respiratory muscle weakness ventilator-induced diaphragm dysfunction
Conditions
Interventions
In both control and intervention group diaphragm activity will be monitored
continuously using esophageal and gastric pressure catheters. In the
intervention group, ventilator settings will be adjus
Sponsors
Vrije Universiteit Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: -Informed consent -Age >18 years -Supportive ventilation mode -Expected duration of mechanical ventilation at least 24 hours at moment of inclusion
Exclusion criteria
Exclusion criteria: -Current neuromuscular disease -Contraindication for nasogastric intubation, including recent upper airway surgery and severe bleeding disorders -Expected difficulties in acquiring reliable pressure measurements
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary endpoint of the study is the time that diaphragm activity was within physiological range during the study period. Diaphragm activity will be continuously measured as the trandiaphragmatic pressure (Pdi), using the formula below: (1) Transdiaphragmatic pressure (Pdi) = Gastic pressure (Pga) - Esophageal pressure (Pes) Pdi will be analysed on a breath-by-breath basis after conclusion of the study period. Every breath within the range of 3-12 cmH2O will be considered as physiological. The percentage of physiological breaths will be calculated as: (2) Percentage of diaphragm-protective breaths = ( number of physiological breaths) / (total number of breaths) *100%. | — |
Secondary
| Measure | Time frame |
|---|---|
| Secundary outcome parameters include: -Percentage of time that the pressure-time product of the diaphragm (PTPdi) was within physiological range during the study period -Effect of the intervention on various clinical parameters including results of blood gas analysis, inflammatory parameters and patient comfort - Various feasibility parameters, such as the percentage of patients admitted during the study period which were eligeble for inclusion, the number of patients that were prematurely withdrawn from the study, reason of early withdrawal and number of adjustments made to the ventilator settings during the study period. | — |
Countries
Netherlands
Outcome results
None listed