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Evaluation of Tracheal Pressure During CPAP

Not Applicable
Completed
Conditions
CPAP Ventilation
Continuous Positive Airway Pressure
Interventions
Device: Evone
Device: Evita Infinity V500
Registration Number
NCT05679635
Lead Sponsor
Medical University Innsbruck
Brief Summary

This trial evaluates tracheal pressure values in intubated intensive care unit patients during continuous positive airway pressure without any ventilatory support, automatic tube compensation and assisted spontaneous breathing.

Detailed Description

Aim of this trial is to investigate if there are any significant differences between airway and tracheal pressure values during continuous positive airway pressure (CPAP) ventilation. For this purpose, a tracheal pressure measurement catheter is inserted into the tracheal tube and the obtained values are compared with the corresponding airway pressure measured on the ventilator. To further evaluate the impact of mild respiratory support automatic tube compensation and assisted spontaneous breathing with 4 cmH2O will be applied and measured pressure values compared as well.

We hypothesize that tracheal pressure will be significantly lower than airway pressure values during inspiration, which represents the primary outcome measure. Secondary outcome parameters include comparison of expiratory and mean pressure values of airway and tracheal pressure. Additionally, effects of mild respiratory support will be evaluated as well.

Measurement of inspiratory tracheal pressure might allow to calculate the pressure drop between the airway pressure at the Y-piece of the ventilator and the pressure at the trachea. Currently it is not known, if this pressure drop is significant during CPAP, which represents the rationale to perform this pilot study. In a second step it would be possible to determine if the recorded pressure drop can be used as a surrogate parameter for the respiratory drive in terms of a risk assessment for the development of patient self-inflected lung injury.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Male and female subjects ≥ 18 years
  • Intubated patient during CPAP without pressure support
  • Informed consent
Exclusion Criteria
  • Female subjects known to be pregnant
  • Known participation in another clinical trial
  • Critical pulmonary state (paO2/FiO2 ratio <100)

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Study participantsEvoneIn intubated patients during CPAP ventilation, a conventional tube adapter (CTA, Ventinova Medical B.V., Eindhoven, The Netherlands) will be connected to the tracheal tube for tracheal pressure measurement. Tracheal pressure measurements will be recorded directly from the respirator Evone (Ventinova Medical B.V., Eindhoven, The Netherlands) three times, as well as the corresponding airway pressure values from the Evita Infinity V500 respirator (Dräger Medical, Lübeck, Germany). Study related time points: T1: 10 minutes after insertion of the conventional tube adapter during CPAP without ventilator support T2: 10 minutes after T1 during CPAP with activated automatic tube compensation (ATC) T3: 10 minutes after T2 during CPAP with assisted spontaneous breathing (ASB) of 4 cmH2O
Study participantsEvita Infinity V500In intubated patients during CPAP ventilation, a conventional tube adapter (CTA, Ventinova Medical B.V., Eindhoven, The Netherlands) will be connected to the tracheal tube for tracheal pressure measurement. Tracheal pressure measurements will be recorded directly from the respirator Evone (Ventinova Medical B.V., Eindhoven, The Netherlands) three times, as well as the corresponding airway pressure values from the Evita Infinity V500 respirator (Dräger Medical, Lübeck, Germany). Study related time points: T1: 10 minutes after insertion of the conventional tube adapter during CPAP without ventilator support T2: 10 minutes after T1 during CPAP with activated automatic tube compensation (ATC) T3: 10 minutes after T2 during CPAP with assisted spontaneous breathing (ASB) of 4 cmH2O
Primary Outcome Measures
NameTimeMethod
inspiratory tracheal pressure10 minutes after insertion of the tracheal pressure measurement catheter

The lowest tracheal pressure value, representing the highest inspiratory effort, will be recorded from the ventilator

Secondary Outcome Measures
NameTimeMethod
mean tracheal pressure10 minutes after insertion of the tracheal pressure measurement catheter

The mean tracheal pressure value will be calculated

peak tracheal pressure10 minutes after insertion of the tracheal pressure measurement catheter

The highest tracheal pressure value will be recorded

inspiratory tracheal pressure during automatic tube compensation (ATC)10 minutes after adding ATC

Effect of a mild respiratory support in terms of automatic tube compensation (ATC) on inspiratory tracheal pressure will be evaluated.

inspiratory tracheal pressure during assisted spontaneous breathing (ASB)10 minutes after adding ASB

Effect of a mild respiratory support in terms of assisted spontaneous breathing (ASB) with 4 cmH2O on inspiratory tracheal pressure will be evaluated.

Trial Locations

Locations (1)

Medical University of Innsbruck

🇦🇹

Innsbruck, Tyrol, Austria

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