CompletedNot Applicable

Pulmonary and Ventilatory Effects of Trigger Modulation in Intubated ICU

France30 participantsStarted 2019-04-03

Plain-language summary

Pressure support ventilation allows intubated ICU patients to breathe spontaneously. Among specific settings, the adjustment of the trigger value (or threshold for triggering the ventilator) has not been explored to date. The trigger threshold corresponds to the sensitivity of the ventilator to detect patient's inspiratory effort and then deliver the predefined pressure support to inflate the lungs and deliver a tidal volume. The purpose of this study is to explore the influence of trigger level on pulmonary and ventilatory physio (-patho)logical parameters in spontaneously breathing ICU patients.

Who can participate

Age range18 Years

SexALL

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Inclusion Criteria: * Age ≥18 years * Patient hospitalized in the Intensive Care Unit of Clermont-Ferrand's Hospital * Patients with mechanical invasive ventilation in spontaneous ventilation with inspiratory support (intubation or tracheostomy) * Trigger level set to minimum * Patient under sedation compatible with spontaneous ventilation (SV) with inspiratory support (AI) and positive end-expiratory pressure (PEP) Patient calm (RASS between -2 and 0) Consent for participation or consent from patient's next of kin or inclusion according to an emergency procedure Patient benefiting from the French social security scheme Exclusion Criteria: * Refusal to participate in the proposed study * Contraindication to the installation of a nasogastric tube: * Severe disorder of uncorrected blood clotting * Known nasosinus lesion * Oesophageal varices recently ligated (\<48h) * Contraindication to the use of the electro-impedancemetry technique by tomography * Thoracic lesions * Chest dressings * Pace-maker / Implantable Defibrillator * Known lesion of central respiratory centers, including patients with neurological injury * Patients with Acute Respiratory Distress Syndrome (according to Berlin criteria) * Patients with restrictive or obstructive pulmonary pathology * Patients admitted post-operatively for surgery that may affect the diaphragmatic function ( thoracic or abdominal supra-mesocolic) * Patients with abdominal distention (ileus, intra-abdominal hyperpressure…

What they're measuring

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T0 (before the first trigger step)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T15 minutes (last minute of the trigger step n°1)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T30 minutes (last minute of the trigger step n°2)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T45 minutes (last minute of the trigger step n°3)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T60 minutes (last minute of the trigger step n°4)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T75 minutes (last minute of the trigger step n°5)

Lung volume (end expiratory lung volume, EELV) at each trigger level

Timeframe: T90 minutes (last minute of the trigger step n°6)

Trial details

NCT IDNCT04041817

SponsorUniversity Hospital, Clermont-Ferrand

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2023-01-31

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