Evaluation of Intracranial Pressure Change by Measuring Optic Nerve Sheath Diameter During Lung Recruitment Maneuver in Patients With Acute Respiratory Distress Syndrome: A Prospective Experimental Study
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 81
- 试验地点
- 1
- 主要终点
- Effect of recruitment maneuver on optic nerve sheath diameter (ONSD)
研究概览
简要总结
Recruitment maneuver is used to reopen atelectasis alveoli. Positive airway pressure applied during the recruitment maneuver may increase intrathoracic pressure, resulting in hemodynamic instability, venous return disorders, and increased intracranial pressure. Our study will examine the effect of recruitment maneuver on intracranial pressure by evaluating Optic Nerve Sheath Diameter change.
详细描述
The therapeutic goal of mechanical ventilation shifts from maintaining regular gas exchange to preventing ventilator-induced lung injury. Atelectasis aggravates lung injury by reducing the lung size available for tidal ventilation. By preventing atelectasis with Positive End Expiratory Pressure (PEEP) and recruitment maneuvers, the end-expiratory lung volume can be increased, and lung damage can be reduced.
Although the recruitment maneuver improves oxygenation and reduces mortality, especially in patients with Acute Respiratory Distress Syndrome (ARDS), adverse side effects are sometimes observed. Most important of these are the risk of barotrauma after positive airway pressure applications, increased intrathoracic pressure and hemodynamic instability, and increased intracranial pressure risk after venous return disorder.
Our study aimed to evaluate the effect of recruitment maneuver on intracranial pressure by measuring optic nerve diameter with ultrasound before and after its application in patients with ARDS with impaired oxygenation and followed up with mechanical ventilator support.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Supportive Care
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 90 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients older than 18 years
- •Patients followed in the Intensive Care Unit (ICU)
- •Patients on mechanical ventilation support
- •Patients diagnosed with ARDS according to the Berlin criteria
- •Patients with oxygen saturation (SpO2) ≤ 92%
排除标准
- •Younger than 18
- •Patients with increased inotropic drug requirement or mean arterial pressure <65 mmHg in the last 2 hours
- •Patients with intracranial hypertension
- •Patients with acute coronary syndrome
- •Patients with hypercapnia, pneumothorax, subcutaneous emphysema, and pneumomediastinum
研究组 & 干预措施
Effect of recruitment maneuver on intracranial pressure
A recruitment maneuver will be performed in patients with decreased oxygen saturation due to atelectasis by applying 30 cm H2O positive pressure support for 30 seconds. The effect of the recruitment maneuver on intracranial pressure will be investigated by measuring the optic nerve sheath diameter with the help of ultrasonography before and after the recruitment maneuver.
干预措施: The recruitment maneuver (Diagnostic Test)
结局指标
主要结局
Effect of recruitment maneuver on optic nerve sheath diameter (ONSD)
时间窗: 1 minute
Change in optic nerve sheath diameter (ONSD) after the recruitment maneuver in acute respiratory distress syndrome (ARDS) patients
次要结局
- Effect of recruitment maneuver on oxygen saturation (SpO2)(10 minute)
- The effect of change of respiratory compliance (Cdyn) on optic nerve sheath diameter (ONSD) after the recruitment maneuver(10 minute)
- Effect of recruitment maneuver on respiratory compliance (Cdyn)(10 minute)
研究者
Ozgur Komurcu
Assistant professor
Ondokuz Mayıs University