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Monitoring airway pressure is essential for patients with mechanical ventilation. However, static airway pressure does not reflect alveolar pressure at all. Airway pressure is supposed to completely interrupt the communication between proximal airway opening and the distal alveolar and/or small airway structures. In this condition, some alveoli may still be inflated but do not communicate with proximal airways and auto-PEEP will give a biased estimated of mean alveolar pressure. To be note, distinguishing the airway closure and alveolar collapse can be challenging at times. The quasi-static PV curve is a useful bedside tool to set mechanical ventilation, which may help us to identify the airway closure and alveolar collapse. Meanwhile, the quasi-static PV curve can only reflects a global behaviour of the lung, while EIT may be a useful tool to assess the regional information on airway closure and alveolar collapse.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| P-V curve group | Experimental | Enrolled patients will receive a PV curve with a low-flow insufflation of 5 L/min starting from 0 cmH2O to a maximal airway pressure corresponding to the plateau pressure. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| pressure-volume curve with a low-flow insufflation of 5 L/min | Other | The patient undergoes a pressure-volume curve with a low-flow insufflation of 5 L/min while in a state of analgesia, sedation, and absence of spontaneous breathing. |
| Measure | Description | Time Frame |
|---|---|---|
| the rate of airway closure and alveolar collapse | airway closure and alveolar collapse are monitored by PV curve with a low-flow insufflation of 5 L/min | up to 24 hours |
| Phenotype of respiratory open pressure | According to the characteristics of the low inflation point of PV curve, the respiratory open pressure phenotype was constructed | up to 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| respiratory system compliance | Respiratory system compliance is calculated as the ratio of tidal volume to the difference between plateau pressure and positive end-expiratory pressure. | up to 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| ling liu, phD | Contact | 15901599659 | liulingdoctor@126.com | |
| xueyan yuan, phD | Contact | 18826401594@163.com |
| Name | Affiliation | Role |
|---|---|---|
| ling liu | Zhongda Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University | Recruiting | Nanjing | Jiangsu | 210000 | China |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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