The energy produced during mechanical ventilation has been established as a contributor to mortality in acute respiratory distress syndrome patients, elucidated through ventilator-induced lung injury (VILI). However, the potential association between strain energy, an engineering-based concept, and the risk of VILI remains unexplored. Acute respiratory distress syndrome, Ventilator-induced lung injury, Alveolar overdistension, Mechanical power, Stress, Strain, Strain energy
Conditions
Interventions
Pateints with moderate to severe ARDS
Prevention
ARDS pateints
Sponsors
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: 1. Adults> over 18 years old admitted to the ICU with moderate or severe ARDS; 2. Patients mechanically ventilated with an esophageal balloon catheter whose primary physicians plan to perform decremental PEEP titration; 3. Patients receiving deep sedation and neuromuscular blockade; 4. Informed consent should be obtained from the patient's relatives.
Exclusion criteria
Exclusion criteria: 1. Pregnancy, 2. On pacemaker, 3. On intercostal drainage, 4. Risk for high PEEP: large lung bleb, chronic obstructive lung disease, pneumothorax, pneumomediastinum, profound shock, high dose vasopressor, right-sided heart failure, postcardiac arrest, intracranial hypertension, 5. Palliative care, 6. Electrical impedance tomography has limitations, particularly for patients with chest or spinal lesions, skin abnormalities, or morbid obesity.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Correlation between strain energy from mechanical ventilation and alveolar overdistension from electrical imepdance tomography During decremental PEEP titration Spearmen rank correlation between strain energy in joules and percentage of alveolar overdistension | — |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between strain energy and single-breath mechanical power During decremental PEEP titration Spearmen rank correlation between strain energy in joules and single-breath mechanical power in joules | — |
Countries
Thailand
Contacts
Public Contactjakkrit laikitmongkhon
Faculty of Medicine Ramathibodi Hospital, Mahidol University
Outcome results
None listed