Use of 'Mechanical Power' as a Predictor of Increased Serum and Pulmonary Proinflammatory Cytokine Concentrations in Patients With Acute Hypoxemic Respiratory Failure: A Prospective Observational Study

University of Roma La Sapienza150 enrolled

Overview

The aim of this study is to report the proportion of patients with acute hypoxemic respiratory failyre (AHRF) undergoing mechanical ventilation who exceed 17 J/min of mechanical power (MP) and the difference in terms of proinflammatory cytokine concentration in blood samples and bronchoalveolar lavage. The main questions it aims to answer are: 1. Which is the proportion of patients who exceed 17 J/min of mechanical power (MP) during the first 72 hours of mechanical ventilation? 2. Is there a difference in terms of cytokine concentration in patients undergoing mechanical power \>17 J/min compared to \<17 J/min? Patients will be divided into two groups based on respiratory mechanics measurements: low MP group (average MP \<17 J/min) and high MP group (average MP ≥17 J/min). The researchers will collect blood and BAL samples and perform cytokine assays.

Study Type

OBSERVATIONAL

Enrollment

150

Conditions

Mechanical Power

Interventions

Mechanical ventilationDEVICE

Mechanical ventilatiom

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with AHRF (P/F \<300 mmHg) undergoing invasive mechanical ventilation within 7 days from the onset of symptoms * Invasive mechanical ventilation for less than 6 hours * Evidence of newly developed lung consolidation on chest imaging (X-ray, CT) * Age ≥18 years Exclusion Criteria: * Prior invasive mechanical ventilation during the same hospitalization * Tracheostomy * Severe anemia (Hb\<7g/dL) * Severe neutropenia * Renal insufficiency or RRT (Renal Replacement Therapy) * Noradrenaline \>0.5 mcg/kg/min * Pregnancy * Extracorporeal circulation (ECCO2R, ECMO) * Life expectancy \<24 hours as clinically judged * Lack of consent

Outcomes

Primary Outcomes

Patients who exceed 17 J/min of MP

Proportion of patients with AHRF undergoing mechanical ventilation who exceed 17 J/min of MP

Time frame: 4 years

Secondary Outcomes

Inflammatory cytokines

Difference in terms of proinflammatory cytokine concentration in blood samples and bronchoalveolar lavage.