Respiration, Artificial Clinical Trial
Official title:
"Feasibility of Ventilation Detection Using Thoracic Impedence Acquired Via Standard Defibrillator Electrode Pads in Mechanically Ventilated Pediatric Patients"
This study is a prospective, observational case series of a convenience sample of
mechanically ventilated pediatric patients in the Pediatric ICU, Progressive Care Unit and
Operating Room at the Children's Hospital of Philadelphia.
We propose to observe, measure and report the accuracy, precision and bias of defibrillator
electrode pads to detect breathing in stable but critically ill and mechanically ventilated
children. This study will provide preliminary data to inform the resuscitation research
community and assist development of evidence-based pediatric resuscitation guidelines in the
future.
Context: Resuscitation (CPR) guidelines recommend target values for rate and depth of rescue
breathing and chest compressions. Defibrillator electrode pads can accurately detect the
size, rate, and speed of machine-generated breaths in adults. The accuracy, precision, bias,
and ability of the defibrillator electrode pads to detect the size, rate and speed of
breathing in children have not been studied.
Objectives: The primary objective is to evaluate the accuracy, precision, bias and ability
of the pads and defibrillator to detect the rate and depth of breathing in critically ill
children on breathing machines. Important secondary objectives include reporting the
accuracy, precision and bias of the measurement of the speed of the breath, measurement
variability, and impact of alternative defibrillator electrode pad location on the chest.
Study Design/Setting/Participants:
Prospective, pilot, observational study in the Pediatric Intensive Care Unit and Progressive
Care Unit at the Children's Hospital of Philadelphia. The participants are all patients in
the PICU and Progressive Care Unit (PCU), 6 months to 17 years, who are supported by their
clinical management team with a tracheal tube, standard breathing machine, and standard ICU
monitoring systems.
Intervention:
Standard defibrillator electrode pads will be placed on the patient's chest in two typical
pediatric configurations, and data will be recorded for 5 minutes in each configuration.
These defibrillator electrode pads will be used exclusively for monitoring, as additions to
the standard ICU monitoring.
Study Measures:
The primary outcome variable will be the successful detection of breathing rate. We will
compare the accuracy, precision and bias of detection of each breath of > 2 ml/kg by the
defibrillator electrode pads compared with the "gold standard" mechanical ventilator
pneumotachometer detected breaths. Secondary outcome variables will include defibrillator
electrode pad detection of breathing depth and speed compared to standard ICU monitors
(considered the gold standard). We will also study the effect of defibrillator electrode pad
location on the accuracy, precision, bias and ability to detect breathing rate, depth, and
speed.
;
Observational Model: Case-Only, Time Perspective: Prospective
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