Esophageal balloon calibration (EBC) has been proposed during controlled mechanical ventilation in intubated patients in order to optimize esophageal pressure (Pes) signal. Actually, at our knowledge, no data exist about EBC during assisted ventilatory modes such as Pressure Support Ventilation (PSV). The primary endpoint of the present investigation is to assess the feasibility of EBC during PSV and PSV plus Sigh.
Assisted ventilatory modes, nowadays, have been proved to reduce complications related to controlled mechanical ventilation. With these modes, ventilatory cycling is under the patient's control to an extent depending on the type of ventilatory modality. Sigh improves oxygenation and lung mechanics during pressure control ventilation and pressure support ventilation (PSV) in patients with acute respiratory distress syndrome. In order to better quantify the effects of both PSV and PSV plus Sigh on respiratory mechanics, the esophageal pressure monitoring could be helpful. However, esophageal pressure (Pes) assessment requires esophageal ballon calibration (EBC) as demonstrated in intubated patients under controlled mechanical ventilation. At our knowledge, no data exist about EBC during assisted ventilatory modes. The primary aim of the present study is to evaluate the effects of PSV and PSV plus Sigh ventilation on esophageal balloon best volume in patients admitted to the intensive care unit for acute respiratory failure. .
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
20
After definitive catheter positioning, esophageal balloon calibration will be performed in: 1. volume-controlled mode with tidal volume set to obtain 6-8 lm/kg of ideal body weight (reference), 2. pressure support ventilation (PSV) with support set to obtain a tidal volume ranging between 6-8 ml/kg of ideal body weight at equal PEEP of volume control mode (PSV baseline); 3. PSV + sigh ventilation (sigh setting: total inspiratory pressure equal to 35 cmH2O at a rate of 1/ minute; inspiratory time equal to 4 seconds).
A.O.U Maggiore della Carità
Novara, Italy
Effects of ventilatory mode on calibrated esophageal ballon best volume
Evaluation of changes of esophageal balloon best volume (ml) induced by ventilatory modes
Time frame: Over 120 minutes in PSV
Number of patients in who esophageal balloon calibration is performed (feasibility) during PSV + Sigh
Evaluate the feasibility of esophageal catheter calibration during assisted ventilation modes during PSV + Sigh
Time frame: Over 30 minutes in PSV + Sigh
Changes of respiratory mechanics indices in PSV
lung, chest wall and respiratory system elastance (cmH2O/l)
Time frame: over 30 minutes in PSV
Changes of respiratory mechanics indices in PSV + sigh
lung, chest wall and respiratory system elastance (cmH2O/l)
Time frame: over 30 minutes in PSV + Sigh
Gas exchange
PaCO2, Ph and blood oxygenation (PaO2) will be obtained performing ABGs.
Time frame: over 30 minutes during each trial
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.