Pressure Controlled Ventilation Versus Pressure Support Ventilation During the Night: New Strategy of Mechanical Ventilation Weaning?
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 19
- 试验地点
- 1
- 主要终点
- Weaning duration
研究概览
简要总结
The purpose of the study is to compare pressure controlled continuous mandatory ventilation versus pressure support ventilation during the night for weaning to mechanical ventilation in chronic obstructive pulmonary disease patients and their impact onto sleep quality.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •The patient and/or legal representative of the patient has provided a written informed consent before inclusion in the study
- •The patients is hospitalized in respiratory and critical care unit (university hospital of AMIENS, FRANCE)
- •the patient is mechanically ventilated (ventilator model : puritan-bennett B840)
- •Pulmonary disease,chronic obstructive (Spirometry and Blood Gas Analysis in chronic state before admission)
- •stable cardiovascular status (cardiac frequency < 140 beats/min and systolic blood pressure : 90-160 mmHg without catecholamines)
- •midazolam < 0,05mg/kg/h
- •sufentanyl < 0,05µ/kg/h
- •the disorder that caused respiratory failure and prompted mechanical ventilation is treated
- •the clinician suspects the patient may be ready to begin the weaning process
- •inspiratory oxygen fraction (FiO2) < 50%
- •positive end-expiratory pressure < or equal 8cmH2O
- •during the day, the patient tolerate pressure support ventilation (pressure support level < 15cmH2O
- •respiratory frequency (FR) < 35 breaths/min
- •tidal volume (VT) > 5ml/kg
- •PaO2/FiO2 > 200 mmHg
- •FR/VT < 105 breaths/min/L
排除标准
- •sleep apnea, central
- •narcolepsy
- •Encephalopathy, Metabolic AND Encephalitis
研究组 & 干预措施
Pressure support ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure support ventilation mode. The level of the pressure support is the same as the previous day.
During the day (9 AM to 10 PM), patients are ventilated with pressure support ventilation (the level of pressure support is progressively decreased).
干预措施: pressure support ventilation (Other)
Pressure controlled ventilation
Patients in this group are ventilated during the night (10 PM to 9 AM) with pressure controlled ventilation mode. The level of inspiratory pressure is set to 20 cm H2O and the respiratory rate is adjusted to avoid any spontaneous breathing (respiratory rate > or equal to 12 breath per min). During the day (9 AM to 10 PM), patients are ventilated with pressure support ventilation (the level of pressure support is progressively decreased).
干预措施: Pressure controlled ventilation (Other)
结局指标
主要结局
Weaning duration
时间窗: between one to 21 days (the study will begin when patient presents weaning criteria and will stop 48 days after extubation.)
weaning duration in days (from the first day with spontaneous ventilation to extubation)
次要结局
- weaning failure(48 hours)
- Quantity and quality of sleep(1 to 21 days)