Effects of Standing at Different Angles on Transpulmonary Pressure
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 50
- 主要终点
- transpulmonary pressure
研究概览
简要总结
Effects of standing at different angles on transpulmonary pressure
详细描述
Objective
To study the effect of different standing angles on cross-lung pressure.Background: Long-term bed rest in ICU patients leads to upward movement of diaphragm and increased intrathoracic pressure in mechanically ventilated patients, resulting in lower cross-lung pressure. If the end-expiratory cross-lung pressure is negative, lung tissue compression and atelectasis will occur.Standing can lower the diaphragm, improve the pressure across the lungs, and improve ventilation.Selection methods: patients with invasive mechanical ventilation in the ICU, on the premise of stable hemodynamics, with the aid of electric bed training in standing in different angles, start from 20 degrees, 5 degrees up every five minutes, the largest up to 80 degrees, each Angle across the pulmonary pressure, die cavity ratio, tidal volume and breathe out carbon dioxide at the end of the record, and record whether low blood pressure, an accident in the process of take off the tube and other adverse reactions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 95 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The age is ≥ 18 years old;
- •the hemodynamics is stable;
- •50 < heart rate < 120 beats / min ;
- •90 < systolic blood pressure < 200mmHg ;
- •55 < mean arterial pressure < 120mmHg;
- •do not increase the dose of pressor drugs for at least 2 hours;
- •intracranial pressure is stable and there are no seizures within 24 hours;
- •the respiratory state is stable;
- •the patient's finger pulse oxygen saturation ≥ 88%;
- •10 < respiratory frequency < 35 beats / min.
排除标准
- •Pregnancy;
- •acute cardio-cerebrovascular events;
- •spinal or limb fractures;
- •active bleeding.
结局指标
主要结局
transpulmonary pressure
时间窗: 5 minutes
End-expiratory pressure across the lungs is recommended at 0-5cmH2O.
Esophageal pressure
时间窗: 5 minutes
The change in esophageal pressure represents the degree of inspiratory effort.The greater the variation, the harder the inhale.
Dead space rate
时间窗: 5 minutes
the smaller,the better
tidal volume
时间窗: 5 minutes
Standard tidal volume: standard weight based on height, 6 to 8ml per kg body weight
partial pressure of carbon dioxide in endexpiratory gas
时间窗: 5 minutes
The smaller the difference between pCO2 and arterial blood gas, the better
次要结局
- adverse reaction(an hour)
研究者
wang kaifei
Director
Chinese PLA General Hospital
