Correlation of Mechanical power to duration of mechanical ventilation in patients with respiratory failure-A prospective observational study
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 47
- 试验地点
- 1
- 主要终点
- To determine the mechanical power of ventilation on day 1 of ICU admission and determine itss correlation with the duration of mechanical ventilation
研究概览
简要总结
Allpatients admitted in St John’s Medical College Hospital ICU who are intubatedand mechanically ventilated will be assessed for inclusion in the study withinthe first 24 hours of initiation of mechanical ventilation. For Consentingpatients, Identification number and basic details - demographics will beentered in the Proforma. Comorbidities, reason for intubation, hemodynamicparameters will be noted.
All evaluations of ventilatoryparameters and Ultrasound based evaluations shall be performed by principalinvestigator under supervision.
• Forpatients who have been intubated, sedated and paralysed, on volume controlledventilation the following parameters shall be noted down – respiratory rate(breaths/min) set, tidal volume (ml) set, minute volume set, PEEP (cm H2O) levelsset and the inspiratory expiratory ratio set.
• Peakpressure(PIP), plateau pressure (by applying inspiratory hold for 3-5 seconds),mean airway pressure, Total positive end expiratory pressure- PEEP ( byapplying expiratory hold for 3 seconds) and hence auto PEEP, driving pressure (plateau pressure – PEEP), (all in units of cm H2O) dynamic compliance(Vt/PIP-PEEP), static compliance (Vt/Plateau-PEEP), resistance will also be noted down.
• Mechanical powerwill be calculated according to the following equation as per the comprehensiveequation for mechanical ventilation defined by gattinoni et al.
MP=0.098* RR * Vt * [ PIP -0.5(Pplat-PEEP)]
· Lung ultrasoundwill be done with a curved array transducer of 2-5MHz as per blue protocol anda composite lung aeration score will be calculated.
This score iscomputed in six regions per hemithorax: anterior, lateral, and posterior fieldsare identified by sternum, anterior, and posterior axillary lines; each fieldis divided into superior and inferior regions
| Score |
Lung findings
aeration
|0
A-lines or ≤ 2 B-lines
normal
|1
≥ 3 or more well spaced B-lines
Moderate loss
|2
Coalescent B-lines
Severe loss
|3
Tissue – like pattern
Complete loss
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 99.00 Year(s)（—）
- 性别
- All
入选标准
- •Patients of age more than 18 years Patients who require mechanical ventilation for atleast 48 hours for respiratory failure Patients who have been sedated and paralysed at the time of evaluation in the first 24 hours.
排除标准
- •Patients with obstructive airway diseases and in respiratory acidosis.
- •Patients requiring obligatory hyperventilation due to raised intracranial pressure of severe metabolic acidosis.
结局指标
主要结局
To determine the mechanical power of ventilation on day 1 of ICU admission and determine itss correlation with the duration of mechanical ventilation
时间窗: Day 1 of ICU admission
次要结局
- 1)To determine the correlation of mechanical power of ventilation on day 1 of ICU admission with the length of ICU stay/mortality.(2)Correlation of mechanical power with lung aeration score)