This study is aimed to compare the changes of FRC after performance of three different placements of external stripes during recruitment maneuver
ID
Source
Brief title
Condition
- Respiratory tract infections
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The effect of external stripes with standardized recruitment maneuver on FRC.
Secondary outcome
Blood pressure
Background summary
Healthy lung needs a low pressure to open up collapsed alveoli, whereas
diseased lung needs higher pressure due to a lack of surfactant. Open up these
collapsed alveoli is aimed to improve the functional residual capacity (FRC),
and therefore improve lung oxygenation. We have shown that recruitment maneuver
with high pressure up to 70-80 cmH2O is needed to open up atelectasis in
diseased lungs but the use of this pressure may increase the risk of barotrauma
and/or hemodynamic instability. Therefore we would like to study if we could
open up diseased lung with lower pressure up to 60 cmH2O by reducing thorax
compliance with the placement of external stripes. We have seen in clinical
practice that putting CVVH fluid sacs (4-5 kg) on the sternum leads to better
recruitment of collapsed alveoli with improvement of FRC and oxygenation by
reducing right-left shunt over the lung. Therefore we expect that the placement
of external stripes around the thorax will mimic these sacs and the effect of a
recruitment maneuver with a pressure of 60 cmH2O on FRC is better compared to
recruitment without external stripes.
Study objective
This study is aimed to compare the changes of FRC after performance of three
different placements of external stripes during recruitment maneuver
Study design
Intervention study in ALI patients.
Intervention
This study is aimed to compare the changes of FRC by recruitment maneuvers with
and without external stripes.
Study burden and risks
In this study, we will use a standardized recruitment maneuver with a maximal
pressure of 60 cmH2O w6 that has proven to be safe in earlier studies and is
nowadays used as standard care in the ventilatory management of patients with
ALI (beademingsprotocol ICV intranet Erasmus MC).
's-Gravendijkwal 230
3015CE Rotterdam
NL
's-Gravendijkwal 230
3015CE Rotterdam
NL
Listed location countries
Age
Inclusion criteria
- ALI according to American-European consensus criteria
- Mechanically ventilated on the second or the third day
- Aged >18 years old
- Supine position
- Written informed consent from legal representatives
Exclusion criteria
- ARDS
- Bullae and/or pneumothorax
- Patient with high intracranial pressure
- Critically ill patients with pH <7.2 or with cardiovascular instability which is defined as hypotension (systolic blood pressure (SBP) <90 mmHg, or mean arterial pressure <60 mmHg) or normotension in combination with a dose of NOR at an infusion rate of more than 0.5 µg/kg/min.
- Multi trauma with spinal, thoracic or abdominal trauma
- Large breast
- Morbid obese
Design
Recruitment
Medical products/devices used
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL35545.000.11 |