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临床试验/NCT04451421
NCT04451421Unknown不适用

Effects of Standing at Different Angles on Transpulmonary Pressure

Chinese PLA General Hospital0 个研究点目标入组 50 人开始时间: 2020年10月1日最近更新:
适应症

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

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

发起方
Chinese PLA General Hospital
申办方类型
Other
责任方
Principal Investigator
主要研究者

wang kaifei

Director

Chinese PLA General Hospital

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