Dynamic Airway Resistance & ML: Guide Sputum Suction in Ventilated Patients

Affiliated Hospital of Nantong University

Status: Enrolling

Conditions: Mechanical Ventilation Pressure High; Respiratory Depression Neonatal; Ventilator-Associated Pneumonia (VAP)

Treatments: Procedure: The dynamics of airway resistance; Diagnostic Test: conventional suctioning

Study type: Interventional

Funder types: Other

Identifiers

NCT07375667

2025-K249-01

Details and patient eligibility

About

Research has shown that timely suctioning not only improves survival rates but also enhances the quality of life in ventilator-dependent patients. However, clinical judgment on the optimal timing for suctioning currently relies primarily on physician experience, lacking scientific evidence [10]. Airway viscous resistance reflects the frictional resistance encountered by gas flow within the airways and is closely associated with airway patency. When airway secretions increase, viscous resistance undergoes dynamic changes. Therefore, analyzing these dynamic variations in viscous resistance derived from ventilator waveforms to determine the optimal suctioning timing and assess its clinical impact on the progression of pulmonary inflammation holds significant scientific value and offers new insights and methodologies for clinical practice.

Full description

To validate the clinical feasibility and reliability of airway viscous resistance monitoring, explore the temporal correlation between inflammatory biomarkers and changes in airway viscous resistance, establish a reference threshold system for special populations, and provide experimental evidence for determining the optimal suctioning timing.

Enrollment: 258 estimated patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Clinical diagnosis of Acute Respiratory Distress Syndrome (ARDS)
• Clinical diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD)
• Clinical diagnosis of Severe pneumonia

Exclusion criteria

• Clinical diagnosis of multiple organ failure;
• Clinical diagnosis of multiple organ bleeding;

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Single Blind

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258 participants in 2 patient groups

Airway resistance-guided sputum suction

Experimental group

Description:

Investigators will continuously monitor the airway viscous resistance of patients, and initiate suctioning when the airway viscous resistance increases by ≥6 cmH₂O.

Treatment:

Diagnostic Test: conventional suctioning

Procedure: The dynamics of airway resistance

conventional suctioning

No Intervention group

Description:

In the control group, the decision to suction was made based on conventional clinical signs, including rhonchi and a rise in peak pressure.