Epidemiology and Treatment Strategy of Open Respiratory Phenotype in Critically Ill Patients

Southeast University, China

Status: Enrolling

Conditions: Mechanical Ventilation Pressure High; Critical Illness

Treatments: Other: pressure-volume curve with a low-flow insufflation of 5 L/min

Study type: Interventional

Funder types: Other

Identifiers

NCT06393179

OPEN-RESPIRATORY

Details and patient eligibility

About

Monitoring airway pressure is essential for patients with mechanical ventilation. However, static airway pressure does not reflect alveolar pressure at all. Airway pressure is supposed to completely interrupt the communication between proximal airway opening and the distal alveolar and/or small airway structures. In this condition, some alveoli may still be inflated but do not communicate with proximal airways and auto-PEEP will give a biased estimated of mean alveolar pressure. To be note, distinguishing the airway closure and alveolar collapse can be challenging at times. The quasi-static PV curve is a useful bedside tool to set mechanical ventilation, which may help us to identify the airway closure and alveolar collapse. Meanwhile, the quasi-static PV curve can only reflects a global behaviour of the lung, while EIT may be a useful tool to assess the regional information on airway closure and alveolar collapse.

Enrollment: 60 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adult patients undergoing controlled mechanical ventilation
• The duration of endotracheal intubation < 48 hrs

Exclusion criteria

• Severe hemodynamic instability
• Severe chronic lung disease requiring long-term home oxygen therapy
• Patients without analgesic sedation
• Decline to participate in the study
• Refusal to sign informed consent

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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60 participants in 1 patient group

P-V curve group

Experimental group

Description:

Enrolled patients will receive a PV curve with a low-flow insufflation of 5 L/min starting from 0 cmH2O to a maximal airway pressure corresponding to the plateau pressure.

Treatment:

Other: pressure-volume curve with a low-flow insufflation of 5 L/min