Acute Mechanical Ventilatory Failure
Conditions
Brief summary
The indications for mechanical ventilation (MV) include excessive work of breathing, with or without evidence of respiratory muscle fatigue. The setting of the MV is still a challenge because it is based on criteria understudied, often subjective and observer-dependent. Despite several studies, to our knowledge has never been done before is the precise definition of the optimal range of ventilatory support. Novel and recognizable diagnostic techniques will be applied. No single parameter of the breathing pattern has good accuracy for the adjustment of ventilatory support. Non-invasive measures such as P0.1 and rate of muscle relaxation may have good accuracy for the adjustment of ventilatory support.
Detailed description
Use of excessive pressure support
Interventions
PROCEDUREVariation of the level of pressure support during the mechanical ventilation
The pressure support of the patient was changed form the baseline to 20 cmH20 and then stepwise decreased to 2 cmH20,
Sponsors
University of Sao Paulo General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* patients under invasive mechanical ventilation for 48h * patients without the objective of complete rest of the respiratory muscles. This decision will be on the discretion of the attending physician, * spontaneous breathing, * clinically stability.
Exclusion criteria
* Previous disease of the central nervous system that can lead to respiratory changes. * Previous disease of the peripheral nervous system that can lead to respiratory changes * Previous muscular disease.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measuring muscular force | From the baseline ventilation to the minimum level of pressure support. Around 3 hours | Muscular force measured by inspiratory force in centimeters of water (cmH2O) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Measuring inspiratory drive | From the baseline ventilation to the minimum level of pressure support. Around 3 hours | Inspiratory drive measured in cmH2O in the first 100 milliseconds of the inspiration |
| Measuring endurance | From the baseline ventilation to the minimum level of pressure support. Around 3 hours | Endurance measured by the maximal relaxation rate (cmH2O/10ms) |
Countries
Brazil
Outcome results
None listed