Epidemiology and Treatment Strategy of Open Respiratory Phenotype in Critically Ill Patients

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorSoutheast University, China

About this trial

Monitoring airway pressure is essential for patients with mechanical ventilation. However, static airway pressure does not reflect alveolar pressure at all. Airway pressure is supposed to completely interrupt the communication between proximal airway opening and the distal alveolar and/or small airway structures. In this condition, some alveoli may still be inflated but do not communicate with proximal airways and auto-PEEP will give a biased estimated of mean alveolar pressure. To be note, distinguishing the airway closure and alveolar collapse can be challenging at times. The quasi-static PV curve is a useful bedside tool to set mechanical ventilation, which may help us to identify the airway closure and alveolar collapse. Meanwhile, the quasi-static PV curve can only reflects a global behaviour of the lung, while EIT may be a useful tool to assess the regional information on airway closure and alveolar collapse.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Adult patients undergoing controlled mechanical ventilation

The duration of endotracheal intubation < 48 hrs

Disqualifiers

Severe hemodynamic instability

Severe chronic lung disease requiring long-term home oxygen therapy

Patients without analgesic sedation

Decline to participate in the study

Trial design

Design model

Single group

Treatments tested in this trial

  • pressure-volume curve with a low-flow insufflation of 5 L/min

    Other intervention

    The patient undergoes a pressure-volume curve with a low-flow insufflation of 5 L/min while in a state of analgesia, sedation, and absence of spontaneous breathing.

Treatment groups

60 Participants
are divided into 1 treatment group
Group A: P-V curve groupExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

the rate of airway closure and alveolar collapse

airway closure and alveolar collapse are monitored by PV curve with a low-flow insufflation of 5 L/min

Time frame
up to 24 hours
2

Phenotype of respiratory open pressure

According to the characteristics of the low inflation point of PV curve, the respiratory open pressure phenotype was constructed

Time frame
up to 24 hours

Secondary outcomes

1

respiratory system compliance

Respiratory system compliance is calculated as the ratio of tidal volume to the difference between plateau pressure and positive end-expiratory pressure.

Time frame
up to 24 hours

Other outcomes

Sponsors and contacts

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