Pulmonary Disease
Conditions
Brief summary
Effects of standing at different angles on transpulmonary pressure
Detailed description
Objective: To study the effect of different standing angles on cross-lung pressure.Background: Long-term bed rest in ICU patients leads to upward movement of diaphragm and increased intrathoracic pressure in mechanically ventilated patients, resulting in lower cross-lung pressure. If the end-expiratory cross-lung pressure is negative, lung tissue compression and atelectasis will occur.Standing can lower the diaphragm, improve the pressure across the lungs, and improve ventilation.Selection methods: patients with invasive mechanical ventilation in the ICU, on the premise of stable hemodynamics, with the aid of electric bed training in standing in different angles, start from 20 degrees, 5 degrees up every five minutes, the largest up to 80 degrees, each Angle across the pulmonary pressure, die cavity ratio, tidal volume and breathe out carbon dioxide at the end of the record, and record whether low blood pressure, an accident in the process of take off the tube and other adverse reactions.
Interventions
BEHAVIORALChange of standing Angle
Change the patient's standing Angle by using an electric bed
Sponsors
Chinese PLA General Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 95 Years
Healthy volunteers
No
Inclusion criteria
* The age is ≥ 18 years old; * the hemodynamics is stable; * 50 \< heart rate \< 120 beats / min ; * 90 \< systolic blood pressure \< 200mmHg ; * 55 \< mean arterial pressure \< 120mmHg; * do not increase the dose of pressor drugs for at least 2 hours; * intracranial pressure is stable and there are no seizures within 24 hours; * the respiratory state is stable; * the patient's finger pulse oxygen saturation ≥ 88%; * 10 \< respiratory frequency \< 35 beats / min.
Exclusion criteria
* Pregnancy; * acute cardio-cerebrovascular events; * spinal or limb fractures; * active bleeding.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| transpulmonary pressure | 5 minutes | End-expiratory pressure across the lungs is recommended at 0-5cmH2O. |
| Esophageal pressure | 5 minutes | The change in esophageal pressure represents the degree of inspiratory effort.The greater the variation, the harder the inhale. |
| Dead space rate | 5 minutes | the smaller，the better |
| tidal volume | 5 minutes | Standard tidal volume: standard weight based on height, 6 to 8ml per kg body weight |
| partial pressure of carbon dioxide in endexpiratory gas | 5 minutes | The smaller the difference between pCO2 and arterial blood gas, the better |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| adverse reaction | an hour | hypotension、Accident to take off the tube、Drop of bed，Record the number of times it happens.The more it happens, the less safe it is. |
Contacts
Primary ContactZhao Ying
Outcome results
None listed