Use of Pressure Muscle Index to Avoid Over-assistance During Pressure Support Ventilation
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Mechanical Ventilation
- Sponsor
- Capital Medical University
- Enrollment
- 20
- Locations
- 2
- Primary Endpoint
- Inspiratory effort
- Last Updated
- 4 years ago
Overview
Brief Summary
Pressure support ventilation (PSV) is the most commonly used mode in mechanical ventilated patients. Studies have shown that over-assistance was prevalent in patients undergoing PSV. Up to now, no reliable method has been recommended to select an "optimal" inspiratory support level. Pressure muscle index (PMI) was introduced recently to evaluate the degree of spontaneous breathing effort. We hypothesize that PMI might be used as an indicator for over-assistance during PSV. In this randomized crossover study, inspiratory support is set at three levels according to negative, positive and zero PMI. Inspiratory effort, work of breathing, and respiratory mechanics are compared among the three inspiratory pressure support levels.
Investigators
Jian-Xin Zhou
Professor
Capital Medical University
Eligibility Criteria
Inclusion Criteria
- •Mechanical ventilated patients within 48 hours after the transition from a controlled mode to PSV
Exclusion Criteria
- •History of neuromuscular disease
- •History of diaphragm dysfunction and surgery
- •History of esophageal, gastric or lung surgery
- •Decreased level of consciousness
- •Central respiratory drive dysfunction
- •Considered withholding of life support
Outcomes
Primary Outcomes
Inspiratory effort
Time Frame: 30 minutes
Inspiratory effort is measured as pressure generated by inspiratory muscles using esophageal pressure monitoring.
Work of breathing
Time Frame: 30 minutes
Work of breathing is measured by the Campbell diagram and pressure-time-product using esophageal pressure monitoring.
Secondary Outcomes
- Partial pressure of carbon dioxide in arterial blood (mmHg)(30 minutes)
- Tidal volume (ml)(30 minutes)
- Respiratory rate (breaths/min)(30 minutes)
- Respiratory system compliance (ml/cmH2O)(30 minutes)
- Rapid shallow breathing index(30 minutes)
- The use of accessory respiratory muscle(30 minutes)
- Partial pressure of oxygen in arterial blood (mmHg)(Partial pressure of oxygen in arterial blood)