Inflammatory Effects of a Lung Recruitment Manoeuvre

Azienda Ospedaliero, Universitaria Pisana

Status: Unknown

Conditions: Respiratory Insufficiency; Respiratory Distress Syndrome, Adult

Treatments: Device: continuous positive airway pressure (CPAP); Procedure: 40/30 recruitment manoeuvre

Study type: Interventional

Funder types: Other

Identifiers

NCT01070654

RMSGMFF (Other Identifier)

RM0910

Details and patient eligibility

About

Recruitment manoeuvres, consisting of sustained inflations at high airway pressures, have been advocated as an adjunct to mechanical ventilation in lung protective ventilation strategies to prevent the collapse of the lung.

This study aims to determine the safety and efficacy of a recruitment manoeuvre, by considering its impact on gas exchange, hemodynamics and on the release of systemic inflammatory mediators.

Full description

This prospective study will analyse the effects of a single recruitment manoeuvre in critically ill patients. Subjects will be mechanically ventilated patients needing alveolar RMs. After a period of stable lung protective approach ventilation, they will receive the "40/30" RM; lung mechanics, gas exchange, hemodynamics and plasmatic concentration of inflammatory mediators will be obtained before and after the RM. An ultrasound score, established from the lung aeration status of upper and lower parts of anterior and lateral chest wall, will also be calculated before and after the manoeuvre.In selected patients cytokine release in the bronchoalveolar lavage will be measured as well.

Enrollment: 10 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Mechanical Ventilation
• Arterial catheter inserted
• Hypoxemic respiratory failure (Pa02/FiO2 <300)
• Radiological evidence of atelectasis or pulmonary infiltrates in the CXR
• Informed consent

Exclusion criteria

• Elevated intracranial pressure >25 mmHg
• Bronchopulmonary fistula
• Emphysema
• Kidney or Liver failure

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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10 participants in 1 patient group

40/30 Recruitment Manoeuvre

Experimental group

Description:

Patients with respiratory failure that will be first ventilated for 30 minutes according to standardized baseline protective ventilation and after that will receive the recruitment manoeuvre

Treatment:

Device: continuous positive airway pressure (CPAP)

Procedure: 40/30 recruitment manoeuvre