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SmartCare Driven Pressure Support-Non Invasive Ventilation Feasibility Study

Not Applicable
Terminated
Conditions
Acute Respiratory Failure
Interventions
Device: SmartCare/PS-NIV Drägerwerk Lübeck Germany
Registration Number
NCT01870089
Lead Sponsor
University of Lausanne Hospitals
Brief Summary

Knowledge-based systems were initially developped to automatically adapt pressure support settings during invasive ventilation, and proved to be at least as efficient as experienced clinicians.

Non-invasive ventilation has become the standard of care for patients suffering from acute hypercapnic respiratory failure (ARF)and has reduced the need for endotracheal intubation in these patients, thus reducing their hospital mortality.

NIV success or failure is closely related to the tolerance of NIV treatment, which is tightly correlated to patient-ventilator synchrony. As severe asynchronies frequently occurs during NIV (namely in more than 40% of patients) and as the occurence of asynchronies is related to the use of high pressure support levels, to the presence of leaks and/or to non optimal expiratory trigger settings, very frequent ventilator settings adaptations should allow reducing patient-ventilator asynchronies but require the presence of an experienced clinician at the bedside during NIV treatment.

A computer-driven ventilator settings adaptation has the adavantage of permitting very frequent ventilator settings adaptation whithout requiring the presence of an experienced clinician at the bedside and could possibly improve patient-ventilator interaction.

The aim of the present study is to test the faisability of using the Smartcare NIV computer-driven system to automatically adapt ventilator settings during non invasive ventilation delivered because of acute respiratory failure.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
11
Inclusion Criteria
  • Acute respiratory failure requiring non invasive ventilation
  • ICU patient equipped with an arterial line.
Exclusion Criteria
  • Contra-indications to NIV:
  • impaired consciousness
  • absence of patient cooperation
  • severe hemodynamic instability
  • vomiting
  • facial lesions
  • indication for immediate intubation
  • Acute neurological problem
  • Poor short term prognosis

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Study groupSmartCare/PS-NIV Drägerwerk Lübeck Germany-
Primary Outcome Measures
NameTimeMethod
Feasibilty of using the Smartcare-NIV system to deliver non-invasive ventilation in case of acute respiratory failure.45 minute NIV-treatment

The main aim of the study is to explore the feasibility of using the Smartcare-NIV system to deliver non-invasive ventilation (NIV) in case of acute respiratory failure. Practically, we will describe how the NIV tratment will go on when using the Smartcare system and report how the system automatically adapt the ventilator settings.

Secondary Outcome Measures
NameTimeMethod
Leaks45 minutes
O2 saturation45 minutes

Transcutaneous measurement

Blood gas analysis45 minutes

Two blood gas analysis will be done, one at the beginning and one at the end of the 45-minyte NIV treatment.

Tidal volumes45 minutes
Alarms generated by the ventilator45 minutes
Blood pressure45 minutes
Respiratory rate45 minutes
Manual ventilator settings modifications required45 minutes
Heart rate45 minutes
Minute ventilation45 minutes
Patient-ventilator asynchronies45 minutes
Patient comfort45 minutes

Patient comfort will be evaluated usuing a visual analogic scale graduated between 0 and 10.

Percentage of time spent in a predifined comfort zone.45 minutes

The comfort zone will be defined as respiratory rate between 14 and 29 breaths/minunte and tidal volume between 5 and 10 ml/ kg IBW

Trial Locations

Locations (1)

Adult Intensive Care and Burn unit, University Hospital of Lausanne

🇨🇭

Lausanne, Switzerland

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