Clinical Trials Logo

Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06024993
Other study ID # 003029
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date June 1, 2024
Est. completion date December 31, 2024

Study information

Verified date April 2024
Source University Hospital, Antwerp
Contact Carine Smitz
Phone +32 3 821 49 30
Email carine.smitz@uza.be
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Conventional continuous mandatory mechanical ventilation relies on the passive recoil of the chest wall for expiration. This results in an exponentially decreasing expiratory flow. Flow controlled ventilation (FCV), a new ventilation mode with constant, continuous, controlled expiratory flow, has recently become clinically available and is increasingly being adopted for complex mechanical ventilation during surgery. In both clinical and pre-clinical settings, an improvement in ventilation (CO2 clearance) has been observed during FCV compared to conventional ventilation. Recently, Schranc et al. compared flow-controlled ventilation with pressure-regulated volume control in both double lung ventilation and one-lung ventilation in pigs. They report differences in dead space ventilation that may explain the improved CO2 clearance, although their study was not designed to compare dead space ventilation within the group of double lung ventilation. Dead space ventilation, or "wasted ventilation", is the ventilation of hypoperfused lung zones, and is clinically relevant, as it is a strong predictor of mortality in patients with the acute respiratory distress syndrome (ARDS) and is correlated with higher airway driving pressures which are thought to be injurious to the lung (lung stress). This trial aims to study the difference in dead space ventilation between conventional mechanical ventilation in volume-controlled mode and flow controlled-ventilation.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 13
Est. completion date December 31, 2024
Est. primary completion date November 1, 2024
Accepts healthy volunteers No
Gender All
Age group 18 Years to 70 Years
Eligibility Inclusion Criteria: - Adults [18-70] yrs - General anaesthesia for elective surgery - Arterial line, central venous line and endotracheal tube as part of standard of care - Expected duration of controlled mechanical ventilation = 60 minutes - Supine position (0±10°) Exclusion Criteria: - One lung ventilation - Known pregnancy - Increased abdominal pressure (laparoscopy or BMI > 30kg/m2) - COPD GOLD IV or home oxygen dependence - Clinical signs of raised intracranial pressure

Study Design


Related Conditions & MeSH terms


Intervention

Device:
Flow-controlled ventilation (FCV)
30 minutes of FCV, delivered with the CE-marked Evone ventilator (Ventinova medical, the Netherlands)
Conventional volume-controlled ventilation (VCV)
30 minutes of conventional VCV, delivered with the CE-marked Aisys CS3 (GE Healthcare, USA) or Flow-i (Getinge, Sweden) ventilators.

Locations

Country Name City State
Belgium Antwerp University Hospital (UZA) Edegem Antwerp

Sponsors (2)

