Predict Transpulmonary Pressure Through ZAM | NCT05378802

NCT05378802

Protocol Section

Identification Module

Results Section

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No data is available for this block.

Annotation Section

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Document Section

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Derived Section

Miscellaneous Info Module

Status Module

Oversight Module

Description Module

Design Module

Interventional Study Design

Biospecimen

No data available

No data is available for this block.

Arms/Interventions Module

Arm Groups

Label	Type	Description	Intervention Names
NAVA mode	Experimental	st select a NAVA level that gives peak pressure about 9-10 cm H2O assist keep NAVA level for 15 minutes, do ZAM breaths every 3 minutes (make sure not to disturb the patient). Insp Hold after every ZAM nd increase NAVA level by 50% and repeat the protocol when patient's breathing has stabilized (only one increase) Do ZAM breaths every 3 minutes (make sure not to disturb the patient). Insp Hold after every ZAM	Other: different modes of mechanical ventilation
N- PSV mode	Experimental	st PS level of 8-10 cmH2O, keep PS level for 15 minutes, do ZAM every 3 minutes (make sure not to disturb patient). Insp Hold after every ZAM At the end of protocol (minute 15) do one end-inspiratory hold-maneuver and one end-expiratory occlusion. nd increase PS by 50% and repeat protocol when patient's breathing has stabilized (only 1 increase). Do ZAM every 3 minutes (make sure not to disturb patient). Insp Hold after every ZAM	Other: different modes of mechanical ventilation
VCV mode	Active Comparator	no spontaneous breathing Set Vt, Ti and RR to match the breathing pattern observed during NAVA. Make sure each change in "level" does not increase the pressure by more than 1 cmH2O. Mode PCV no spontaneous breathing-do ZAM after each PS level Increase PSV level from 8 to 20 in steps of 1 cmH2O every 2 minutes. Be careful at the higher pressures.	Other: different modes of mechanical ventilation
PCV mode	Active Comparator	Increase PSV level from 8 to 20 in steps of 1 cmH2O every 2 minutes. Be careful at the higher pressures The idea is not to have pressures as high as 20 cmH2O, it is important to have high enough VCV & PCV flow rates so we can match the flow rates during spontaneous breathing. You might find that 15 or 16 cmH2O is enough to generate flow rates that match the "maximum" flow rate you saw during spontaneous breathing.

Interventions

Name	Type	Description	Arm Group Labels	Other Names
different modes of mechanical ventilation	Other	Four different ventilation modes were performed one by one and respiratory parameters were recorded.	N- PSV mode NAVA mode

Outcomes Module

Measure	Description	Time Frame
Predicted transpulmonary pressure	Transpulmonary pressure calculated from airway pressure by Prediction formula	6 hours

Secondary Outcomes

Measure	Description	Time Frame
patient-ventilator breath contribution	An index for quantifying the respective patient and ventilator breath contributions	6 hours
inspiratory flow	the inspiratory flow measured by the ventilator

Eligibility Module

Name	Affiliation	Role
Haibo Qiu	Southeast University	Principal Investigator

Facility	Status	City	State	ZIP	Country	Contacts
Zhongda hospital, Southeast university		Nanjing	Jiangsu	210009	China

References Module

Citations

PubMed Identifier	Type	Citation	Retractions
39365383	Derived	Liu L, He H, Liang M, Beck J, Sinderby C. Estimation of transpulmonary driving pressure using a lower assist maneuver (LAM) during synchronized ventilation in patients with acute respiratory failure: a physiological study. Intensive Care Med Exp. 2024 Oct 4;12(1):89. doi: 10.1186/s40635-024-00674-z.