Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Aeration and Homogeneity During Pressure Assist Ventilation: A Preliminarily Physiological Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- The homogeneity of distribution of tidal volume
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Crossover
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 80 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The post operative patients who received pressure support ventilation;
- •After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity.
排除标准
- •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).
结局指标
主要结局
The homogeneity of distribution of tidal volume
时间窗: 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.
次要结局
- Changes in global and regional EELV(within 20 minutes after changing flow trigger)
研究者
Jian-Xin Zhou
Professor
Capital Medical University
