Effects of Sedation on Transpulmonary Pressure and Lung Homogenous of ARDS Patients
Overview
- Phase
- N/A
- Intervention
- Deep sedated
- Conditions
- ARDS
- Sponsor
- Southeast University, China
- Enrollment
- 24
- Locations
- 1
- Primary Endpoint
- Transpulmonary pressure generate by patient during deep or light sedation
- Status
- Completed
- Last Updated
- 8 years ago
Overview
Brief Summary
The acute respiratory distress syndrome (ARDS) is characterized by severe respiratory failure. Open Lung and Lung Protective Strategy have been proved to improve mortality of ARDS patients. Preserving spontaneous breathing (SB) is good for inflating the lung lobe near diaphram during mechanical ventilation, however, strong respiratory drive could generate more transpulmonary pressure in ARDS patients, which increase the stress and strain in injured lung. Nonetheless, it's not clear if sedative has any effects on transpulmonary pressure of ARDS patients.The purpose of this study is to investigate the effects of sedation on transpulmonary pressure of ARDS patients.
Detailed Description
Further study details as provided by Nanjing Zhong-da Hospital, School of Medicine, Southeast University
Investigators
Songqiao Liu
Principal Investigator
Southeast University, China
Eligibility Criteria
Inclusion Criteria
- •ARDS group patient (1) Acute onset of all of the following criteria within a 48-hour period:
- •Requires positive pressure ventilation through an endotracheal tube
- •Bilateral infiltrates consistent with edema on frontal chest radiograph, with a duration of no more than 7 days
- •PaO2/FiO2 less than 300 while receiving positive end-expiratory pressure (PEEP) at more than 5 cm H2O for at least 4 hours, with a duration of no more than 7 days
- •No clinical evidence of left atrial hypertension (2) Hemodynamics stable (dopamine \<10ug/kg•min or norepinephrine \<10ug/kg)
- •Surgical patient Surgical patient requires positive pressure ventilation through an endotracheal tube PaO2/FiO2 more than 300 Hemodynamics stable (dopamine \<10ug/kg•min or norepinephrine \<10ug/kg)
Exclusion Criteria
- •Age younger than 18 years or older than 85 years
- •Cardiac failure
- •Known pregnancy
- •Increased intracranial pressure
- •Severe neuromuscular disease
- •Recent injury or other pathologic condition of the esophagus
- •Pneumothorax
- •Pleural effusion
- •Diaphragmatic hernia
- •Severe chronic respiratory disease
Arms & Interventions
Deep sedation
In this Arm, patients were sedated to the level of Ramsay 5(Deep sedated) by Midazolam IV continuously
Intervention: Deep sedated
Light sedation
In this Arm, patients were sedated to the level of Ramsay 3(Light sedated)by Midazolam IV continuously
Intervention: Light sedated
Outcomes
Primary Outcomes
Transpulmonary pressure generate by patient during deep or light sedation
Time Frame: 15 minutes during deep or light sedation
Ispiratory transpulmonary pressure and expiratory transpulmonary pressure measured during sedation
Secondary Outcomes
- PaO2(15 minutes)
- static compliance of respiratory system(15min during deep or light sedation)