Mechanical Power During Pressure-Controlled Versus Volume Controlled Mechanical Ventilation in Patients With Acute Respiratory Failure
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 186
- 试验地点
- 1
- 主要终点
- Mechanical power
研究概览
简要总结
This prospective observational cohort study aims to compare mechanical power between pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in critically ill adult patients receiving invasive mechanical ventilation. Mechanical power will be assessed at different time points during the first 24 hours after intubation, with the primary comparison performed at 24 hours. The study will also evaluate the association between mechanical power and clinical outcomes, including ICU mortality, hospital mortality, successful weaning, duration of mechanical ventilation, and length of ICU and hospital stay.
详细描述
Mechanical ventilation is a life-saving intervention for critically ill patients with acute respiratory failure. However, mechanical ventilation can also contribute to ventilator-induced lung injury when excessive energy is delivered to the respiratory system. Mechanical power, which represents the energy transferred from the ventilator to the respiratory system per unit of time, has emerged as a potentially important parameter for assessing the intensity of mechanical ventilation.
The mode of ventilation may influence mechanical power through changes in airway pressure, tidal volume, respiratory rate, and inspiratory flow. Pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) are commonly used modes of invasive mechanical ventilation, but their effects on mechanical power in critically ill patients may differ.
Therefore, this prospective observational cohort study aims to compare mechanical power between PCV and VCV in critically ill adult patients receiving invasive mechanical ventilation and to evaluate the relationship between mechanical power and relevant clinical outcomes.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult patients aged >18 years.
- •Patients with acute respiratory failure who are receiving invasive mechanical ventilation.
排除标准
- •Patients whose condition requires shifting between VCV and PCV after enrollment.
- •Patients with neurological, neuromuscular, or muscular disorders.
- •Neurological disorders, e.g., stroke, multiple sclerosis, Parkinsonism, and Guillain-Barré syndrome.
- •Neuromuscular junction disorders, e.g., myasthenia gravis.
- •Muscular disorders, e.g., polymyositis and Duchenne muscular dystrophy.
- •Chest wall abnormalities, e.g., kyphoscoliosis, scoliosis, and pectus excavatum.
- •Tracheostomized patients.
- •Patients with raised intra-abdominal pressure (IAP ≥12 mmHg), as estimated by transvesical manometry e.g., massive ascites, bowel obstruction, and postoperative abdominal surgery.
- •Patients with documented chronic type 2 respiratory failure, characterized by an elevated partial pressure of carbon dioxide (PaCO₂ >45 mmHg), low partial pressure of oxygen (PaO₂), and chronically elevated bicarbonate (HCO₃-) reflecting renal compensation.
研究组 & 干预措施
93 patients in Pressure controlled ventilation
93 patients in Volume controlled ventilation
93 patients in PCV
93 patients in Volume controlled ventilation
结局指标
主要结局
Mechanical power
时间窗: 24 hours after intubation
Mechanical power will be measured and compared between pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) at 24 hours after intubation.
次要结局
- mechanical power and ICU mortality, hospital mortality, time to death.(From hospital admission until 30 days after hospital admission.)
- Mechanical power over time(At 1, 6, 12, and 24 hours after initiation of invasive mechanical ventilation.)
- Successful weaning from mechanical ventilation(From intubation until successful weaning( successful extubation without need for ventilatory support within the following 48 hours))
研究者
Sahar Ahmed
Principle investigator
Assiut University