Ventilator-Induced Lung Injury Clinical Trial
Official title:
The Effect of Bispectral Index Controlled Sedation on QT Distance and P Dispersion in ECG in Patients Having Bronchoscopy in the Intensive Care Unit
Fiberoptic bronchoscopy (FOB) is one of the most useful procedures for diagnosing and treating respiratory illnesses to figure out symptoms like hemoptysis, wheezing, or cough. Furthermore, FOB is a frequent method, in intensive care units, for both diagnoses of ventilator-associated pneumonia (VAP) and treatment of atelectasis with bedside sedation.) Propofol is often used in anesthesia for endoscopic treatments. Using propofol for deep anesthesia may be indicated to prevent the patient from feeling discomfort before FOB and to reduce the chance of complications. Although major complications of FOB such as hypoxia and pneumothorax are known, there are limited studies showing its effects on cardiac hemodynamics. The cardiac effects of laryngoscope and intubation were investigated by using different anesthetic agents. In this study, we evaluated the effect of bronchoscopy with BIS-controlled sedation on ECG in ICU patients by monitoring the QT interval and P interval.
For this study, it was planned to recruit 40 patients who would have FOB in the ICU of Abant İzzet Baysal University Anesthesia department. All intubated patients over 18 years of age who do not meet the exclusion criteria will be included. Before the procedure, all patients were given i.v. 0:02 - 0:04 mg / kg midazolam (zolamide 15 mg / 3 mL, and medications, Turkey) will be administered. Volume-controlled ventilation modes will be preferred during FOB. The pre-trade-inspired FiO2 will be increased to 100%. During the procedure, mean blood pressure, heart rate, oxygen saturation, respiratory rate, CVP, airway pressure, and BIS will be closely monitored. Enteral feeding will be discontinued at least 6 hours before the procedure. At the end of the procedure, the endotracheal tube position will be checked. FOB will be performed using mobile bronchoscopy (Storz FB; 5.0 mm outer diameter). All patients will be monitored with BIS (Bispectral Index A-2000, Aspect Medical Systems, Netherlands) to measure the depth of sedation. Patients will be randomly divided into two groups by an anesthesiologist blinded to the study. Propofol will not be given to Group I after midazolam, while propofol 0.5 mg/kg bolus dose will be administered to Group II. Maintenance will be provided with 60 mcg/kg/min propofol infusion, and the propofol infusion dose will be increased by 10 mcg/kg/min by titration until the BIS value is 40-60 during the procedure. Patients under the age of 18, pregnancy, using sedative drugs in the last 24 hours, hypersensitivity to the drugs used in the study, severe cardiac disorder (EF: < 40), those who increase the QT interval (quinidine, lithium, procainamide, amiodarone, sotalol, phenothiazine, tricyclic Those who use antidepressants, disopyramide) or reducing (digitals) drugs, affecting QT such as hypomagnesemia- hypocalcemia - hypo or hyperthermia - hypo or hypercalcemia - hyperkalemia - hyper or hypothyroidism - myocarditis - mitral heart prolapse, etc. will be excluded from the study. Patients will be randomly divided into 2 equal groups using the closed envelope method. Oral and written consent will be obtained from the first-degree relatives of all patients. All patients will be monitored with BIS to measure the depth of sedation. Age, weight - height, gender, medications used, comorbidities, hospitalization diagnosis, and duration of the procedure will be recorded for both groups. In addition, systolic blood pressure, diastolic blood pressure, mean blood pressure, heart rate, SpO2, BIS, respiratory rate, CVP, and airway pressure will be noted before and after the procedure of the first, fifth, tenth, and fifteenth minute. P wave dispersion, OTc, and OTd values will be calculated according to the max and min wavelengths as the primary outcomes. ;
Status | Clinical Trial | Phase | |
---|---|---|---|
Not yet recruiting |
NCT06296173 -
Open Lung Protective Extubation Following General Anesthesia
|
N/A | |
Not yet recruiting |
NCT03245684 -
Assisted or Controlled Ventilation in Ards (Ascovent)
|
N/A | |
Completed |
NCT03401463 -
Assesment of the Endotracheal Tube Cuff Pressure Values in ICU Pateints Before and After Training Seminar
|
N/A | |
Completed |
NCT02386683 -
Intraoperative Lung-Protective Ventilation in Neurosurgery
|
N/A | |
Completed |
NCT03651817 -
Lung Protection Strategy in Open Heart Surgery: Which Tidal Volume is Better 8ml/kg or 6ml/kg
|
N/A | |
Recruiting |
NCT03709199 -
Long Term Follow up of Children Enrolled in the REDvent Study
|
||
Recruiting |
NCT03367221 -
Physiological Response in Lung Transplant Recipients Undergoing Neurally Adjusted Ventilatory Assist
|
N/A | |
Completed |
NCT03056885 -
Inflammatory Local Response During OLV: Protective vs Conventional Ventilation Strategy
|
N/A | |
Recruiting |
NCT03746236 -
Transpulmonary Pressure Under Stressing Conditions
|
||
Not yet recruiting |
NCT06334523 -
Ventilation of the Extremely Premature Infants Optimized by Dead Space Washout
|
N/A | |
Recruiting |
NCT03719365 -
Driving Pressure Variation: NAVA vs PSV
|
N/A | |
Completed |
NCT03659552 -
Percutaneous Temporary Placement of a Transvenous Phrenic Nerve Stimulator for Diaphragm Pacing Using Jugular Access
|
N/A | |
Completed |
NCT02732041 -
Asynchrony During Mechanical Ventilation in Patients With Acute Respiratory Distress Syndrome
|
||
Terminated |
NCT03525691 -
Enhanced Lung Protective Ventilation With ECCO2R During ARDS
|
N/A | |
Not yet recruiting |
NCT05859906 -
The Effect of Two Different Intra-abdominal Pressure Applications on "Mechanical Power" in Laparoscopic Cholecystectomy
|
||
Recruiting |
NCT05977153 -
CT for Personalized Mechanical Ventilation
|
N/A | |
Active, not recruiting |
NCT06430606 -
Novel Oxygenation Indices in Robot-Assisted Laparoscopic Surgeries
|
||
Recruiting |
NCT04484727 -
"Lung Barometric Measurements in Normal And in Respiratory Distressed Lungs"
|
||
Recruiting |
NCT05991258 -
Effect of End-inspiratory Airway Pressure Measurements on the Risk of VILI in Ventilated Patients
|
||
Terminated |
NCT03951064 -
Providing Optimal PEEP During Mechanical Ventilation for Obese Patients Using Esophageal Balloon
|
N/A |