Efficacy of Mechanical Power in Predicting Weaning Outcome of Patients receiving Invasive Mechanical Ventilation for Acute Exacerbation of Chronic Obstructive Pulmonary Disease
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 63
- 试验地点
- 1
- 主要终点
- To evaluate the efficacy of mechanical power (on invasive mechanical ventilation) in predicting difficult weaning of patients with acute exacerbation of chronic obstructive pulmonary disease.
研究概览
简要总结
Invasive Mechanical Ventilation is aimed at unloading respiratory muscles of excessive load in patients with Acute exacerbation of chronic obstructive pulmonary disease. Mechanial Power (MP) is the amount of energy transferred to respiratory system with each breath to overcome the airway resistance and thoracic wall elastance. Requirement of higher MP aggravates lung injury. We hypothesize that higher need to MP at baseline or at 24 hours, in patients initiated on Invasive Mechanical Ventilation at ICU admission for Acute Exacerbation of chronic obstructive pulmonary disease, would relate to difficult weaning. It would help in identifying at risk patients and to develop targeted protocols for weaning in such patients.
研究设计
- 研究类型
- Observational
入排标准
- 年龄范围
- 18.00 Year(s) 至 80.00 Year(s)（—）
- 性别
- All
入选标准
- •1.Admision to ICU for acute exacerbation of chronic obstructive pulmonary disease 2.Acute respiratory failure (PaCO2 > 50 mm Hg, PaO2 <60 mm Hg, pH<7.2, increased work of breathing) 3.Tracheal intubation with controlled mechanical ventilation.
排除标准
- •Pregnancy
- •History of neuromuscular disease
- •Chest wall deformities
- •Intracranial hypertension
- •Septic shock.
- •Refusal to consent.
- •Need of mechanical ventilation for less than 24hr hours
- •Respiratory failure requiring invasive mechanical ventilation for condition other than acute exacerbation of chronic obstructive pulmonary disease
- •Existing tracheostomy
- •Required long term ventilation within past 3 months.
- •Associated Interstitial lung disease
- •Lobar pneumonia
- •Presence of pulmonary edema.
结局指标
主要结局
To evaluate the efficacy of mechanical power (on invasive mechanical ventilation) in predicting difficult weaning of patients with acute exacerbation of chronic obstructive pulmonary disease.
时间窗: At admission after 15 minutes of intubation and initiation of invasive mechanical ventilation (Day 1) | At 24 hours(Day2) | Day2-Day28
次要结局
- To evaluate the efficacy of mechanical power (on invasive mechanical ventilation) in predicting simple weaning of patients with acute exacerbation of chronic obstructive pulmonary disease.(At admission after 15 minutes of intubation and initiation of invasive mechanical ventilation (Day 1))
- Baseline parameters (Demographics, SOFA score, APACHE II score, Arterial blood gas, diagnosis and co-morbidities).(At admission(Day1))
- To analyse correlation between positive end expiratory pressure and mechanical power in patients receiving invasive mechanical ventilation for acute exacerbation of chronic obstructive pulmonary disease.(At admission after 15,20,25,30,35,40,45,50,55,60,65 minutes of intubation and initiation of invasive mechanical ventilation (Day1))
- Other outcome parameters (morbidities in ICU, nutritional parameters, prolonged weaning, unsuccessful weaning, Post-extubation NIV need, Post-extubation failure, ventilator free days, ICU length of stay, ICU free days, in-hospital length of stay, readmission to ICU, ICU mortality, and 28-day mortality)(Day1-Day28)