Respiratory Function Monitoring of Patients With Chest Blunt Injury With Mechanical Ventilation
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 80
- 主要终点
- ventilation blood flow ratio
研究概览
简要总结
The goal of this observational study is to learn about EIT in observing the application of lung protective ventilation strategies in patients with pulmonary contusion, particularly the impact on pulmonary ventilation blood flow ratio, oxygen, and condition. The main question it aims to answer is:
Can lung protective ventilation strategies improve respiratory function in patients with severe chest contusion? We will collect clinical data of participants who already taking lung protective ventilation strategies as part of their regular medical care.
详细描述
Trauma is the leading cause of death among middle-aged and young people in China, with over 25% of patients dying from chest trauma. The incidence of pulmonary contusion in severe chest trauma is over 70%, and it is an important cause of respiratory failure and even death in patients. The occurrence of pulmonary contusion and respiratory failure in patients with chest contusion is a dynamic process, and Regional inhomogeneities of the damaged lung should be taken into consideration to develop improved ventilation strategies. Currently, there is no ideal monitoring method to evaluate the severity of injury, and guide the ventilation strategies. Electrical impedance tomography (EIT) is a non-invasive, radiation-free imaging technique. It measures regional lung ventilation and aeration distribution by means of changes in electrical potentials at the skin surface of the chest wall during breathing cycles, which has been proven to have good practicality in patients with non-invasive ARDS and pulmonary embolism. In this study, we aim to characterize the physiologic effects of positive end expiratory pressure (PEEP) on key mechanisms of regional lung protection, namely: recruitment, reduced atelectrauma, and improved ventilation-perfusion matching, by CT scan and EIT
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 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with severe chest contusion admitted to the intensive care unit (ICU);
- •Abbreviated Injury Scale (AIS) ≥ 3 and/or Blunt Pulmonary Contusion 18 score (BPC18) ≥ 3;
- •Age range from 18 to 90 years old;
- •Mechanical ventilation;
- •Stay in the ICU for less than 12 hours.
排除标准
- •Perinatal women;
- •Expected to be mechanically ventilated for less than 48 h;
- •Expected duration of stay in the ICU is less than 24 hours;
- •There are contraindications for the use of EIT (pacemaker implantation, local skin wounds after chest surgery, etc.);
- •Accept extracorporeal membrane oxygenator;
- •Mechanical ventilation>7 days;
- •Confirmed ventilator-associated pneumonia;
- •Pneumothorax without drainage or presence of subcutaneous emphysema.
结局指标
主要结局
ventilation blood flow ratio
时间窗: through study completion, an average of 1 year
ventilation blood flow ratio of lung
次要结局
- oxygenation index(through study completion, an average of 1 year)
- 28-day mortality(through study completion, an average of 1 year)
- Mechanical ventilation-free from day 1 to 28(through study completion, an average of 1 year)
- Length of hospital stay(through study completion, an average of 1 year)
- The rate of successful weaning(through study completion, an average of 1 year)
- Length of ICU stay(through study completion, an average of 1 year)
研究者
Li Shu
associate professor
Peking University People's Hospital