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

Capital Medical University

Status: Completed

Conditions: Mechanical Ventilation

Treatments: Procedure: flow trigger

Study type: Observational

Funder types: Other

Identifiers

NCT03241654

KY-2017-001

Details and patient eligibility

About

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.

Full 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.

Enrollment: 20 patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

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).

Trial design

20 participants in 2 patient groups

the lowest trigger sensitivity

Description:

The flow trigger of ventilator was set as the lowest level of sensitivity.

Treatment:

Procedure: flow trigger

the highest trigger sensitivity

Description:

The flow trigger of ventilator was set as the highest level of sensitivity.

Treatment:

Procedure: flow trigger