Visualization of Inspiratory Effort and Respiratory Mechanics to Promote Lung- and Diaphragm Protective Ventilation
University Hospital, Antwerp
150 participants
Sep 21, 2022
INTERVENTIONAL
Conditions
Summary
This is a multicentre prospective cohort trial in adult and pediatric ICU patients. The investigators will measure the effect of a patient's inspiratory effort during mechanical ventilation on the lungs and diaphragm. The investigators will daily (for a maximum of 8 days) measure esophageal pressures with a balloon catheter to quantify inspiratory effort and respiratory muscle function, and perform daily ultrasound measurements of the diaphragm and the lungs. The investigators hypothesize that a small inspiratory effort will result in the preservation of diaphragm function and have no adverse effect on lung function.
Eligibility
Inclusion Criteria4
- age \> 28 days
- weight \> 3kg
- requiring invasive mechanical ventilation
- anticipated length of ventilation \> 48h
Exclusion Criteria4
- refusal of consent
- mechanical ventilation ≤ 2 weeks before inclusion
- known anatomical malformation of the diaphragm (including congenital diaphragmatic hernia)
- contra-indication to the placement of a naso-gastric esophageal balloon catheter
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Interventions
A nasogastric balloon catheter will be inserted after inclusion. This will be a NutriVent (Sidam S.R.L., Mirandola, Italy) for patients \>40kg, and a SmartCath Esophageal pressure catheter (Vyaire/Carefusion) for patients \<40kg. This placement is similar to a standard nasogastric tube placement, which is a common procedure in an ICU. Potential minor side effects include a nosebleed, sore throat and erosion of the nose where the tube is anchored. All patients will receive this intervention. When the esophageal catheter becomes displaced or is accidentally removed during the study period, it will be replaced.
Locations(3)
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NCT05459116