A New Method for Estimating Dynamic Intrinsic PEEP

IRCCS Azienda Ospedaliero-Universitaria di Bologna10 enrolled

Overview

Dinamic intrinsic PEEP is

Dynamic intrinsic positive end-expiratory pressure (PEEPi dyn) play an important pathophysiology role in many acute respiratory pathologies. The most accurate method to quantify PEEPi dyn is to measure the rise in transdiaphragmatic pressure (Pdi) at end expiration at the point of the contraction of the inspiratory muscles until inspiratory flow starts. Such method, however, is invasive, poor comfortable and require patient active collaboration. The purpose of this study is describe a new non-invasive method for estimate PEEPi dyn and validate this method with gold-standard-one.

Study Type

OBSERVATIONAL

Enrollment

Conditions

PEEP, Intrinsic PEEP, Occult Respiratory Insufficiency

Interventions

diaphragm ecographyDEVICE

recording of diaphragm ecography

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Acute or chronic respiratory failure * Age \>=18 y Exclusion Criteria: * Lack of informed consent * Controindication to the placement of oesophageal and gastric catheter: esophageal varices, gastric or oesophageal bleeding in the previous 30 days, gastric or oesophageal surgery in the preceding year. * Cardiac arrest * Severe emodinamic instability (\> 1 vasoacttive drug) * Acute coronary syndrome (AMI/UA) * Inability to protect airway * Respiratory arrest * Pregnancy suspected or confirmed * Diaphragm palsy * Curarization in the preceding five hours * Mechanical ventilation in controlled mode.

Locations (1)

Sant'Orsola Malpighi

Bologna, Italy

Outcomes

Primary Outcomes

Correlation and agreement between AutoPEEP recorded with the transdiaphragmatic pressure (Pdi) vs ecography measurements.

Time frame: 20 minutes

Secondary Outcomes

Correlation and agreement between neural inspiratory time and ecographic inspiratory time

Time frame: 10 minutes

Inter-rater agreement to assest method reliability

Time frame: 10 minutes

Data from ClinicalTrials.gov

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