratory failure type I (hypoxemic) Endotracheal intubation and mechanical ventilation less than 48 hours Respiratory failure based on P / F Ratio = 150-250
Exclusion criteria
Exclusion criteria: Patients with acute respiratory failure and P / F Ratio less than 150 Neuromuscular and diaphragmatic disorders Chest deformity Suspected Intracranial Hypertension COPD and severe asthma CHF CKD , ESRD Refractory shock Diagnosed Barotrauma and Lung Contusion Age under 16 and over 85 years Pregnancy Abdominal compartment syndrome
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Lung compliance. Lung resistance. Timepoint: Measurement of lung compliance and resistance on days 1, 2, 3 and 7 after long-term onset of APRV and PSV. Method of measurement: compliance and resistance measurment is based on ventilator information. | — |
Secondary
| Measure | Time frame |
|---|---|
| Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) II Scoring System. Timepoint: At the time of admission. Method of measurement: According to the case report.;Oxygenation based on the ratio of arterial oxygen pressure to the Fio2. Timepoint: Days 1, 2, 3 and 7 after the start of ventilation mode. Method of measurement: Based on sample information of ABG blood gas analysis.;Arterial blood carbon dioxide pressure PaCO2. Timepoint: Days 1, 2, 3 and 7 after the start of ventilation mode. Method of measurement: Based on sample information of ABG blood gas analysis.;Fentanyl intake. Timepoint: ?????? 1?2?3?7 ??? ?? ???? ?? ????? ??. Method of measurement: Based on patient record (micrograms).;Number of ventilator free days at day 28. Timepoint: Twenty-eighth day after intervention. Method of measurement: Based on patient record.;Intensive care unit length of stay. Timepoint: At the time of discharge from the intensive care unit. Method of measurement: Based on patient record.;Richmond Agitation and Sedation Scale (RASS score). Timepoint: Days 1, 2, 3 and 7 after the start of ventilation mode. Method of measurement: Based on patient record.;The amount of shunt: (1-SaO2)/(1-SvO2). Timepoint: Days 1, 2, 3 and 7 after the start of ventilation mode. Method of measurement: Based on ABG information. | — |
Countries
Iran (Islamic Republic of)
Contacts
Public ContactElham Naseh
Tehran University of Medical Sciences
Outcome results
None listed