This multicentric prospective clinical practice study aims at evaluating risk factors associated with a prolonged mechanical ventilation and other outcomes such as barotrauma and ICU length of stay in patients with elevated initial mean airway pressure based on a remote ventilation monitoring system which records venlitor input and output data (including waveforms).
Brief Background: Evidence has accumulated that protective lung ventilation and the patient-ventilator interaction are related to the outcome of patients with lung injury. While most current studies focus on the static parameters and their association with outcomes, dynamic ventilation parameters may provide a more comprehensive assessment than static ones. Time-varying features of ventilator parameters should be paid more attention. Recently, we have developed a remote mechanical ventilation visualization network system (RemoteVentilateView) and, simultaneously, a related automatic recognition algorithm for different types of patient-ventilator asynchrony. This system enables ventilation data fully used. Our main focus is on patients who have an average airway pressure no less than 10 cmH2O upon admission to the ICU. This population has a higher ventilation intensity and may be more at risk of ventilator-induce lung injury than the average ICU patients. We aims to identify risks factors associated with a prolonged mechanical ventilation and other outcomes such as barotrauma in this specific population.
Study Type
OBSERVATIONAL
Enrollment
400
Invasive mechanical ventilation for patients admitted to the ICU
Peking Union Medical College Hospital
Beijing, Beijing Municipality, China
RECRUITINGQilu Hospital of Shangdong University
Jinan, Shandong, China
NOT_YET_RECRUITINGSichuan Provincial People's Hospital
Chengdu, Sichuan, China
NOT_YET_RECRUITINGliberation from MV at day 7
liberation from MV was defined as no need for MV at least 24 consecutive hours.
Time frame: 7 days
Duration of mechanical ventilation and 28 days ventilator free days
Ventilator-free days (VFDs) were defined as a time frame of 28 days from intubation. For intubated patients, in caseof reintubation within 28 days, VFDs were counted from the last successful extubation. The use of non-invasive ventilation (NIV) after extubation was not considered as a ventilation period. Finally, zero VFDs were assigned to 28-day non-survivors, regardless of their intubation status.
Time frame: 28 days
Barotrauma
We consider as barotrauma within 7 days any pneumothorax, pneumomediastinum, subcutaneous emphysema or pneumatocele \> 2cm detected on image exams between inclusion and 7 days, except those judged to be clearly caused by invasive procedures.
Time frame: 7 days
28-day Mortality
Time frame: 28 days
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Shanghai Tenth People's Hospital
Shanghai, China
NOT_YET_RECRUITING