Acute respiratory distress syndrome (ARDS) in children is associated with significant morbidity and mortality. Current studies seek to individualize the management of children by defining several phenotypes, based until now mainly on clinical presentation. A better understanding of the respiratory mechanics of each patient could allow the individualization of other phenotypes and adapt their management with individualized ventilation. The method for detecting airway opening pressure (AOP) in children has not yet been validated and the reference methods in adults are difficult to apply in children due to their physiological particularities. The main objective of the study is to evaluate the feasibility of two methods for measuring airway opening pressure in invasively ventilated pediatric patients.
Acute respiratory distress syndrome (ARDS) in children is associated with significant morbidity and mortality. Current studies seek to individualize the management of children by defining several phenotypes, based until now mainly on clinical presentation. A better understanding of the respiratory mechanics of each patient could allow the individualization of other phenotypes and adapt their management with individualized ventilation. The method for detecting airway opening pressure (AOP) in children has not yet been validated and the reference methods in adults are difficult to apply in children due to their physiological particularities. The main objective of the study is to evaluate the feasibility of two methods for measuring airway opening pressure in invasively ventilated pediatric patients: "pediatric slow flow method" based on a recent bench study and "fixed flow method" based on an adult study. The two methods will be separated by a wash out. The method will be considered feasible if at least one on three measures can be interpretated. Air flow will be recorded using a pneumotachograph connected to a T piece.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
50
Measurement of airway opening pressure in invasively ventilated pediatric patients with 2 methods, "fixed flow method" and "pediatric slow flow method". The two methods will be separated by a washout period. The order of the airway opening pressure detection methods will be random.
Hôpital Necker-Enfants Malades
Paris, France
RECRUITINGFeasibility of the two methods of measuring airway opening pressure
The method will be considered feasible if at least one maneuver out of three allows a measurement of the airway opening pressure to be obtained.
Time frame: 5 years
Prevalence of airway opening pressure
Estimation of the prevalence of airway opening pressure during pediatric acute respiratory distress syndrome.
Time frame: 5 years
Value of airway opening pressure with each of the two measurement methods
Value of airway opening pressure with each of the two measurement methods of the study
Time frame: 1 day
Value of Positive end-expiratory pressure settled by the clinican and measured airway opening pressure
Value of Positive end-expiratory pressure settled by the clinican and measured airway opening pressure
Time frame: 1 day
Description of the tolerance of the two methods of measuring airway opening pressure
Description of the tolerance of the two methods of measuring airway opening pressure using the following parameters: minimum SpO2 value (%), variations in heart rate (HR, /min), systolic ans diastolic blood pressure (mmHg), expired CO2 (mmHg).
Time frame: 5 years
Duration of the methods
Duration of each method
Time frame: 5 years
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