Measuring work-of-breathing in mechanically ventilated childre

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 48

Inclusion Criteria

•mechanical ventilation for at least 48 hours before the start of weaning
•weight >= 3 kg
•deemed eligible for weaning by the attending physician
•stable haemodynamics, defined by the absence of need for increase in vaso-active drugs and/or fluid challenges at least 6 hours prior to enrolment

Exclusion Criteria

•mechanical ventilation less than 48 hours for unplanned admissions before the start of weaning
•post-operative admission with expected duration of mechanical ventilaton less than 48 hours
•not eligible for weaning as assessed by the attending physician (usually when there are unstable ventilator settings, defined by the need for increase of inspiratory pressures or positive end-expiratory pressure, and a FiO2 > 0.6 within 6 hours prior to enrolment)
•unstable haemodynamics, defined by the need for increase in vaso-active drugs and/or fluid challenges within 6 hours prior to enrolment
•admitted to the neonatal intensive care unit
•premature birth with gestational age corrected for post-conceptional age less than 40 weeks
•congenital or acquired neuromuscular disorders
•congenital or acquired central nervous system disorders with depressed respiratory drive
•severe traumatic brain injury (i.e. Glasgow Coma Scale < 8)
•congenital or acquired damage to the phrenic nerve
•congenital or acquired paralysis of the diaphragm
•use of neuromuscular blockade prior to enrolment
•uncorrected congenital heart disorder
•chronic lung disease
•severe pulmonary hypertension

Study & Design

Study Type: Observational non invasive

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The level and time course of the patient work-of-breathing measured by the area<br /><br>under the pressure-volume curve during PS ventilation with the<br /><br>work-of-breathing during SIMV-PS ventilation with a lower rate of breaths per<br /><br>minute delivered by the ventilator. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>The level and time course of surrgatoe parameters for work-of-breathing (PRP,<br /><br>PTP, expiratory airway resistance, imposed work of breathing), distribution of<br /><br>tidal volume, and level and time course of oxygenation (PaO2/FiO2 ratio) during<br /><br>PS ventilation with the work-of-breathing during SIMV-PS ventilation with a<br /><br>lower rate of breaths per minute delivered by the ventilator.</p><br>