Distribution of Pulmonary Ventilation in Lateral Decubitus of Healthy Adults Under Non-Invasive Mechanical Ventilation

Distribution of Pulmonary Ventilation in Lateral Decubitus of Healthy Adults Under Non-Invasive Mechanical Ventilation Supply

The aim was to investigate via impedance tomography apparatus the distribution of pulmonary ventilation at a lateral position at different Continuous Positive Airway Pressure levels (0, 5, 10 cm Η2Ο) in healthy subjects.

Study Overview

• Status: Completed
• Conditions: Noninvasive Ventilation; Patient Positioning
• Intervention / Treatment: Device: Positive End Expiratory Pressure 5 H2O; Device: Positive End Expiratory Pressure 10 H2O

Detailed Description

In lateral decubitus, the largest percentage of pulmonary ventilation of non-sedated subjects is distributed mainly in the dependent lung. The aim It was to investigate via impedance tomography apparatus the distribution of pulmonary ventilation at a lateral position at different Continuous Positive Airway Pressure levels (0, 5, 10 cm Η2Ο) in healthy subjects. The volunteers were noninvasively ventilated in both lateral positions and supine positions at the beginning and end of the process. It is concluded that implementing Non-Invasive Ventilation in the lateral body position resulted in increased ventilation of the dependent lung. In contrast, the respective ventilation of the non-dependent lung was further decreased.

• Study Type: Interventional
• Enrollment (Actual): 10
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Greece
  • Attica
    • Athens, Attica, Greece, 12462
      • Attikon University Hospital
    • Athens, Attica, Greece, 18452
      • Grigoriadis Konstantinos

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Healthy Volunteers

Exclusion Criteria:

• Chronic respiratory disease
• BMI>40
• Smoking history

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Supine position; Supine experimental position	Device: Positive End Expiratory Pressure 5 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus; Device: Positive End Expiratory Pressure 10 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus
Active Comparator: Right position; Right lateral decubitus	Device: Positive End Expiratory Pressure 5 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus; Device: Positive End Expiratory Pressure 10 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus
Active Comparator: Left position; Left lateral decubitus	Device: Positive End Expiratory Pressure 5 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus; Device: Positive End Expiratory Pressure 10 H2O; Positive End Expiratory Pressure 5 H2O from CPAP apparatus

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The percentage change in pulmonary ventilation	The percentage change in pulmonary ventilation was measured at each position, without applying external positive end-expiratory pressure and under positive end-expiratory pressure of 5 and 10 cmH2O	Up to 3 minutes

Collaborators and Investigators

• Sponsor: Attikon Hospital
• Investigators: Principal Investigator: Konstantinos Grigoriadis, Dr, PT, Attikon University Hospital; Study Director: Anna Grigoriadou, MSc, PT, Attikon University Hospital; Study Director: Frantzeska Frantzeskaki, MD, Attikon University Hospital; Study Director: Ioannis Efstathiou, PT, Attikon University Hospital; Study Chair: Iraklis Tsangaris, Professor, Attikon University Hospital

Publications and helpful links

General Publications

• Schnidrig S, Casaulta C, Schibler A, Riedel T. Influence of end-expiratory level and tidal volume on gravitational ventilation distribution during tidal breathing in healthy adults. Eur J Appl Physiol. 2013 Mar;113(3):591-8. doi: 10.1007/s00421-012-2469-7. Epub 2012 Aug 8.
• Sharma JP, Salhotra R, Kumar S, Tyagi A, Sethi AK. Noninvasive lung recruitment maneuver prevents reintubation and reduces ICU stay. Lung India. 2016 Jan-Feb;33(1):99-101. doi: 10.4103/0970-2113.173070. No abstract available.
• Hurewitz AN, Susskind H, Harold WH. Obesity alters regional ventilation in lateral decubitus position. J Appl Physiol (1985). 1985 Sep;59(3):774-83. doi: 10.1152/jappl.1985.59.3.774.
• Lobo B, Hermosa C, Abella A, Gordo F. Electrical impedance tomography. Ann Transl Med. 2018 Jan;6(2):26. doi: 10.21037/atm.2017.12.06.
• Miura MC, Ribeiro de Carvalho CR, Yamada da Silveira LT, de Moraes Regenga M, Petri Damiani L, Fu C. The effects of recruitment maneuver during noninvasive ventilation after coronary bypass grafting: A randomized trial. J Thorac Cardiovasc Surg. 2018 Dec;156(6):2170-2177.e1. doi: 10.1016/j.jtcvs.2018.05.004. Epub 2018 May 28.
• Nishimura M. Electrical Impedance Tomography: The Promise of Noninvasive Lung Images at the Bedside. Respir Care. 2020 Mar;65(3):402-403. doi: 10.4187/respcare.07716. No abstract available.

Study record dates

Study Major Dates

• Study Start (Actual): December 6, 2017
• Primary Completion (Actual): July 8, 2018
• Study Completion (Actual): July 8, 2018

Study Registration Dates

• First Submitted: June 26, 2024
• First Submitted That Met QC Criteria: July 3, 2024
• First Posted (Actual): July 8, 2024

Study Record Updates

• Last Update Posted (Actual): July 9, 2024
• Last Update Submitted That Met QC Criteria: July 7, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: Noninvasive Ventilation; impedance tomography; distribution of ventilation; lateral decubitus
• Additional Relevant MeSH Terms: Skin Diseases; Skin Ulcer; Pressure Ulcer
• Other Study ID Numbers: EBD2878

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

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