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Protective ventilation - combining a low tidal volume (between 6 and 8 ml/kg) and alveolar recruitment (AR) manoeuvres repeated every 30 minutes - is currently the standard of care for decreasing morbidity associated with mechanical ventilation.
In contrast, there is no consensus on the type of recruitment manoeuvre, which varies from one centre to another and from one study to another.
The investigators intend to compare two currently used AR techniques with regard to their ventilatory efficacy and hemodynamic safety:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 30 cmH20 for 30 seconds | plateau pressure is hold on at 30 cmH20 pour 30 seconds. The cardiac output and the lung aeration is assessed by ultrasound measures at 3 times: before, at the end of the recruitment and 30 minutes later. echocardiography - arterial oximetry |
| |
| 10 cmH20 above | plateau pressure is hold on at 10 cmH20 above. The cardiac output and the lung aeration is assessed by ultrasound measures at 3 times: before, at the end of the recruitment and 30 minutes later. echocardiography - arterial oximetry |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| echocardiography | Device | • Prospective, simultaneous recording of the cardiac output (measured non-invasively via transthoracic echocardiography) and a number of parameters commonly monitored in the surgical intensive care unit (CVP, SBP/DBP/MBP). |
| Measure | Description | Time Frame |
|---|---|---|
| Variations in cardiac output induced by each type of AR manoeuvre | Day 0 |
| Measure | Description | Time Frame |
|---|---|---|
| Variations in PaO2 variations induced by each type of AR manoeuvre | Day 0 |
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Inclusion Criteria:
Exclusion Criteria:
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sedated, intubated, mechanically ventilated adult patients
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| Name | Affiliation | Role |
|---|---|---|
| Emmanuel LORNE, MD, PhD | CHU Amiens | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| CHU Amiens | Amiens | 80054 | France |
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| Arterial oximetry | Device | measured by co-oximetry of a blood sample taken via the arterial catheter implemented for critical care |
|
| ID | Term |
|---|---|
| D004452 | Echocardiography |
| ID | Term |
|---|---|
| D057791 | Cardiac Imaging Techniques |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D014463 | Ultrasonography |
| D006334 | Heart Function Tests |
| D003935 | Diagnostic Techniques, Cardiovascular |
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