To Determine the Annual Prevalence of Airway Closure
Conditions
Keywords
airway closure, mechanical ventilation
Brief summary
The primary objective of this study is to describe the prevalence of airway closure during the total support phase of invasive mechanical ventilation in subjects admitted to an intensive care unit (ICU). The secondary objective is to analyze whether there are clinical-demographic and/or ventilatory characteristics associated with the presence of airway closure.
Detailed description
Cross-sectional study. To detect airway closure, the maneuver will be performed at low flow and in case of having an opening pressure greater than 5 cmh20, the electrical impedance tomograph will be placed to record the delay in the change of impedance of each quadrant.
Interventions
OTHERairway closure
After setting the flow at 5 L/min and positive end-expiratory pressure (PEEP) at 0 cmH2O, the respiratory rate will be transiently decreased to achieve a prolonged expiration of 5-10 seconds to eliminate auto-PEEP. During two breaths, the change in the slope of the pressure-time curve will be observed. Airway Closure be detected as a change in the slope of the pressure-time curve. Airway Opening Pressure value, in cmH2O, will be identified on the pressure-volume curve using the cursor while the mechanical ventilator screen is frozen. Upon completion of this procedure, the ventilator settings will be returned to the patient's initial parameters.
Sponsors
Romina Belen Mattei
Study design
Observational model
OTHER
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients over 18 years of age * Requiring invasive mechanical ventilation within 48 to 72 hours after orotracheal intubation * Hemodynamically stable (mean arterial pressure greater than 60 mmHg and/or norepinephrine less than 0.5 mcg/kg/min) * Without respiratory muscle effort
Exclusion criteria
* Neumothorax * Bronchopleural fistula * Clinical evidence or suspicion of elevated intracranial pressure (greater than 18 mmHg)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| airway closure | first 72 hours after intubation | After setting the flow at 5 Litres/minute and positive end-expiratory pressure (PEEP) at 0 cmH2O, the respiratory rate will be transiently decreased to achieve a prolonged expiration of 5-10 seconds to eliminate auto-PEEP. During two breaths, the change in the slope of the pressure-time curve will be observed. Airway Closure be detected as a change in the slope of the pressure-time curve. Airway Opening Pressure value, in cmH2O, will be identified on the pressure-volume curve using the cursor while the mechanical ventilator screen is frozen. Upon completion of this procedure, the ventilator settings will be returned to the patient's initial parameters. |
Countries
Argentina
Contacts
CONTACTRomina B Mattei
CONTACTMaria E Dotta
PRINCIPAL_INVESTIGATORRomina B Mattei
CMPFA Churruca-Visca
Outcome results
None listed