The occurrence of PVA in mechanically ventilated children is higher than reported during visual inspection of the pressure – time and flow – time tracings when this is combined with non-invasive diaphragmatic and intercostal muscle EMG monitoring.
ID
Bron
Verkorte titel
Aandoening
Longaandoeningen welke kunstmatige beademingen behoeven
Respiratory failure in need of mechanical ventilation
Ondersteuning
Onderzoeksproduct en/of interventie
Uitkomstmaten
Primaire uitkomstmaten
Incidence of patient-ventilator-asynchrony.
Achtergrond van het onderzoek
Patient-ventilator asynchrony can lead to considerable patient distress, lead to increase used of sedatives. Surprisingly, relatively little is known about its incidence in mechanically ventilated children.
Currently, PVA can be detected in three different ways. At present, the most readily available method to detect PVA is analyzing the waveforms (the pressure-time, flow-time and volume-time waveform) displayed by the ventilator to detect PVA. However, for a true assessment of the occurrence of PVA it is mandatory to know if there is any patient effort before the ventilator delivers a breath. This can be most reliable method by detected by observing oesophageal pressure waveforms. Alternatively, electrical activity of the respiratory muscles has also been used to study PVA. EMG activity – especially of the diaphragm – also indicates patient effort. We hypothesized that the occurrence of PVA in mechanically ventilated children is higher than reported during visual inspection of the pressure – time and flow – time tracings when this is combined with non-invasive diaphragmatic and intercostal muscle EMG monitoring. Recruitment: the Netherlands
Doel van het onderzoek
The occurrence of PVA in mechanically ventilated children is higher than reported during visual inspection of the pressure – time and flow – time tracings when this is combined with non-invasive diaphragmatic and intercostal muscle EMG monitoring.
Onderzoeksopzet
Daily recordings (2x15 minutes)
Onderzoeksproduct en/of interventie
n/a
Publiek
Beatrix Children’s Hospital <br>
University Medical Center Groningen
R.G.T. Blokpoel
Groningen
The Netherlands
r.g.t.blokpoel@umcg.nl
Wetenschappelijk
Beatrix Children’s Hospital <br>
University Medical Center Groningen
R.G.T. Blokpoel
Groningen
The Netherlands
r.g.t.blokpoel@umcg.nl
Belangrijkste voorwaarden om deel te mogen nemen (Inclusiecriteria)
- all patients who require mechanical ventilation aged 0-18 years
- patients should be able to trigger the ventilator with a pre-set flow trigger of 1 liter/min
Belangrijkste redenen om niet deel te kunnen nemen (Exclusiecriteria)
- premature birth with gestational age corrected for post-conceptional age less than 40 weeks
- congenital or acquired neuromuscular disorders
- congenital or acquired central nervous system disorders with depressed respiratory drive
- severe traumatic brain injury (i.e. Glasgow Coma Scale < 8)
- congenital or acquired damage to the phrenic nerve
- congenital or acquired paralysis of the diaphragm
- use of neuromuscular blockade
- chronic lung disease
- severe pulmonary hypertension
Opzet
Deelname
Opgevolgd door onderstaande (mogelijk meer actuele) registratie
Geen registraties gevonden.
Andere (mogelijk minder actuele) registraties in dit register
Geen registraties gevonden.
In overige registers
| Register | ID |
|---|---|
| NTR-new | NL4350 |
| NTR-old | NTR4706 |
| Ander register | M13.143975 ID toegekend door lokale METc : Ped.PVA.EMG.1 Lokaal protocol nummer |