Evaluation of Regional Ventilation Distribution Using Electrical Impedance Tomography During Weaning From Mechanical Ventilation

Università degli Studi di Ferrara30 enrolled

Overview

The goal of this physiological cross-over clinical trial is to evaluate the effect of different clinically used weaning trials on regional mechanical ventilation in a population of patients undergoing weaning from mechanical ventilation for acute respiratory failure. The main question\[s\] it aims to answer are: * to evaluate which weaning trial is associated to a better regional ventilation distribution * to evaluate which weaning trial can be comparable to ventilation distribution after extubation Participants will undergo 3 clinically used weaning trials in a random order (cross-over trial). Researchers will compare the different steps to see if regional ventilation distribution is different among the different trial .

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

DIAGNOSTIC

Masking

DOUBLE

Enrollment

Conditions

Acute Respiratory Failure Mechanical Ventilation Complication Ventilator-Induced Lung Injury Weaning Failure

Interventions

Weaning trial - Low support, high Positive end-expiratory pressureDIAGNOSTIC_TEST

The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with low pressure support ventilation and a positive end expiratory pressure of 5 cmH2O

Weaning trial - Low support, zero positive end-expiratory pressureDIAGNOSTIC_TEST

The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with low pressure support ventilation and a positive end expiratory pressure of 0 cmH2O

Weaning trial - Zero support, zero positive end-expiratory pressureDIAGNOSTIC_TEST

The researcher will evaluate the readiness to be weaned of the patient using a weaning trial with 0 pressure support ventilation and a positive end expiratory pressure of 0 cmH2O

Eligibility

Sex: ALLMin age: 18 YearsMax age: 70 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age \> 18 and \< 70 years * Ready to be weaned from mechanical ventilation according to clinical criteria Exclusion Criteria: * Age \< 18 years or \> 70 years * Presence of chest drains * Presence of pacemaker/impantable cardiac device; * diagnosis of Pneumothorax, or pneumomediastinum * Diagnois of neuromuscular diseases * Use of neuromuscular blockers in the 48 hours before screening; * Body mass index \> 35 kg/m2 * Refusal to participate of the patient/next of kin

Outcomes

Primary Outcomes

Regional Ventilation distribution using Electrical Impedance Tomography

The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials using Electrical Impedance Tomography and focusing on: * Regional ventilation distribution * Regional inhomogeneity * Regional compliance distribution * Center of Ventilation * Silent Spaces

Time frame: 2 hours

Secondary Outcomes

Differences in Regional Ventilation distribution using Electrical Impedance Tomography between weaning trials and post-extubation phase

The researchers will evaluate differences in ventilation distribution pattern among the different weaning trials and the post-extubation phase using Electrical Impedance Tomography and focusing on: * Regional ventilation distribution * Regional inhomogeneity * Regional compliance distribution * Center of Ventilation * Silent Spaces

Time frame: 48 hours