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Effects of Inspiratory Flow Waveforms on Preload

M

Military Hospital of Tunis

Status

Completed

Conditions

Cardiac Output, Low

Treatments

Device: varying inspiratory flow waveforms

Study type

Interventional

Funder types

Other

Identifiers

NCT01892696
CvD1977 (Other Identifier)
CvDVPPIVC

Details and patient eligibility

About

The clinical usefulness of inspiratory flow pattern manipulation during mechanical ventilation remains unclear. The aim of this study was to investigate the effects of different inspiratory flow waveforms, i.e. constant and decelerating, on cardiac preload in mechanically ventilated patients assessed by arterial pulse pressure variation (PPV) and inferior vena cava distensibility.

Full description

During mechanical ventilation the lungs can be inflated with different pressure and flow waveforms. Originally the piston-driven mechanical ventilators generated a quasi-sinusoidal flow waveform, whereas the newer electronically controlled ventilators can also produce constant and decelerating waveforms. According to several theoretical,animal and clinical studies,the inspiratory flow waveform affects the distribution of the inspired gas as well as respiratory mechanics and gas exchange. However, other studies failed to show any significant effect.But there is no study interested to the effects of inspiratory flow waveforms on cardiac preload. Thus, the clinical usefulness of inspiratory flow pattern manipulation remains unclear, though the capacity for selection of different inspiratory flow waveforms is provided by most modern, microprocessor-equipped ventilators. Therefore, the purpose of this study was to compare the effects of flow patterns (sinusoidal, constant and decelerating) on dynamic measurements of cardiac preload dependence such as arterial pulse pressure variation (ΔPP) and distensibility index of the inferior vena cava (dIVC).

Enrollment

60 patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

  • mechanical ventilation
  • Volume AssistControl Ventilation
  • sinus rhythm

Exclusion criteria

  • pressure mode
  • arrhythmia

Trial design

Primary purpose

Supportive Care

Allocation

N/A

Interventional model

Single Group Assignment

Masking

None (Open label)

60 participants in 1 patient group

mechanically ventilated patients
Other group
Description:
patients admitted to a 18-bed medical surgical intensive care unit of the military hospital of Tunisia and were mechanically ventilated fully adapted to their ventilator and in sinus rhythm. intervention:varying inspiratory flow waveforms
Treatment:
Device: varying inspiratory flow waveforms

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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