Effects of Standing at Different Angles on Transpulmonary Pressure

Effects of standing at different angles on transpulmonary pressure

Study Overview

• Status: Unknown
• Conditions: Pulmonary Disease
• Intervention / Treatment: Behavioral: Change of standing Angle

Detailed Description

Objective: To study the effect of different standing angles on cross-lung pressure.Background: Long-term bed rest in ICU patients leads to upward movement of diaphragm and increased intrathoracic pressure in mechanically ventilated patients, resulting in lower cross-lung pressure. If the end-expiratory cross-lung pressure is negative, lung tissue compression and atelectasis will occur.Standing can lower the diaphragm, improve the pressure across the lungs, and improve ventilation.Selection methods: patients with invasive mechanical ventilation in the ICU, on the premise of stable hemodynamics, with the aid of electric bed training in standing in different angles, start from 20 degrees, 5 degrees up every five minutes, the largest up to 80 degrees, each Angle across the pulmonary pressure, die cavity ratio, tidal volume and breathe out carbon dioxide at the end of the record, and record whether low blood pressure, an accident in the process of take off the tube and other adverse reactions.

• Study Type: Interventional
• Enrollment (Anticipated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Zhao Ying; Phone Number: 17600953801 17600953801; Email: 1412888703@qq.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 95 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• The age is ≥ 18 years old;
• the hemodynamics is stable;
• 50 < heart rate < 120 beats / min ;
• 90 < systolic blood pressure < 200mmHg ;
• 55 < mean arterial pressure < 120mmHg;
• do not increase the dose of pressor drugs for at least 2 hours;
• intracranial pressure is stable and there are no seizures within 24 hours;
• the respiratory state is stable;
• the patient's finger pulse oxygen saturation ≥ 88%;
• 10 < respiratory frequency < 35 beats / min.

Exclusion Criteria:

• Pregnancy;
• acute cardio-cerebrovascular events;
• spinal or limb fractures;
• active bleeding.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Standing Angle; Assist the electric hospital bed to conduct different Angle standing training, starting from 20 degrees, every five minutes to rise 5 degrees, the maximum rise to 80 degrees	Behavioral: Change of standing Angle; Change the patient's standing Angle by using an electric bed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
transpulmonary pressure	End-expiratory pressure across the lungs is recommended at 0-5cmH2O.	5 minutes
Esophageal pressure	The change in esophageal pressure represents the degree of inspiratory effort.The greater the variation, the harder the inhale.	5 minutes
Dead space rate	the smaller，the better	5 minutes
tidal volume	Standard tidal volume: standard weight based on height, 6 to 8ml per kg body weight	5 minutes
partial pressure of carbon dioxide in endexpiratory gas	The smaller the difference between pCO2 and arterial blood gas, the better	5 minutes

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
adverse reaction	hypotension、Accident to take off the tube、Drop of bed，Record the number of times it happens.The more it happens, the less safe it is.	an hour

Collaborators and Investigators

• Sponsor: Chinese PLA General Hospital
• Investigators: Principal Investigator: xin li xie, Ph.D., The First Medical Center of PLA General Hospital

Study record dates

Study Major Dates

• Study Start (Anticipated): October 1, 2020
• Primary Completion (Anticipated): October 1, 2021
• Study Completion (Anticipated): October 1, 2021

Study Registration Dates

• First Submitted: June 26, 2020
• First Submitted That Met QC Criteria: June 26, 2020
• First Posted (Actual): June 30, 2020

Study Record Updates

• Last Update Posted (Actual): July 7, 2020
• Last Update Submitted That Met QC Criteria: July 1, 2020
• Last Verified: June 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases
• Other Study ID Numbers: transpulmonary pressure

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No