Asthma/COPD and obstructive pulmonary dissease Asthma/COPD and obstructive pulmonary dissease
Conditions
Interventions
Patients are mechanically ventilated with VCV at baseline. Upon inclusion the
EIT-belt and an esophageal balloon are placed to assess the EILV and
transpulmonary pressures respectively. Besides, pat
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
16 Years to 99 Years
Inclusion criteria
Inclusion criteria: - 18 years or older; - Provided written informed consent; - Undergoing controlled mechanical ventilation via an endotracheal tube; - Reason for intubation being exacerbation of asthma or COPD; - Intubated
Exclusion criteria
Exclusion criteria: - Severe sputum stasis or production requiring frequent bronchial suctioning (more than 5 times per nurse shift) - Untreated pneumothorax (i.e. no pleural drainage) - Hemodynamic instability defined as a mean arterial pressure below 60mmHg not responding to fluids and/or vasopressors or a noradrenalin dose >0.5mcrg/kg/min - High (>15 mmHg) or instable (an increase in sedation or osmotherapy is required) intracranial pressure - An inner tube diameter of 6mm or less - Anticipating withdrawal of life support and/or shift to palliation as the goal of care - Inability to perform adequate electrical impedance tomography (EIT) measurements with, e.g.: o Have a thorax circumference inappropriate for EIT-belt o Thoracic wounds, bandages or deformities preventing adequate fit of EIT-belt o Recent (
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary endpoint is the difference in minute volume after 90 minutes on FCV compared to after 90 minutes of VCV. | — |
Secondary
| Measure | Time frame |
|---|---|
| These following secondary study parameters will be measured at baseline (VCV) and thereafter every 30 minutes on FCV and VCV for a total of 180 minutes: - Dynamic hyperinflation (EILV; End-Inspiratory Lung Volume) - Vei (volume end-inspiration; estimated by formula: Vei = ((tidal volume x Pplateau)/(Plateau - PEEPtotal)) - Mechanical Power (Joules per minute) - Dissipated energy (Joules per tidal volume) - Airway pressures (peak airway pressure, plateau pressure, mean airway pressure, PEEP, intrinsic PEEP, driving pressure) - Transpulmonary pressures (end-expiratory transpulmonary pressure, end-inspiratory transpulmonary pressure, transpulmonary driving pressure) - Regional Ventilatory Delay Index (RVDI) - Global Inhomogenity Index (GI) - Gas exchange (ventilatory ratio, arterial blood gas measurements) - Hemodynamic parameters (e.g. mean arterial pressure, heart rate) | — |
Countries
Netherlands
Contacts
Public ContactJ. Oosten
Erasmus MC, Universitair Medisch Centrum Rotterdam
Outcome results
None listed