To evaluate the effects of different types of pressure selection on aeration of lung by using various parameters (medically termed as Recruitment to inflation ratio, lung strain, mechanical power) during those PEEPs: A prospective observational study
- Conditions
- Health Condition 1: J189- Pneumonia, unspecified organism
- Registration Number
- CTRI/2024/07/070155
- Lead Sponsor
- Rainbow childrens Medicare Ltd
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- ot Yet Recruiting
- Sex
- Not specified
- Target Recruitment
- 0
Invasively ventilated children more than one month and up to 18 years of age shall be enrolled for the study with acute hypoxemic respiratory failure due to non-cardiogenic etiology.
Acute Hypoxemic lung injury shall be defined as
1-Less than one week duration of illness
2- Unilateral or bilateral haziness on lung fields in chest X Ray not due to cardiac dysfunction or fluid overload.
3-PF Ratio below 300 or an SF ratio below 265 or OI above 4 at PEEP of 5cmH2O or more.
4-Without cardiac etiology as the cause of hypoxia.
•Children on NIV
•Children who are hemodynamically unstable for data collection
•Children who are already on High Frequency Oscillatory ventilation
•Children with significant Patient Ventilator Asynchrony
•Children with open chest (following surgery)
•Children with air leaks, with chest Drains
•Children with raised Intra cranial pressure
•Children on Extracorporeal therapies (CRRT, hemodialysis), ECMO
•Children in Prone position
•Children with chronic lung diseases
•Children with cyanotic heart diseases
•For Nitrogen Wash-in washout technique, the manufacturer recommends the respiratory rates to be below 35 breathes/min and FiO2 to be below 65-70%, hence any child who doesn’t fit in to these criteria shall also be excluded automatically from the study purpose.
•Children on inhaled Nitric Oxide or extracorporeal therapies (ECMO/CRRT/Hemodialysis etc) are also not recommended by the manufacturer, hence considered under exclusion criteria.
•Even during the RI study, if at the PEEP of 15cmH2O, if the DP is above 15 cmH2O or the PPlat is above 28-30cmH2O, then the study will not be conducted any further and the patient shall be excluded from the study.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method To assess the recruitment-to-inflation ratio through end expiratory lung volume measurement across the traditionally tested 15 to 5 cm H2O PEEP range and in the narrower ranges of PEEP-change in three stepsTimepoint: with in 7 days of illness
- Secondary Outcome Measures
Name Time Method 1.To assess respiratory mechanics like driving pressure, mechanical power, stress, strain, S/F ratio, Vd/Vt and EILV/TLC at each PEEP-step and compare with RI Index at those PEEP-steps <br/ ><br>2.To correlate FRC at ZEEP with the volume measured by the single breath derecruitment method from PEEP of 5cmH2O to ZEEP. <br/ ><br>Timepoint: With in 7days of illness