respiratoir falen op de intensive care mechanical ventilation
Conditions
Interventions
Patients will be randomized to two PEEP setting strategies. In the intervention
group PEEP will be set by a target EELV with an upper pressure limit (UPL) to
avoid overdistention. The PEEP in the co
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: - >18 years of age - Written informed consent from legal representatives - Mechanical ventilation 300 mmHg) - Requiring mechanical ventilation with acute respiratory failure (PaO2/FiO2 ratio > 300 mmHg)
Exclusion criteria
Exclusion criteria: - Inability to perform reliable lung volume measurements * Air leak * Severe airflow obstruction due to COPD (forced Expired Volume in 1 sec or Vital Capacity below predicted value minus 2 SD * Patients with known emphysema and the presence of bullae on X-ray * Patients with pneumothorax on x-ray - Inability to use the standard reference EELV values * Thoracic deformities - Severe hemodynamic instability
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary: Feasibility of an EELV guided PEEP ventilation protocol and calculations of standard deviations to allow sample size calculations for an outcome study based on this protocol. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secondary: Difference in arterial oxygenation (PaO2/FiO2 ratio), required inspired oxygen fraction and respiratory compliance between groups at 48 hours. Ability of the FiO2-upper pressure limit (UPL) table to prevent overdistension evaluated by electrical impedance tomography (EIT). Also time on ventilator, length of stay on ICU and number of organ failure will be recorded. | — |
Countries
Netherlands
Outcome results
None listed