Critical Illness, Mechanical Ventilation Pressure High
Conditions
Keywords
mechanical ventilation, airway closure, alveolar collapse
Brief summary
Monitoring airway pressure is essential for patients with mechanical ventilation. However, static airway pressure does not reflect alveolar pressure at all. Airway pressure is supposed to completely interrupt the communication between proximal airway opening and the distal alveolar and/or small airway structures. In this condition, some alveoli may still be inflated but do not communicate with proximal airways and auto-PEEP will give a biased estimated of mean alveolar pressure. To be note, distinguishing the airway closure and alveolar collapse can be challenging at times. The quasi-static PV curve is a useful bedside tool to set mechanical ventilation, which may help us to identify the airway closure and alveolar collapse. Meanwhile, the quasi-static PV curve can only reflects a global behaviour of the lung, while EIT may be a useful tool to assess the regional information on airway closure and alveolar collapse.
Interventions
OTHERpressure-volume curve with a low-flow insufflation of 5 L/min
The patient undergoes a pressure-volume curve with a low-flow insufflation of 5 L/min while in a state of analgesia, sedation, and absence of spontaneous breathing.
Sponsors
Southeast University, China
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adult patients undergoing controlled mechanical ventilation * The duration of endotracheal intubation \< 48 hrs
Exclusion criteria
* Severe hemodynamic instability * Severe chronic lung disease requiring long-term home oxygen therapy * Patients without analgesic sedation * Decline to participate in the study * Refusal to sign informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the rate of airway closure and alveolar collapse | up to 24 hours | airway closure and alveolar collapse are monitored by PV curve with a low-flow insufflation of 5 L/min |
| Phenotype of respiratory open pressure | up to 24 hours | According to the characteristics of the low inflation point of PV curve, the respiratory open pressure phenotype was constructed |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| respiratory system compliance | up to 24 hours | Respiratory system compliance is calculated as the ratio of tidal volume to the difference between plateau pressure and positive end-expiratory pressure. |
Countries
China
Contacts
Primary Contactling liu, phD
Backup Contactxueyan yuan, phD
Outcome results
None listed