Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Ventilation Distribution

Capital Medical University20 enrolled

Overview

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region.Decrease of flow trigger sensitivity might improve homogeneous of tidal volume distribution.

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region. High positive end expiratory pressure (PEEP) has been applied to improve the homogeneous distribution of ventilation by increasing the end expiratory lung ventilation (EELV) and alveolar recruitment. However, for patients who increasing PEEP in some extent still existed poor aeration in the dependent region, further elevating PEEP seems to be unreasonable that perhaps lead to overdistension. Decreasing trigger sensitivity might further evoke inspiratory efforts to improve the ventilation for this type of patients.The Electrical impedance tomography (EIT) was applied in monitoring the regional ventilation distribution at the bedside.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Mechanical Ventilation

Interventions

flow triggerPROCEDURE

The flow trigger will be adjust during the pressure assist ventilation.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. The post operative patients who received pressure support ventilation; 2. After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity. Exclusion Criteria: 1. Under 18 years; 2. History of diaphragm dysfunction and surgery; 3. Central respiratory drive dysfunction; 4. history of esophageal, gastric or lung surgery; 5. The contraindication of using EIT (pacemaker, defibrillator, and implantable pumps).

Locations (1)

Jian-Xin Zhou

Beijing, Beijing Municipality, China

Outcomes

Primary Outcomes

The homogeneity of distribution of tidal volume

EIT was used to monitoring the homogeneity of distribution of tidal volume that was divided into two contiguous regions of interest (ROI) equally, the dependent and non-dependent area. The ratio of relative distribution of tidal ventilation of two ROI was calculated.

Time frame: within 20 minutes after changing flow trigger

Secondary Outcomes

Changes in global and regional EELV

The change of EELV was measured after changing flow trigger based on the baseline level.

Time frame: within 20 minutes after changing flow trigger

Data from ClinicalTrials.gov

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