Reducing high respiratory drive to facilitate supported ventilation in ARDS patients: a pilot study

Recruiting

Conditions: Acute respiratory distress syndrome
severe lung syndrome
10024970

Registration Number: NL-OMON38185

Lead Sponsor: niversitair Medisch Centrum Sint Radboud

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Recruiting

Sex: Not specified

Target Recruitment: 12

Inclusion Criteria

• age > 18 year
• informed consent
• ARDS according to the Berlin definition
• RASS -4/-5
• tidal volume > 8 ml/kg during supported ventilation
• esophageal EMG catheter with balloons in situ

Exclusion Criteria

• recent use of muscle relaxants / neuromuscular blocking agents (< 3 hours)
• pre-existent neuromuscular disease (congenital or acquired) or diseases / disorders know to be associated with myopathy including auto-immune diseases
• phrenic nerve lesions
• elevated intracranial pressure or clinical suspicion of elevated intracranial pressure (i.e. neurotrauma)
• open chest or abdomen
• pregnancy
• systolic blood pressure < 90 mm Hg / mean arterial pressure (MAP) < 65 mm Hg

Study & Design

Study Type: Interventional

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The main study parameter is the ability to titrate rocuronium in order to<br /><br>decrease the tidal volume (Vt) to approximately 6 ml/kg (yes/no). </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>• Respiratory rate<br /><br>• Diaphragm activity (Edi)<br /><br>• Transpulmonary pressure<br /><br>• Transdiaphragmatic pressure<br /><br>• Work of breathing<br /><br>• Dynamic and static respiratory compliance<br /><br>• Neuroventilatory efficiency (tidal volume/Edi)<br /><br>• Neuromechanical efficiency (transdiaphragmatic pressure/Edi)<br /><br>• Patient-ventilator contribution to breathing: PVBC = (tidal volume/Edi,<br /><br>no-assist) / (tidal volume/Edi, assist)<br /><br>• Oxygenation index (arterial oxygen tension / fraction of inspired oxygen)<br /><br>• Patient-ventilator asynchrony</p><br>