Management of the Expiratory End-expiratory Pressure (PEEP) and Body Position Clinical Trial
Official title:
Effect of PEEP and Trendelenburg on Ultrasound Size of Internal Jugular and Subclavian Veins: A Cross-over Randomized Controlled Study
There is no recommendation for the management of the positive end-expiratory pressure (PEEP)
during setting of a central venous catheter (CVC) in a ventilated patient. Several
non-randomized studies have investigated the cross-sectional area (AST) ultrasound minor
axis for different pressure levels by evaluating a single vessel every time or by not
displaying the right or left side in the evaluation. Another study showed that there could
be unpredictable size differences between the 2 subclavian veins.
In ventilated patient, the PEEP, which is intrathoracic, will result in a decrease of venous
return and thus possibly a superior vena cava dilation, located outside the pleura,
depending on their capacitance. Different pressure levels showed an increase of AST with the
increase of intra-thoracic pressure on certain veins, in a heterogeneous and not randomized
manner.
The primary purpose of the study is to measure the effect of PEEP (0, 5, 10 or 15 cm H2O)
and the patient's position (supine or Trendelenburg strict -15-20 °) on the cross-sectional
area of the jugular and subclavian veins.
There is no recommendation for the management of the positive end-expiratory pressure (PEEP)
during setting of a central venous catheter (CVC) in a ventilated patient. Several
non-randomized studies have investigated the cross-sectional area (AST) ultrasound minor
axis for different pressure levels by evaluating a single vessel every time or by not
displaying the right or left side in the evaluation. Another study showed that there could
be unpredictable size differences between the 2 subclavian veins.
In ventilated patient, the PEEP, which is intrathoracic, will result in a decrease of venous
return and thus possibly a superior vena cava dilation, located outside the pleura,
depending on their capacitance. Different pressure levels showed an increase of AST with the
increase of intra-thoracic pressure on certain veins, in a heterogeneous and not randomized
manner.
The primary purpose of the study is to measure the effect of PEEP (0, 5, 10 or 15 cm H2O)
and the patient's position (supine or Trendelenburg strict -15-20 °) on the cross-sectional
area of the jugular and subclavian veins.
;
Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention