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The Effect of Positive End-Expiratory Pressure on Functional Residual Capacity During Mechanical Ventilation

China30 participantsStarted 2020-08-01

Plain-language summary

Although positive end-expiratory pressure (PEEP) has been widely used in mechanical ventilated patients with acute respiratory distress syndrome (ARDS), how to select the "optimal" PEEP is far from consensus. The application of PEEP may result in beneficial effect by recruiting previously collapsed lung areas, harmful effect by over-distending previously aerated lung areas, or a combination of the both. The net effect of PEEP in a certain patient may depend on the recruitability. Because recruitability varies extremely in ARDS patients and strongly correlates with the response to PEEP, estimation of end-expiratory lung volume (EELV) may be essential for individualized setting of PEEP. Whether the FRC changes at different PEEP levels remains unknown.

Who can participate

Age range18 Years – 80 Years

SexALL

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Inclusion criteria

✓. Diagnosed with ARDS according to the Berlin Definition;
✓. Age 18-80 years;
✓. Ventilated with volume-controlled ventilation using constant flow;
✓. Deep sedation (RASS -4 to -5) and absence of spontaneous breathing (i.e., no triggering during tidal breaths and no inspiratory effort during a 5-second end-expiratory hold).

Exclusion criteria

✕. Evidence of active air leak from the lung, including bronchopleural fistula, pneumothorax, pneumomediastinum, or existing chest tube;
✕. Chest wall and/or abdominal injuries;
✕. Evidence suggesting reduced chest wall compliance, such as existing large pleural effusion, thoracic trauma and intra-abdominal hypertension (i.e., intra-abdominal pressure \> 20 mmHg).
✕. Presence of pacemaker, defibrillator, and implantable pumps).

What they're measuring

The change of FRC

Timeframe: 1) One hour after using clinical PEEP 2) One hour after using clinical PEEP + 5cmH2O

Trial details

NCT IDNCT03511651

SponsorCapital Medical University

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2021-02-28

Contact for this trial

Jian-Xin Zhou, MD

8610 67096579 zhoujx.cn@icloud.com

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