Expiratory Flow Limitation during mechanical ventilation Respiration, Artificial Lung Diseases, Obstructive Respiratory Distress Syndrome, Adult Obesity Respiratory Insufficiency
Conditions
Interventions
- Changing the settings of the ventilators and screening for EFL status.
- For eligible patients, real-time ventilators'
parameters would be collected via the RS-232 port.
- Record baseline waveforms
- Sedative drugs and neuromuscular blocking agents given
- Attachment of the Electrical Impedance Tomography (EIT) devic
Experimental Other
Detection of EFL, lung mechanics measurements, and PEEP titration
Sponsors
Faculty of Medicine Ramathibodi Hospital
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: A patient receiving invasive mechanical ventilation via the endotracheal or tracheostomy tube with: 1. Age 18 years or more 2. Admitted to the intensive and intermediate critical care wards, Ramathibodi hospital 3. Have one or more of the following conditions: - Exacerbation of obstructive airway disease (e.g. Asthma, Bronchiectasis, COPD) - Presence of the risk-factor for EFL (e.g. ARDS, Obese patients with respiratory failure, pulmonary edema) with simple PEEP reduction test positive for EFL screening 4. Approval by the attending physician to receive sedative and muscle-relaxant agents 5. Consented to participate by the next-of-kin 6. Permission to perform the study is granted by the attending physician 7. Able to perform the study within 48 hours after initiation of invasive mechanical ventilation
Exclusion criteria
Exclusion criteria: 1. Uncorrectable severe hypoxemia defined by PF ratio < 100 2. Unstable hemodynamic conditions: - Mean arterial blood pressure < 60 mmHg - Systolic blood pressure > 180 mmHg - Heart rate < 40or > 160 beat per minute 3. A patient already enrolled in this study 4. The patient or the relatives deny to participate in the study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Descriptive data of response to PEEP titration 30 seconds after each level of PEEP adjustment Value of total PEEP (in cmH2O) in each set PEEP level | — |
Secondary
| Measure | Time frame |
|---|---|
| Imaging from EIT device during PEEP titration 30 seconds after each level of PEEP adjustment Pattern or change of pixel impedance over time, acquired from the Electrical Impedance Tomography device | — |
Countries
Thailand
Contacts
Public ContactDetajin Junhasavasdikul
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand
Outcome results
None listed