Lead Sponsor Collaborator
University Hospital, Antwerp Universiteit Antwerpen

Country where clinical trial is conducted

Belgium, 

Outcome

Type Measure Description Time frame Safety issue
Primary Change in Bohr dead space ventilation (VDBr/VT) Quantified by the Bohr approach with volumetric capnography During FCV and VCV measurements (30 minutes)
Secondary Change in Enghoff dead space ventilation (VDEng/VT) Quantified by the Enghoff approach with volumetric capnography During FCV and VCV measurements (30 minutes)
Secondary Change in physiological dead space volume (Vdfys) Measured with volumetric capnography and Enghoff's approach During FCV and VCV measurements (30 minutes)
Secondary Change in airway dead space volume (Vdaw) Measured with volumetric capnography and Fletcher's approach During FCV and VCV measurements (30 minutes)
Secondary Change in alveolar dead space volume (Vdalv) As measured with volumetric capnography and Fletcher's approach During FCV and VCV measurements (30 minutes)
Secondary Ventilatory efficiency (VE/VCO2) Ratio of minute ventilation to carbon dioxide output During FCV and VCV measurements (30 minutes)
Secondary Change in airway driving pressure (?Paw) Calculated as the difference between the plateau pressure (Pplat) during an inspiratory pause and the dynamic positive end-expiratory pressure (PEEP), as no expiratory hold is possible on the Evone. During FCV and VCV measurements (30 minutes)
Secondary Change in transpulmonary shunt fraction (Qs/Qt) calculated with the modified Berggren equation During FCV and VCV measurements (30 minutes)
Secondary Change in global lung hyperdistention (hyperdistentionEIT) Calculated from electric impedance tomography During FCV and VCV measurements (30 minutes)
Secondary Change in anterio-posterior distribution of ventilation on EIT (AP) % anterior / % posterior During FCV and VCV measurements (30 minutes)
Secondary Change in right-left distribution of ventilation on EIT (RL) % right / % left During FCV and VCV measurements (30 minutes)
Secondary Change in 4-layered distribution of ventilation on EIT During FCV and VCV measurements (30 minutes)
Secondary Change in centre of ventilation on EIT During FCV and VCV measurements (30 minutes)
Secondary Change in cardiac index (CI) Calculated from the arterial waveform (pulse contour analysis) by the HemoSphere monitor During FCV and VCV measurements (30 minutes)
Secondary Change in mean arterial pressure (MAP) Measured on a radial artery line During FCV and VCV measurements (30 minutes)
Secondary Change in partial pressure of arterial CO2 (PaCO2) Measured on an arterial blood gas During FCV and VCV measurements (30 minutes)
Secondary Change in peak expiratory flow (PEF) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in peak inspiratory flow (PIF) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in mean airway pressure (MPaw) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in tidal volume (TV) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in respiratory rate (RR) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in minute ventilation (MV) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in inspiratory time (Ti) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in expiratory time (Te) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in ratio of inspiratory time to total breath time (Ti / Tt) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in positive end-expiratory pressure (PEEP) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in peak inspiratory pressure (PIP) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in plateau pressure (Pplat) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in static airway compliance (Caw) Calculated as tidal volume / airway driving pressure During FCV and VCV measurements (30 minutes)
Secondary Change in end-tidal CO2 (ETCO2) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in global airway resistance (Raw) As measured by the citrex respiratory monitor During FCV and VCV measurements (30 minutes)
Secondary Change in global airway time constant (TAUaw) Calculated as global airway resistance x global airway compliance During FCV and VCV measurements (30 minutes)
Secondary Change in total energy As calculated from monitoring data During FCV and VCV measurements (30 minutes)
Secondary Change in dissipated energy As calculated from monitoring data During FCV and VCV measurements (30 minutes)
Secondary Change in P/F ratio Calculated as partial pressure of arterial oxygen divided by inspiratory fraction of oxygen During FCV and VCV measurements (30 minutes)
See also
  Status Clinical Trial Phase
Completed NCT05921656 - Construction and Evaluation of Airway Leakage Risk Model of Patients With Endotracheal Tube
Recruiting NCT03941002 - Continuous Evaluation of Diaphragm Function N/A
Withdrawn NCT04288076 - The Brain and Lung Interaction (BALI) Study N/A
Completed NCT03031860 - Semi-quantitative Cough Strength Score (SCSS) N/A
Completed NCT02545621 - A Role for RAGE/TXNIP/Inflammasome Axis in Alveolar Macrophage Activation During ARDS (RIAMA): a Proof-of-concept Clinical Study
Completed NCT02312869 - Local Assessment of Management of Burn Patients N/A
Completed NCT01885442 - TryCYCLE: A Pilot Study of Early In-bed Leg Cycle Ergometry in Mechanically Ventilated Patients N/A
Completed NCT01204281 - Proportional Assist Ventilation (PAV) in Early Stage of Critically Ill Patients Phase 4
Terminated NCT01059929 - Dexmedetomidine Versus Propofol in the Medical Intensive Care Unit (MICU) Phase 4
Completed NCT00824239 - Intermittent Sedation Versus Daily Interruption of Sedation in Mechanically Ventilated Patients Phase 3
Completed NCT00529347 - Mechanical Ventilation Controlled by the Electrical Activity of the Patient's Diaphragm - Effects of Changes in Ventilator Parameters on Breathing Pattern Phase 1
Unknown status NCT00260676 - Protective Ventilatory Strategy in Potential Organ Donors Phase 3
Terminated NCT00205517 - Sedation and Psychopharmacology in Critical Care N/A
Completed NCT03281785 - Ultrasound of Diaphragmatic Musculature in Mechanically Ventilated Patients. N/A
Recruiting NCT04110613 - RCT: Early Feeding After PEG Placement N/A
Completed NCT04410783 - The Emergency Department Sedation Pilot Trial N/A
Recruiting NCT04821453 - NAVA vs. CMV Crossover in Severe BPD N/A
Completed NCT03930147 - Ventilation With ASV Mode in Children N/A
Recruiting NCT05029167 - REstrictive Versus LIberal Oxygen Strategy and Its Effect on Pulmonary Hypertension After Out-of-hospital Cardiac Arrest (RELIEPH-study) N/A
Recruiting NCT04849039 - Lung Microbiota and VAP Development (PULMIVAP)