Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Ventilation Distribution

Completed

• Conditions: Mechanical Ventilation
• Interventions: Procedure: flow trigger

• Registration Number: NCT03241654
• Lead Sponsor: Capital Medical University

Brief Summary

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region.Decrease of flow trigger sensitivity might improve homogeneous of tidal volume distribution.

Detailed Description

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region. High positive end expiratory pressure (PEEP) has been applied to improve the homogeneous distribution of ventilation by increasing the end expiratory lung ventilation (EELV) and alveolar recruitment. However, for patients who increasing PEEP in some extent still existed poor aeration in the dependent region, further elevating PEEP seems to be unreasonable that perhaps lead to overdistension. Decreasing trigger sensitivity might further evoke inspiratory efforts to improve the ventilation for this type of patients.The Electrical impedance tomography (EIT) was applied in monitoring the regional ventilation distribution at the bedside.

Study Timeline

• Study Start: 2017-05-01
• Status Verified: 2017-08
• Study First Submitted: 2017-08-03
• Study First Submitted QC: 2017-08-04
• Study First Posted: 2017-08-07
• Primary Completion: 2017-08-20
• Study Completion: 2018-02-01
• Last Update Submitted: 2018-02-09
• Last Update Posted: 2018-02-12

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. The post operative patients who received pressure support ventilation;
2. After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity.

Exclusion Criteria

1. Under 18 years;
2. History of diaphragm dysfunction and surgery;
3. Central respiratory drive dysfunction;
4. history of esophageal, gastric or lung surgery;
5. The contraindication of using EIT (pacemaker, defibrillator, and implantable pumps).

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
the lowest trigger sensitivity	flow trigger	The flow trigger of ventilator was set as the lowest level of sensitivity.
the highest trigger sensitivity	flow trigger	The flow trigger of ventilator was set as the highest level of sensitivity.

Primary Outcome Measures

Name	Time	Method
The homogeneity of distribution of tidal volume	within 20 minutes after changing flow trigger	EIT was used to monitoring the homogeneity of distribution of tidal volume that was divided into two contiguous regions of interest (ROI) equally, the dependent and non-dependent area. The ratio of relative distribution of tidal ventilation of two ROI was calculated.

Secondary Outcome Measures

Name	Time	Method
Changes in global and regional EELV	within 20 minutes after changing flow trigger	The change of EELV was measured after changing flow trigger based on the baseline level.

Trial Locations

Locations (1)

Jian-Xin Zhou; 🇨🇳 Beijing, Beijing, China