Physiological Study of High PEEP in Noninvasive Ventilation
A Physiological Study of High PEEP During Noninvasive Ventilation in Patients With Hypoxemic Respiratory Failure
Chongqing Medical University
50 participants
Mar 26, 2024
INTERVENTIONAL
Conditions
Summary
To investigate the physiological effects of high positive end-expiratory pressure (PEEP) during noninvasive ventilation in patients with hypoxemic respiratory failure, and to elucidate the mechanisms underlying high PEEP-induced improvement in oxygenation.
Eligibility
Inclusion Criteria4
- Age ≥ 18 years
- PaCO₂ ≤ 50 mmHg
- PaO₂/FiO₂ ≤ 300 mmHg
- Use of a noninvasive ventilator with esophageal pressure monitoring capability (e.g., Mindray SV70) -
Exclusion Criteria3
- Respiratory failure caused by heart failure, asthma, or acute exacerbation of chronic obstructive pulmonary disease (COPD) (COPD as a comorbidity may be included)
- Pneumothorax
- Patients who refuse to participate in this trial -
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Interventions
First, PEEP was set at 5 cmH₂O, and inspiratory pressure was adjusted to achieve a target tidal volume of 6-8 mL/kg. Fraction of inspired oxygen (FiO₂) was titrated to maintain peripheral oxygen saturation (SpO₂) between 88% and 92%. Subsequently, PEEP was increased in 5 cmH₂O increments every 10-20 minutes from the initial value of 5 cmH₂O. Once PEEP reached 20 cmH₂O or above, increments were made every 3-5 minutes until the recruitment level was achieved (i.e., PEEP was increased stepwise from 5 to 10, 15, 20, 25, and 30 cmH₂O). Inspiratory pressure was adjusted concurrently to maintain a constant pressure difference. Throughout the procedure, physiological parameters-including respiratory rate, oxygenation, work of breathing, and others-were collected.
Locations(1)
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NCT07503509