Screening Expiratory Flow Limitation by Flow-time Curve
- Conditions
- ARDS, Human
- Registration Number
- NCT03215316
- Lead Sponsor
- Unity Health Toronto
- Brief Summary
Expiratory flow limitation (EFL) is defined as a dynamic condition that expiratory flow cannot be further increased with higher expiratory driving pressure. Under mechanical ventilation, it can cause intrinsic positive end-expiratory pressure (PEEP) and dynamic hyperinflation, and be associated with worse clinical outcome. The detection of EFL however needs special maneuvers and offline analysis of flow-volume curves, which are infeasible in routine practice and cannot be used during real-time monitoring. The investigators propose a new and simple approach using flow derived parameters to detect EFL in real time without needing any intervention.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 80
Inclusion Criteria
- Age ≥18 years, intubated or tracheostomized
- Receiving invasive mechanical ventilation in assist/control mode with PEEP ≥ 5 cmH2O
- Receiving continuous intravenous sedation
- Displaying a monotonous regular breathing pattern with no obvious asynchrony
Read More
Exclusion Criteria
- Severe hypoxemia in baseline clinical ventilator settings (SpO2 < 90%)
- Hemodynamic instability (mABP <60 mmHg, systolic arterial pressure >180 mmHg, heart rate <40/min or >150/min)
Read More
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Outcome (Presence / absence of EFL) will be determined by off-line analysis of recorded flow-volume loops during PEEP reduction. 2 years
- Secondary Outcome Measures
Name Time Method Percentage of intrinsic PEEP caused by the EFL. 2 years
Trial Locations
- Locations (1)
St. Michael's Hospital
🇨🇦Toronto, Ontario, Canada