Acute Respiratory Distress Syndrome
Conditions
Brief summary
Mechanical power (MP) is a summary variable, which includes static and dynamic respiratory parameters, is associated with ventilator-induced lung injury. MP is transferred primarily to smaller functional lung size, often referred to as baby lung (BL). Functional lung size (BL) is associated with respiratory system compliance (Crs). For this reason, MP normalized to Crs (MP/Crs) could be an important parameter to evaluate. The objectives of this study were to compare variables according to the MP/Crs cut-off point and to identify the MP components associated with MP/Crs.
Detailed description
In patients with acute respiratory distress syndrome (ARDS), undergoing mechanical ventilation (MV), each respiratory cycle transfers a specific amount of mechanical energy to the lung, aimed to expand and overcome airway resistance. The total mechanical energy multiplied by the respiratory rate (RR) defines the mechanical power (MP). It has been hypothesized that a smaller functional lung size, often referred to as baby lung (BL), increases mechanical energy transfer that exacerbates lung damage. Functional lung size (BL) is associated with respiratory system compliance (Crs). Whatever the size of this operational BL, protective ventilation strategies should be aimed at preserving its size and functionality, to avoid ventilator-induced lung injury (VILI). For this reason, MP normalized to Crs (MP/Crs) could be an important parameter to evaluate. Preclinical studies have found that VILI arises primarily from a combination of MP components and not from any of its components individually. We believe that MP/Crs should have the same behavior in relation to MP components as a whole. Therefore, the objectives of this study are to compare variables according to the MP/Crs cut-off point and to identify the MP components associated with MP/Crs.
Interventions
OTHERMP/Crs assessment < = 0.48 J/min/ml/cmH2O
Assessment of the ventilatory variables according to the MP/Crs value (\<= or \> 0.48 J/min/ml/cmH2O)
Sponsors
Ramos Mejía Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
15 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* patients who have been receiving mechanical ventilation (MV) and have been defined as with ARDS according to the Berlin definition
Exclusion criteria
* patients with chronic pulmonary disease * patients with an expected duration of MV shorter than 48 h * patients with a high risk of death within 3 months for reasons other than ARDS * patients having made the decision to withhold life-sustaining treatment.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To compare variables according to the MP/Crs (J/min/ml/cmH2O) cut-off point | Third day of mechanical ventilation | MP/Crs (J/min/ml/cmH2O) will be used to establish the cut-off and compare variables. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Components of MP associated with MP/Crs (J/min/ml/cmH2O) | Third day of mechanical ventilation | Through a multivariate analysis, the association between MP/Crs (J/min/ml/cmH2O) and the components of MP will be assessed. |
Countries
Argentina
Outcome results
None listed