Mechanical Ventilation Complication Clinical Trial
Official title:
Lung Mechanics Assessment During Extubation Trial in Critical Ill Patients
Weaning from mechanical ventilation is milestone in intensive care unit. The prolongation of mechanical ventilatory support is associated with contractility disorders of the diaphragm muscle as well as an increase in the incidence of nosocomial pneumonia. On the other hand, an early interruption of mechanical ventilatory support could be associate with the onset of acute respiratory failure, pulmonary edema, hemodynamic instability and the increased risk of re-intubation. Therefore, careful analysis of surrogate clinical parameters is essential in understanding "when" the critically ill patient is really ready for a complete weaning from mechanical ventilatory support. To date, the physician is invited to examine various clinical parameters predicting the success of extubation, such as hemodynamic stability, metabolic structure and the patient's state of consciousness. In addition, various surrogate ventilatory parameters help the clinician to understand the patient's degree of autonomy in the spontaneous breathing process, such as alveolar exchange, as well as the degree of ventilatory performance through the analysis of ventilatory parameters that can be evaluated during assisted mechanical ventilation. To date, the use of proportional assisted ventilation methods such as Proportional Assisted Ventilation + (PAV +) allow us to continuously evaluate the mechanical characteristics of the respiratory system as well as the respiratory work that the patient sustains breath by breath. The objective of this study is to evaluate whether the ventilatory parameters derived from the PAV ventilatory algorithm are also predictors of extubation success.
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