The lung Mechanics and PEEP Absorption in patients with Flow limitation during mechanical ventilation: an Analysis by electrical Impedance tomography and Real-time EXpiratory resistance

Phase 1

• Conditions: Expiratory Flow Limitation during mechanical ventilation; Respiration, Artificial; Lung Diseases, Obstructive; Respiratory Distress Syndrome, Adult; Obesity; Respiratory Insufficiency

• Registration Number: TCTR20240525001
• Lead Sponsor: Faculty of Medicine Ramathibodi Hospital

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2024-05-25
• Last Update Posted: 19 August 2024
• Study Completion: 2026-05-31

Recruitment & Eligibility

• Status: Pending (Not yet recruiting)
• Sex: All
• Target Recruitment: 125

Inclusion Criteria

A patient receiving invasive mechanical ventilation via the endotracheal or tracheostomy tube with:
1. Age 18 years or more
2. Admitted to the intensive and intermediate critical care wards, Ramathibodi hospital
3. Have one or more of the following conditions:
- Exacerbation of obstructive airway disease (e.g. Asthma, Bronchiectasis, COPD)
- Presence of the risk-factor for EFL (e.g. ARDS, Obese patients with respiratory failure, pulmonary edema) with simple PEEP reduction test positive for EFL screening
4. Approval by the attending physician to receive sedative and muscle-relaxant agents
5. Consented to participate by the next-of-kin
6. Permission to perform the study is granted by the attending physician
7. Able to perform the study within 48 hours after initiation of invasive mechanical ventilation

Exclusion Criteria

1. Uncorrectable severe hypoxemia defined by PF ratio < 100
2. Unstable hemodynamic conditions:
- Mean arterial blood pressure < 60 mmHg
- Systolic blood pressure > 180 mmHg
- Heart rate < 40or > 160 beat per minute
3. A patient already enrolled in this study
4. The patient or the relatives deny to participate in the study

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Descriptive data of response to PEEP titration 30 seconds after each level of PEEP adjustment Value of total PEEP (in cmH2O) in each set PEEP level

Secondary Outcome Measures

Name	Time	Method
Imaging from EIT device during PEEP titration 30 seconds after each level of PEEP adjustment Pattern or change of pixel impedance over time, acquired from the Electrical Impedance Tomography device