Effects of Nasal Ventilation on Cerebral and Pulmonary Function in Orally Intubated Patients
Assistance Publique - Hôpitaux de Paris
22 participants
Jan 31, 2025
OBSERVATIONAL
Conditions
Summary
The passage of air through the nasal cavity generates rhythmic oscillations transmitted by the olfactory bulb to the brain, which induces cerebral activation in functional areas and is associated with better cognitive performance compared to oral breathing. Consequently, the abolition of nasal ventilation in patients intubated via the orotracheal route could have deleterious effects on brain activity. Besides the loss of olfaction, the abolition of nasal ventilation could affect brain activity and respiratory control, consequently altering regional pulmonary ventilation. The hypothesis of the study is that nasal ventilation through the passage of humidified nasal airflow in patients intubated via the orotracheal route would be associated with modulation of cerebral electrical activity and tissue oxygenation and a modification of regional pulmonary ventilation.
Eligibility
Inclusion Criteria7
- Age ≥ 18 years old
- Hypoxemic acute respiratory failure
- Intubation and mechanical ventilation since less than 4 days
- PaO2/FiO2 ratio less than 200
- RASS\<-4
- Consent obtained from next of kin
- Patient with health insurance
Exclusion Criteria6
- Central nervous system diseases (stroke, MS, epilepsy)
- Psychiatric illnesses (psychosis, depression) (indicated on patient's medical record)
- Hemodynamic instability (noradrenalin\>2mg/h)
- Patient on AME
- Patients under legal protection (guardianship/curators)
- Pregnant or breast-feeding women
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Interventions
The nasal ventilation device (placed as part of the research) (AIRVO 2; Fisher and Paykel Healthcare, Auckland, New Zealand) will be positioned via nasal cannulas adapted to the patient's anatomy. The FiO2 will be set at 21% and the flow rate will be fixed at 0 L/min at the inclusion visit. The temperature of the humidified nasal oxygenator will be set at 31°C. Six 30-minute experimental conditions will be performed successively: 1) 0 L/min flow, FiO2 21%, 2) 30 L/min flow, FiO2 21%, 3) 30 L/min flow, FiO2 100%, 4) 60 L/min flow, FiO2 21%, 5) 60 L/min flow, FiO2 100%, 6) Negative control. At the end of each condition, a 10-minute thoracic electrical impedance tomography recording, a 10-minute EEG recording, a 10-minute cerebral NIRS recording and an instantaneous temporal Doppler velocity measurement will be performed. A blood gas (1.5 mL) will also be taken at the end of each condition.
Locations(1)
View Full Details on ClinicalTrials.gov
For the most up-to-date information, visit the official listing.
NCT06438302