Physiological Effects and Safety of Continuous High-frequency Oscillatory Ventilation in Mechanical Ventilation Patients
Assessing the Physiological Impact and Safety of Continuous High-Frequency Oscillatory Ventilation in Critically Ill Patients Under Mechanical Ventilation
Shanghai Zhongshan Hospital
30 participants
Nov 19, 2024
INTERVENTIONAL
Conditions
Summary
Mechanical ventilation is an important treatment modality for intensive care unit (ICU) patients, but it also brings a series of problems such as ventilator-associated pneumonia, ventilator-induced lung injury, and atelectasis. Continuous High-Frequency Oscillation (CHFO )is often considered to have a protective effect on the lungs. CHFO provides effective gas exchange at supraphysiological frequencies while minimizing pressure fluctuations, producing tidal volumes smaller than dead space and adjusting around a continuously expanding pressure to optimize end-expiratory lung volume (EELV) by achieving and maintaining lung recruitment. However, the physiological effects and safety of CHFO in critically ill patients on mechanical ventilation lack relevant research. The objective of this research is to assess the feasibility, safety, and efficacy of CHFO in a population of mechanically ventilated critically ill patients.
Eligibility
Inclusion Criteria3
- Patients older than 18 and younger than 90 years;
- Admitted to the ICU after October 15, 2024, who are intubated and expected to be unable to be extubated within 48 hours due to ARDS, or have atelectasis, or have VAP.
- Signed informed consent for MetaNeb treatment.
Exclusion Criteria9
- Refusal to participate in the proposed study.
- Age \< 20 years;
- Pregnancy;
- Significant hemodynamic instability defined as an increase of more than 20% in catecholamine doses in the last hour, despite optimization of blood volume, for a target mean blood pressure between 65 and 75 mmHg.
- Participation in another trial within 30 days prior to meeting eligibility criteria;
- Severe chronic respiratory disease requiring long-term oxygen therapy or home mechanical ventilation;
- Pneumothorax;
- Expected duration of mechanical ventilation \< 48 hours
- Decision to refuse life-sustaining treatment.
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Interventions
Administer 10 minutes of high-frequency oscillatory ventilation in mechanically ventilated patients.
Locations(1)
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NCT06662630