Mechanical Ventilation Complication Clinical Trial
Official title:
Frequency of Respiratory Acidosis and Alkalosis in Intensive Care Department of the IUCPQ-UL After Cardiac Surgery. Potential Impact of the Use of the Application VentilO
Verified date | June 2024 |
Source | Laval University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
Mechanical ventilation is a vital support associated with the treatment of patients with acute respiratory failure and in other indications such as surgery under general anesthesia, coma or shock. Optimization of settings during mechanical ventilation and implementation of protective ventilation help to avoid ventilation-induced injury, ensure adequate oxygenation and maintain adequate carbon dioxide concentration to avoid respiratory acidosis or alkalosis. Similarly, there is also no clear recommendation, to our knowledge, for the initial setting of the respiratory rate. Therefore, initial settings are not always adequate and in the literature the frequency of respiratory acidosis is very high, reaching about half of the patients receiving mechanical ventilation. VentilO, is an application that is available on smart phones. This educational application provides clinicians with initial settings and optimization of these settings based on gender, height, weight, body temperature and patient type. The algorithm used is based on published data regarding ventilatory requirements in different populations and the anatomical and instrumental dead space of patients. The purpose of our study is to: Assess whether ventilatory settings after intensive care unit admission after cardiac surgery are appropriate to compare the ventilatory adjustments made by clinicians with those proposed by the VentilO application.
Status | Active, not recruiting |
Enrollment | 100 |
Est. completion date | December 2024 |
Est. primary completion date | October 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Adults (> or = 18 years old) - Intubated patients admitted to the ICU immediately postoperative from cardiac surgery - Obtained a postoperative arterial gas within 1 hour of arrival in the ICU Exclusion Criteria: - Lack of patient anthropometric data (height and weight) available in the patient record |
Country | Name | City | State |
---|---|---|---|
Canada | Institut Universitaire de Cardiologie et de Pneumologie de Québec | Quebec |
Lead Sponsor | Collaborator |
---|---|
Laval University |
Canada,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | acid-base abnormalities on arterial blood gases | Evaluate the frequency of acid-base abnormalities, either acidosis or alkalosis, of respiratory or mixed origin on the first arterial gases after intubation. Respiratory acidosis is defined as a pH < 7.35 with a PaCO2 > 45 mmHg, and respiratory alkalosis as a pH > 7.45 with a PaCO2 < 35 mmHg) |
On the first result available of arterial blood gases after intensive care unit admission; 1 hour maximum after intensive care admission | |
Secondary | Occurence of optimal arterial blood gases result | An optimal arterial blood gases as defined by a pH between 7.35 and 7.45 with a PaCO2 between 36 and 45 mmHg | On the first result available of arterial blood gases after intensive care unit admission; 1 hour maximum after intensive care admission | |
Secondary | Severity of unbalance of arterial blood gases result | For acid-base abnormalities, they will be evaluated according to their level of severity: the frequency of moderate (pH between 7.30 and 7.34) and severe (pH < 7.30) acidoses, and the frequency of moderate (pH between 7.46 and 7.50) and severe (pH > 7.50) alkaloses. The frequency of moderate (PaCO2 between 46 and 50 mmHg) and severe (PaCO2 > 50 mmHg) hypercapnia, and the frequency of moderate (PaCO2 between 31 and 35 mmHg) and severe (PaCO2 < 31 mmHg) hypocapnia. |
On the first result available of arterial blood gases after intensive care unit admission; 1 hour maximum after intensive care admission | |
Secondary | hemodynamic instabilities | Number of arterial hypotension requiring vascular filling > 1000 ml and/or use of vasopressors or inotropes such as levophed or adrenaline at > 0.05 mcg/kg/min) | Between Hour0 to Hour1 after intensive care unit admission | |
Secondary | ICU length of stay | ICU length of stay - ICU admission through ICU discharge | up to 90 days. ICU stay - ICU admission through ICU discharge or until death if occured | |
Secondary | Mechanical Ventilation duration | Time spent with invasive mechanical ventilation during ICU length of stay | up to 90 days. ICU stay - ICU admission through ICU discharge or until death if occured | |
Secondary | Acute renal failure | rate of acute renal failure during ICU length of stay. Renal failure will be defined according to the usual criteria, i.e., an increase of >27 mmol/L creatinine in 48 hours or 1.5x over the preoperative baseline | up to 90 days. ICU stay - ICU admission through ICU discharge or until death if occured | |
Secondary | Hospital length of stay | Hospital length of stay - ICU admission through hospital discharge | up to 90 days. ICU stay - ICU admission through ICU discharge or until death if occured | |
Secondary | ICU mortality | Occurence of death during ICU stay | up to 90 days. ICU admission through until death if occured |
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