Providing Optimal PEEP During Mechanical Ventilation for Obese Patients Using Esophageal Balloon — PROP OPEN  

Respiratory Failure Clinical Trial

Official title: Effect of Esophageal Pressure Measurement to Determine Optimal Positive End-expiratory Pressure Compared to Usual Care in Obese Patients Receiving Mechanical Ventilation

Status Enrolling by invitation

Clinical Trial Summary

This is a research study to determine if identifying an optimal level of positive end-expiratory pressure (PEEP) targeted specifically to individualized patient characteristics will shorten the time on the ventilator. Participants will have catheter placed through the nose into the esophagus to measure the pressure inside the chest. This catheter will remain until the patient is freed from the ventilator. Participants will be randomized to usual care or to have the level of PEEP determined by the esophageal balloon pressure readings. The total time spent on the ventilator will be recorded.

Clinical Trial Description

Study Design: Randomized-controlled clinical trial. Patients will be enrolled within 4 days of mechanical ventilation and randomized 1:1 to titration of PEEP based on esophageal balloon pressures or based on the "High PEEP" ARDSnet PEEP/FiO2 (fraction of inspired oxygen) table. All patients will have esophageal balloons placed with baseline measurement of Ptp. Patients randomized to the intervention arm will then undergo titration of PEEP based on Ptp measurements to achieve "Optimal PEEP," defined as end expiratory Ptp of 0 to +2 cm H2O. ;

Related Conditions & MeSH terms

• Lung Injury
• Obesity, Morbid
• Respiratory Failure
• Respiratory Insufficiency
• Ventilator-Induced Lung Injury

• NCT number: NCT03951064
• Study type: Interventional
• Source: University of North Carolina, Chapel Hill
• Status: Enrolling by invitation
• Phase: N/A
• Start date: March 31, 2021
• Completion date: November 2024