Intrabronchial Airway Pressures in Intubated Patients During Bronchoscopy

Intrabronchial Airway Pressures in Intubated Patients During Bronchoscopy Under Volume Controlled (VC) and Pressure Controlled (PC) Ventilation

The purpose of this study is to examine changes in ventilation and airway pressures during conventional bronchoscopy of intubated patients.

Study Overview

• Status: Completed
• Conditions: Acute Respiratory Distress Syndrome; Acute Lung Injury (ALI)
• Intervention / Treatment: Other: Bronchoscopy

Detailed Description

Mechanically ventilated patients often need bronchoscopy as a diagnostic procedure or for visually directed elimination of secretions. Partial endotracheal tube occlusion by the bronchoscope increases airflow resistance. Inhibition of inspiratory flow may be compensated for by augmented inspiratory pressure. Reduced expiratory flow however, cannot be compensated for by most ventilators and could lead to higher airway - and intrathoracic pressures that are not detected by pressure transducers in the ventilator tubing. In this study we compare changes in ventilation, airway pressures, ventilator pressures and blood gases during bronchoscopy of intubated patients in both volume controlled and pressure controlled ventilation. Our hypothesis are that 1) increased resistance in the tube during bronchoscopy leads to high intrabronchial airway pressures when the ventilator is in volume controlled mode, and 2) when the ventilator is in pressure controlled mode, increased resistance in the tube during bronchoscopy leads to reduced Tidal Volume and moderately increased paCO2.

• Study Type: Observational
• Enrollment (Anticipated): 20

Contacts and Locations

Study Locations

• Norway
  • Oslo, Norway, 0407
    • Oslo University Hospital - Ullevål

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

ARDS/ALI patients on mechanical ventilation where a therapeutic or diagnostic bronchoscopy has been requested by the staff physician.

Description

Inclusion Criteria:

• ARDS/ALI patients on mechanical ventilation
• endotracheal tube size 7-9mm
• age > 18 years
• therapeutic or diagnostic bronchoscopy requested by staff physician

Exclusion Criteria:

• SpO2 < 90%
• unstable BP
• pneumothorax
• acute cardiovascular disease
• cerebrovascular or other condition that requires stable BP and saturation

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
ARDS / ALI patients	Other: Bronchoscopy; Airway pressures, ventilation changes and blood gas changes are recorded in a group of intubated patients on mechanical ventilation before and after bronchoscope insertion. The registration is done immediately before a therapeutic/diagnostic bronchoscopy requested by a staff physician not involved n the study.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in ventilation, airway pressures and blood gases after bronchoscope insertion.	paO2, paCO2 (kPa), airway and ventilator pressures (cmH2O)	2 minutes after bronchoscope insertion/ mode change

Collaborators and Investigators

• Sponsor: Oslo University Hospital
• Investigators: Study Director: Helge Opdahl, MD, PhD, Oslo University Hospital - Ulleval, Norway; Study Director: Ole H Skjønsberg, MD, PhD, Ullevaal University Hospital; Study Director: Fredrik Borchsenius, MD, Ullevaal University Hospital

Study record dates

Study Major Dates

• Study Start: March 1, 2002
• Primary Completion (ACTUAL): April 1, 2010
• Study Completion (ACTUAL): April 1, 2010

Study Registration Dates

• First Submitted: March 1, 2010
• First Submitted That Met QC Criteria: March 1, 2010
• First Posted (ESTIMATE): March 2, 2010

Study Record Updates

• Last Update Posted (ESTIMATE): November 11, 2010
• Last Update Submitted That Met QC Criteria: November 10, 2010
• Last Verified: November 1, 2010

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Respiration Disorders; Lung Diseases; Wounds and Injuries; Infant, Newborn, Diseases; Infant, Premature, Diseases; Thoracic Injuries; Respiratory Distress Syndrome; Respiratory Distress Syndrome, Newborn; Acute Lung Injury; Lung Injury
• Other Study ID Numbers: REK-HO Ref 191-01055, 03052001