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| Name | Class |
|---|---|
| Real Hospital Português de Beneficência em Pernambuco | UNKNOWN |
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This study evaluates the effects of VCV, PCV and PSV ventilatory modes during the immediate postoperative period on the variables resulting from regional and global pulmonary electrical impedance and diaphragmatic mobility, as well as perform ventilator synchrony analysis in PSV mode by mechanical ventilator. Half of the participants will receive VCV followed by PSV for weaning, while the other half will receive PCV followed by PSV for weaning.
In the immediate postoperative period of cardiac surgery, patients are found under mechanical ventilatory support. Commonly, they are ventilated in controlled and assisted-controlled volume (VCV) or pressure (PCV) modes, with weaning at pressure support (PSV).
Systematic reviews indicate that there is no difference between the VCV and PCV ventilatory modes for some clinical outcomes or that the existing evidence is insufficient. The distribution of regional ventilation and diaphragmatic mobility can be measured from the use of electrical impedance tomography (EIT) and diaphragmatic ultrasonography (US) to clarify the physiological changes and / or mechanisms of adaptation of the organism submitted to controlled modes cycled at volume or at pressure and spontaneously flow cycled mode.
Besides EIT and US measures, gasometric, hemodynamic and respiratory data will also be recorded. The statistical analysis will be considered α≤0.05 for a statistically significant difference.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| VCV+PSV | Experimental | volume controlled cycled, assisted-controlled cycled ventilation mode + pressure support ventilation mode. Progression of invasive ventilatory assistance as the patient recovers during post-surgery. |
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| PCV+PSV | Experimental | pressure controlled cycled, assisted-controlled cycled ventilation mode + pressure support ventilation mode. Progression of invasive ventilatory assistance as the patient recovers during post-surgery. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| VCV+PSV | Device | invasive mechanical mechanical modes by volume cycling and by pressure support which the patients will be submitted to before weaning. Post-operative mechanical ventilation average time: 6 hours after ICU admission. |
| Measure | Description | Time Frame |
|---|---|---|
| electrical impedance measures | impedance variation data recorded by a tomograph. | 5 minutes of recording at each step of mechanical ventilation progression before extubation. |
| Measure | Description | Time Frame |
|---|---|---|
| arterial gas blood analysis data | measures of pH, PaCO2 (mmHg), PaO2 (mmHg), PaO2/FiO2 | up to 12h, following routine care while patients are mechanically ventilated |
| patient-ventilator synchrony |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| WAGNER S LEITE | Universidade Federal de Pernambuco | Principal Investigator |
| Shirley Lima Campos | Universidade Federal de Pernambuco | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospital Real Português de Beneficência em Pernambuco | Recife | Pernambuco | 52010-040 | Brazil |
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| Label | URL |
|---|---|
| Right ventricular function during one-lung ventilation: effects of pressure-controlled and volume-controlled ventilation | View source |
| Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. | View source |
| ID | Type | URL | Comment |
|---|---|---|---|
| Study Protocol | View IPD |
to be shared are: data provided by electrical impedance tomograph, by ultrasound and general clinical one (such as blood pressure, oxygen supplementary concentration, heart rate, respiratory rate, mechanical ventilation duration, surgery duration). These data will be available for sharing after the end of the study and it will be obtained by a copy in a USB flash drive.
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A parallel group study is a simple and commonly used clinical design which compares two treatments. Usually a test therapy is compared with a standard therapy. The allocation of subjects to groups is usually achieved by randomisation. The groups are typically named the treatment group and the control group. Parallel group designs do not require the same number of subjects in each group, although often similar numbers are observed. The design is commonly used in randomised controlled trials. Statistical analysis often boils down to a simple t-test of the between group difference in the outcome, which is usually a mean or a proportion.
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| PCV+PSV | Device | invasive mechanical mechanical modes by pressure cycling and by pressure support which the patients will be submitted to before weaning. Post-operative mechanical ventilation average time: 6 hours after ICU admission. |
|
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events of discomfort between patient and ventilator: ineffective efforts and auto-triggering. Expressed in present or ausent.
| 5 minutes of recording at each step of mechanical ventilation progression before extubation |
| Tidal ventilation distribution during pressure-controlled ventilation and pressure support ventilation in post-cardiac surgery patients. |
| View source |
| Monitoring perioperative changes in distribution of pulmonary ventilation by functional electrical impedance tomography. | View source |
| Refining ventilatory treatment for acute lung injury and acute respiratory distress syndrome. | View source |
| Bedside waveforms interpretation as a tool to identify patient-ventilator asynchronies. | View source |
| Volume-controlled versus pressure-controlled ventilation-volume guaranteed mode during one-lung ventilation | View source |
| Ultrasonographic diagnostic criterion for severe diaphragmatic dysfunction after cardiac surgery. | View source |
Search for "buscar pesquisas aprovadas" and fill the the blanks with research title and investigator's full name |