Individual PEEP setting guided by End Expiratory Lung Volume with an Upper Pressure Limit in mechanically ventilated critically ill patients
Recruiting
- Conditions
- respiratoir falen op de intensive caremechanical ventilation
Recruitment & Eligibility
- Status
- Recruiting
- Sex
- Not specified
- Target Recruitment
- 40
Inclusion Criteria
- >18 years of age
- Written informed consent from legal representatives
- Mechanical ventilation < 24 hour after intubation
- Requiring mechanical ventilation without acute respiratory failure (PaO2/FiO2 ratio > 300 mmHg)
- Requiring mechanical ventilation with acute respiratory failure (PaO2/FiO2 ratio > 300 mmHg)
Exclusion Criteria
- Inability to perform reliable lung volume measurements
* Air leak
* Severe airflow obstruction due to COPD (forced Expired Volume in 1 sec or Vital Capacity below predicted value minus 2 SD
* Patients with known emphysema and the presence of bullae on X-ray
* Patients with pneumothorax on x-ray
- Inability to use the standard reference EELV values
* Thoracic deformities
- Severe hemodynamic instability
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method <p>Primary: Feasibility of an EELV guided PEEP ventilation protocol and<br /><br>calculations of standard deviations to allow sample size calculations for an<br /><br>outcome study based on this protocol. </p><br>
- Secondary Outcome Measures
Name Time Method <p>Secondary: Difference in arterial oxygenation (PaO2/FiO2 ratio), required<br /><br>inspired oxygen fraction and respiratory compliance between groups at 48 hours.<br /><br>Ability of the FiO2-upper pressure limit (UPL) table to prevent overdistension<br /><br>evaluated by electrical impedance tomography (EIT). Also time on ventilator,<br /><br>length of stay on ICU and number of organ failure will be recorded.</p><br>