Mechanical Ventilation Pressure High, Respiratory Depression Neonatal, Ventilator-Associated Pneumonia (VAP)
Conditions
Keywords
Airway resistance
Brief summary
Research has shown that timely suctioning not only improves survival rates but also enhances the quality of life in ventilator-dependent patients. However, clinical judgment on the optimal timing for suctioning currently relies primarily on physician experience, lacking scientific evidence \[10\]. Airway viscous resistance reflects the frictional resistance encountered by gas flow within the airways and is closely associated with airway patency. When airway secretions increase, viscous resistance undergoes dynamic changes. Therefore, analyzing these dynamic variations in viscous resistance derived from ventilator waveforms to determine the optimal suctioning timing and assess its clinical impact on the progression of pulmonary inflammation holds significant scientific value and offers new insights and methodologies for clinical practice.
Detailed description
To validate the clinical feasibility and reliability of airway viscous resistance monitoring, explore the temporal correlation between inflammatory biomarkers and changes in airway viscous resistance, establish a reference threshold system for special populations, and provide experimental evidence for determining the optimal suctioning timing.
Interventions
PROCEDUREThe dynamics of airway resistance
Monitoring the dynamic changes in airway resistance in patients can be used to reflect the progression of pulmonary inflammation and determine the optimal timing for suctioning.
DIAGNOSTIC_TESTconventional suctioning
The timing for suctioning is determined based on clinical signs such as rhonchi and an elevated peak pressure.
Sponsors
Affiliated Hospital of Nantong University
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
SUPPORTIVE_CARE
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of Acute Respiratory Distress Syndrome (ARDS) * Clinical diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) * Clinical diagnosis of Severe pneumonia
Exclusion criteria
* Clinical diagnosis of multiple organ failure; * Clinical diagnosis of multiple organ bleeding;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The drop in airway viscous resistance before and after sputum suction | the process of sputum aspiration(at most 30 minutes) | Airway viscous resistance drop (AVRD) is the primary efficacy endpoint of this study. It is defined as the difference in airway viscous resistance measured immediately before and after suctioning. Procedure: Record the ventilator-displayed viscous resistance value pre-suction; immediately after the maneuver, re-measure both viscous resistance and peak airway pressure with a high-precision pressure-time sensor. Calculation: The within-patient difference (pre minus post) is the AVRD. In a pilot study of nine patients, AVRD averaged 6.889 ± 3.551 cmH₂O, significantly larger than the concurrent peak-pressure drop (1.556 ± 1.740 cmH₂O), indicating that AVRD is more sensitive to the effect of suction on airway secretions. Clinical implication: AVRD can serve as a quantitative criterion for determining the optimal timing of endotracheal suction. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| The number of participants with abnormal laboratory tests | Laboratory testing time ( at least 30 minutes) | Venous blood testing was performed, including a complete blood count (white blood cell count \[WBC\], neutrophil percentage \[NEUT%\]), C-reactive protein (CRP), and procalcitonin (PCT) to assess the systemic inflammatory status. |
| Sputum bacterial culture | 3 days | Sputum culture is performed to identify the source of infection and to diagnose VAP. |
Countries
China
Contacts
CONTACTHong-lei Wu Nursing Department, MS
CONTACTxuan Qian Nursing Department, MS
Outcome results
None listed