Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Aeration and Homogeneity During Pressure Assist Ventilation: A Preliminarily Physiological Study
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Mechanical Ventilation
- Sponsor
- Capital Medical University
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- The homogeneity of distribution of tidal volume
- Status
- Completed
- Last Updated
- 8 years ago
Overview
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.
Investigators
Jian-Xin Zhou
Professor
Capital Medical University
Eligibility Criteria
Inclusion Criteria
- •The post operative patients who received pressure support ventilation;
- •After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity.
Exclusion Criteria
- •Under 18 years;
- •History of diaphragm dysfunction and surgery;
- •Central respiratory drive dysfunction;
- •history of esophageal, gastric or lung surgery;
- •The contraindication of using EIT (pacemaker, defibrillator, and implantable pumps).
Outcomes
Primary Outcomes
The homogeneity of distribution of tidal volume
Time Frame: 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 Outcomes
- Changes in global and regional EELV(within 20 minutes after changing flow trigger)