Respiratory failure, acute respiratory failure breathing problems
Conditions
Interventions
We will change the modality of ventilation from volume-controlled to pressure-controlled or vice versa, making sure that the level of inspiratory support (above PEEP) will be titrated to target the sa
Sponsors
Radboud Universitair Medisch Centrum
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Age above 18 yearsUse of the VentFree device for clinical reasonsA PaO2/FiO2 between 100-300 mmHgMechanically ventilated in controlled modeDeep sedation, defined by a Richmond Agitation-Sedation Scale (RASS) score of -5 or -4
Exclusion criteria
Exclusion criteria: Pre-existing neuromuscular diseaseMuscle paralysisPneumothoraxContra-indication to EIT monitoring (e.g. burns, pacemaker, thoracic wounds limiting electrode placement);Contra-indications for oesophageal balloon catheter placement (e.g. history of gastric bypass surgery, gastro-oesophageal junction surgery, oesophageal stricture, recent upper gastrointestinal hemorrhage or known/suspected varices);
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The change in end-inspiratory transpulmonary pressure with or without expiratory muscle stimulation during volume-controlled ventilation and pressure-controlled ventilation. | — |
Secondary
| Measure | Time frame |
|---|---|
| - To investigate the impact of abdominal FES on end-expiratory, driving and elastancederived end-inspiratory transpulmonary pressure. - To investigate the impact of abdominal FES on mechanical power. - To investigate the impact of abdominal FES on the distribution of ventilation, lung collapse, overdistention and tidal recruitment, as measured by EIT. - To investigate the impact of abdominal FES on expiratory flow and flow limitation. - To investigate the effects of expiratory diaphragm activity. - To investigate whether expiratory diaphragm contractions modulate lung mechanics, including end-expiratory lung volume and expiratory flow. - To investigate changes in inspiratory effort in response to active expiration. - To investigate the extent to which abdominal FES influences the occurrence and magnitude of the Pendelluft phenomenon. - To investigate whether abdominal FES supports lung-protective ventilation strategies, for example reducing driving pressure or improving respiratory system compliance. - To investigate the effects of abdominal FES on gas exchange parameters. | — |
Countries
Netherlands
Contacts
Public ContactEM Leijer
Radboud Universitair Medisch Centrum
Outcome results
None listed