Respiratory Mechanics Assessment at Different Head of the Bed Elevations in Mechanically Ventilated Patients
NCT06409897 · Status: RECRUITING · Phase: NA · Type: INTERVENTIONAL · Enrollment: 40
Last updated 2024-05-10
Summary
The effects of different degrees of head-of-bed elevation on respiratory mechanics are poorly explored in the literature, and no study has investigated such effects using electrical impedance tomography, esophageal and gastric balloons to identify the ideal angle for optimizing respiratory mechanics. The hypothesis is that there is a optimal degree for the respiratory mechanics.
Conditions
- Respiratory Failure
- Pulmonary Disease
Interventions
- OTHER
-
Sequencial increasing of head of the bed elevation and alveolar recruitment maneuver followed by a PEEP titration with 10° of head of the elevation
Patients will be sequentially positioned at 0, 10, 20, 30, and 40 degrees of head-of-bed elevation. An alveolar recruitment maneuver will be performed. For patients with body mass index ≤ 30 kg/m\^2, the maneuver will be conducted in pressure control mode, pressure control = 15 cmH2O, respiratory rate = 20 breaths per minute, and the PEEP will be increased in steps of 5 up to 30 cmH2O. For patients with body mass index \> 30, the PEEP will be increased up to 35. Then, a PEEP titration will be performed, tidal volume = 5 mL/Kg, respiratory rate = 25 breaths per minute, and the PEEP will be decreased from 24 down to 4 cmH2O in steps of 2 cmH2O with 30 seconds in each PEEP level. The PEEP titration software of Enlight 2100 will be used to determine the ideal PEEP, defined as the PEEP level with a collapse less than 5%. The alveolar recruitment maneuver will be performed again to reopen the lungs. Then, data will be collected, as with the 0 and 40-degree steps, with ideal PEEP.
Sponsors & Collaborators
-
University of Sao Paulo General Hospital
lead OTHER
Principal Investigators
-
Marcelo BP Amato, MD, PhD · University of Sao Paulo General Hospital
Study Design
- Allocation
- NA
- Purpose
- BASIC_SCIENCE
- Masking
- NONE
- Model
- SINGLE_GROUP
Eligibility
- Min Age
- 18 Years
- Sex
- ALL
- Healthy Volunteers
- No
Timeline & Regulatory
- Start
- 2023-10-15
- Primary Completion
- 2025-04-01
- Completion
- 2025-04-01
Countries
- Brazil
Study Locations
More Related Trials
-
Analysis of Advanced Physiological Ventilatory Parameters During Spontaneous Breathing Effort in Patients with Acute Hypoxemic Respiratory Failure
NCT06490523 ·Status: COMPLETED
-
Ventilator Mode and Respiratory Physiology
NCT06624254 ·Status: ENROLLING_BY_INVITATION
-
Criteria Analysis for Ventilatory Support Adjustment of Mechanical Ventilation
NCT02743624 ·Status: COMPLETED ·Phase: NA
-
Hemodynamic Effects of Two Modalities of Alveolar Recruitment Maneuvers - ICU Patients
NCT05365854 ·Status: UNKNOWN ·Phase: NA
-
Position and Esophageal Pressure
NCT02816359 ·Status: COMPLETED ·Phase: NA
-
Effects of Non-invasive Ventilation on Function Diaphragmatic and Caval Distension
NCT06384027 ·Status: COMPLETED ·Phase: NA
-
Effectiveness of Preoxygenation With Positive Airway Pressure: a Comparison of the Supine and 25° Head up Position
NCT03861949 ·Status: COMPLETED ·Phase: NA
-
Distribution of Ventilation, Respiratory Drive and Gas Exchange: Measurements and Monitoring
NCT05462600 ·Status: ENROLLING_BY_INVITATION
-
GapCO2 and Respiratory Rate in Patients Under Volume Mechanical Ventilation
NCT02867943 ·Status: UNKNOWN
-
Optimizing Intraoperative Mechanical Ventilation Using EIT-titrated PEEP
NCT02314845 ·Status: COMPLETED ·Phase: NA
-
Prone Positioning and Abdominal Binding on Lung and Muscle Protection in ARDS Patients During Spontaneous Breathing
NCT05826847 ·Status: RECRUITING ·Phase: NA
-
Physiological Response and Experience Between Sitting in Bed and Sitting in a Chair in ICU
NCT05118529 ·Status: COMPLETED ·Phase: NA
-
Impact of Decreasing Respiratory Rate on Lung Injury Biomarkers in ARDS Patients
NCT04641897 ·Status: COMPLETED ·Phase: NA
-
Position of Esophageal Balloon in Patients With Mechanical Ventilation
NCT02446938 ·Status: COMPLETED
-
Positive End-expiratory Pressure and Esophageal Catheter Optimal Calibration Volume in ARDS Patients
NCT02945917 ·Status: UNKNOWN
-
Effect of PP in Patients With Ultra-low VT
NCT06215209 ·Status: RECRUITING
-
Reverse Trendelenburg Position Versus Semi-recumbent Position in Obese Critically Ill Patients
NCT04376047 ·Status: COMPLETED ·Phase: NA
-
Effect of End-inspiratory Pause on Gas Exchange During Mediastinal Mass Excision With CO2 Insufflation and One-lung Ventilation
NCT06956079 ·Status: NOT_YET_RECRUITING ·Phase: NA
-
Effects of Different I:E Ratio on Intrapulmonary Shunt Fraction and Oxygenation During One Lung Ventilation in the Lateral Decubitus Position
NCT01499212 ·Status: COMPLETED ·Phase: NA
-
Effect of Continuous Prolonged Prone Position Versus Intermittent Daily Prone Position in ARDS
NCT06854627 ·Status: RECRUITING ·Phase: NA
-
The Effect of High Frequency Percussive Ventilation on Cerebral Tissue Oxygenation
NCT02545803 ·Status: UNKNOWN ·Phase: NA
-
Effects of Chest Wall Elastance on Pulmonary Mechanics of Acute Respiratory Failure (ARF)
NCT02196870 ·Status: COMPLETED
-
Heart Rate Variability During Weaning From Mechanical Ventilation
NCT00851825 ·Status: COMPLETED
-
Ventilation and Esophageal Pressure Changes
NCT05859672 ·Status: COMPLETED
-
Effect of the Steep Trendelenburg Position on Respiratory Gas Heat Content
NCT02153164 ·Status: COMPLETED