Efficacy of mechanical power in predicting weaning of patients from invasive ventilation, who are on mechanical ventilator for acute worsening of chronic obstructive pulmonary disease

Not yet recruiting

Conditions: Chronic obstructive pulmonary disease with (acute) exacerbation,

Registration Number: CTRI/2021/01/030817

Brief Summary: 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.

Detailed Description: Not available

Recruitment & Eligibility

Status: Not Yet Recruiting

Sex: All

Target Recruitment: 63

Inclusion Criteria

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.

Exclusion Criteria

Pregnancy 2.
History of neuromuscular disease 3.
Chest wall deformities 4.
Intracranial hypertension 5.
Septic shock.
Refusal to consent.
Need of mechanical ventilation for less than 24hr hours 8.
Respiratory failure requiring invasive mechanical ventilation for condition other than acute exacerbation of chronic obstructive pulmonary disease 9.
Existing tracheostomy 10.
Required long term ventilation within past 3 months.
Associated Interstitial lung disease 12.
Lobar pneumonia 13.
Presence of pulmonary edema.

Study & Design

Study Type: Observational

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
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.	At admission after 15 minutes of intubation and initiation of invasive mechanical ventilation (Day 1) \| At 24 hours(Day2) \| Day2-Day28

Secondary Outcome Measures

Name	Time	Method
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

Trial Locations

Locations (1): Critical Care Unit
🇮🇳
Dehradun, UTTARANCHAL, India
Critical Care Unit
🇮🇳Dehradun, UTTARANCHAL, India
Dr UDHAYACHANDHAR R
Principal investigator
9788385166
udcsmg86@gmail.com