Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Ventilation Distribution

Mechanical Ventilation Clinical Trial

Official title:

Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Aeration and Homogeneity During Pressure Assist Ventilation: A Preliminarily Physiological Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03241654
• Other study ID #: KY-2017-001
• Status: Completed
• Phase: N/A
• First received: August 3, 2017
• Last updated: February 9, 2018
• Start date: May 1, 2017
• Est. completion date: February 1, 2018

Study information

• Verified date: August 2017
• Source: Capital Medical University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region.Decrease of flow trigger sensitivity might improve homogeneous of tidal volume distribution.

Description:

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region. High positive end expiratory pressure (PEEP) has been applied to improve the homogeneous distribution of ventilation by increasing the end expiratory lung ventilation (EELV) and alveolar recruitment. However, for patients who increasing PEEP in some extent still existed poor aeration in the dependent region, further elevating PEEP seems to be unreasonable that perhaps lead to overdistension. Decreasing trigger sensitivity might further evoke inspiratory efforts to improve the ventilation for this type of patients.The Electrical impedance tomography (EIT) was applied in monitoring the regional ventilation distribution at the bedside.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 20
• Est. completion date: February 1, 2018
• Est. primary completion date: August 20, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 80 Years

Eligibility

Inclusion Criteria:

1. The post operative patients who received pressure support ventilation;

2. After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity.

Exclusion Criteria:

1. Under 18 years;

2. History of diaphragm dysfunction and surgery;

3. Central respiratory drive dysfunction;

4. history of esophageal, gastric or lung surgery;

5. The contraindication of using EIT (pacemaker, defibrillator, and implantable pumps).

Related Conditions & MeSH terms

• Mechanical Ventilation

Intervention

Procedure:
• flow trigger
The flow trigger will be adjust during the pressure assist ventilation.

Locations

Country	Name	City	State
China	Jian-Xin Zhou	Beijing	Beijing

Sponsors (1)

Lead Sponsor	Collaborator
Capital Medical University

Country where clinical trial is conducted

China, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	The homogeneity of distribution of tidal volume	EIT was used to monitoring the homogeneity of distribution of tidal volume that was divided into two contiguous regions of interest (ROI) equally, the dependent and non-dependent area. The ratio of relative distribution of tidal ventilation of two ROI was calculated.	within 20 minutes after changing flow trigger
Secondary	Changes in global and regional EELV	The change of EELV was measured after changing flow trigger based on the baseline level.	within 20 minutes after changing flow trigger