Estimating the Transpulmonary Pressure From the Central Venous Pressure in Mechanically Ventilated Patients With Respiratory Failure
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 20
- 试验地点
- 1
- 主要终点
- Transpulmonary pressure
研究概览
简要总结
Central venous pressure (CVP) is characterized by a low-frequency pleural-dependent as well as a high-frequency cardiac pulsatile component. The aim of the study is to compare the low-frequency component of CVP with the esophageal pressure (Pes), as surrogate of pleural pressure, to estimate trans-pulmonary pressure (PL).
详细描述
The investigators will enroll mechanically ventilated patients admitted to the intensive care unit with the diagnosis of respiratory failure monitored with a dedicated nasogastric catheter and a central venous catheter for measuring Pes and CVP, respectively. Electrocardiogram trace, Pes, CVP and airway pressure (Paw) will be recorded at the end of inspiratory and expiratory pauses. The CVP waveforms will be analyzed off-line using a dedicated low-pass digital filter to obtain the low-frequency component of CVP (filtered CVP, fCVP). Paw, Pes and fCVP will be used to calculate PL using transpulmonary driving pressure formula (PL-Pes and PL-fCVP, respectively). The PL values obtained with fCVP and Pes will be compared to assess the correlation of the two methods.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •adult patients receiving invasive mechanical ventilation
- •diagnosis of acute respiratory failure (defined as the ratio of partial oxygen pressure and fraction of inspired oxygen below 200 mmHg)
- •esophageal balloon catheter
- •central venous catheter
排除标准
- •age under 18 years old
- •Hemodynamic instability
- •Esophageal diseases (varices, stenosis..)
- •Refusal of the patient
- •evidence of active air leak from the lung (pneumothorax, pneumomediastinum, existing chest tube....)
- •history of lung/abdominal surgery
- •pregnancy
- •severe coagulopathy
结局指标
主要结局
Transpulmonary pressure
时间窗: Within 72 hours from the starting of mechanical ventilation
Correlation and agreement between the transpulmonary pressure obtained from esophageal balloon catheter and central venous catheter
次要结局
- Transpulmonary pressure in patients at risk for ventilator-induced-lung-injury(Within 72 hours from the starting of mechanical ventilation)
- Transpulmonary pressure in subgroups of patients(Within 72 hours from the starting of mechanical ventilation)
研究者
Federico Franchi
Principal Investigator; Associate professor of Anesthesiology; Anesthesia and Intensive Care Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
University of Siena