Acute respiratory distress syndrome severe lung syndrome
Conditions
Interventions
Low dose rocuronium will be administered to decrease respiratory drive until
the patient ventilates with a tidal volume ~6 ml/kg. This will be done in steps
of 5 mg boluses. Ventilator modes will be
Sponsors
Universitair Medisch Centrum Sint Radboud
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: • age > 18 year • informed consent • ARDS according to the Berlin definition • RASS -4/-5 • tidal volume > 8 ml/kg during supported ventilation • esophageal EMG catheter with balloons in situ
Exclusion criteria
Exclusion criteria: • recent use of muscle relaxants / neuromuscular blocking agents (
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The main study parameter is the ability to titrate rocuronium in order to decrease the tidal volume (Vt) to approximately 6 ml/kg (yes/no). | — |
Secondary
| Measure | Time frame |
|---|---|
| • Respiratory rate • Diaphragm activity (Edi) • Transpulmonary pressure • Transdiaphragmatic pressure • Work of breathing • Dynamic and static respiratory compliance • Neuroventilatory efficiency (tidal volume/Edi) • Neuromechanical efficiency (transdiaphragmatic pressure/Edi) • Patient-ventilator contribution to breathing: PVBC = (tidal volume/Edi, no-assist) / (tidal volume/Edi, assist) • Oxygenation index (arterial oxygen tension / fraction of inspired oxygen) • Patient-ventilator asynchrony | — |
Countries
Netherlands
Outcome results
None listed