Computed Inspiratory Muscle Pressure to Monitor Inspiratory Effort During Pressure Support Ventilation
Validation of Computed Inspiratory Muscle Pressure to Monitor Inspiratory Effort During Pressure Support Ventilation: A Prospective Physiological Study
The goal of this study is to validate computed inspiratory muscle pressure (cPmus) for monitoring inspiratory effort in adults receiving pressure support ventilation. Researchers will compare cPmus with reference inspiratory muscle pressure calculated using an esophageal balloon catheter, a thin pressure-measuring tube placed in the esophagus. The study will look at how closely the two methods are related and whether they give similar results. Participants will undergo simultaneous monitoring with cPmus and an esophageal balloon catheter. Researchers will adjust pressure support across six levels, recording measurements from both methods at each level.
Study Overview
Status
Conditions
Detailed Description
This is a prospective validation study with repeated measurements. It aims to validate computed inspiratory muscle pressure (cPmus), a noninvasive estimate of inspiratory muscle pressure provided by the study ventilator (Prunus Padus 9, Shenzhen, China). The reference method is esophageal pressure-derived inspiratory muscle pressure (Pmus). The study will enroll adults receiving invasive pressure support ventilation (PSV).
After obtaining informed consent, participants will undergo simultaneous monitoring with the cPmus algorithm and an esophageal balloon catheter. Pressure support will be adjusted in six levels. Positive end-expiratory pressure (PEEP) will remain unchanged. Each pressure support level will be maintained for 10 minutes. Brief end-expiratory and end-inspiratory occlusion maneuvers will also be performed at each level to obtain additional indices of respiratory drive and inspiratory effort. Esophageal balloon will be removed after completing the last pressure support step.
At each pressure support level, paired values of cPmus and reference Pmus were measured. The corresponding inspiratory pressure-time products, cPTPmus and PTPmus, will also be calculated.
All procedures will follow the study protocol and standardized measurement procedures. Study data will be recorded in case report forms and an electronic database, with checks for completeness, accuracy, and waveform quality.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Jian-Xin Zhou, MD, PhD
- Phone Number: 8610 6392 6666
- Email: zhoujx.cn@icloud.com
Study Contact Backup
- Name: Meng-Xue Hou, MD
- Email: himengxue@163.com
Study Locations
-
-
-
Beijing, China
- Recruiting
- Beijing Shijitan Hospital
-
Contact:
- Jian-Xin Zhou, MD, PhD
- Phone Number: 8610 6392 6666
- Email: zhoujx.cn@icloud.com
-
Contact:
- Meng-Xue Hou, MD
- Email: himengxue@163.com
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age 18 years or older.
- Receiving pressure support ventilation.
- Written informed consent provided by the participant or a legally authorized representative.
Exclusion Criteria:
- Contraindication to esophageal catheter placement, including uncontrolled coagulopathy, skull base fracture, upper gastrointestinal bleeding, tumor or surgery, neck surgery, or esophagogastric varices.
- Chest trauma, a postoperative state following lung surgery, an active pulmonary air leak (pneumothorax, pneumomediastinum, or bronchopleural fistula), or an indwelling chest drain.
- Neuromuscular disease, diaphragmatic dysfunction, or diaphragmatic surgery.
- Impaired central respiratory drive due to intracranial hypertension or brainstem injury.
- Hemodynamic instability, defined as mean arterial pressure <60 mmHg, systolic blood pressure >180 mmHg, heart rate <40 or >150 beats/min, or norepinephrine dose >1 mcg/kg/min.
- Pregnancy or breastfeeding.
- A decision to withdraw life-sustaining treatment or provide palliative care.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
Experimental: Pressure support 15
Pressure support of 15 cm H2O will be applied for 10 minutes. |
Pressure support of 15 cm H2O will be applied for 10 minutes. |
|
Experimental: Pressure support 13
Pressure support of 13 cm H2O will be applied for 10 minutes. |
Pressure support of 13 cm H2O will be applied for 10 minutes. |
|
Experimental: Pressure support 11
Pressure support of 11 cm H2O will be applied for 10 minutes. |
Pressure support of 11 cm H2O will be applied for 10 minutes. |
|
Experimental: Pressure support 9
Pressure support of 9 cm H2O will be applied for 10 minutes. |
Pressure support of 9 cm H2O will be applied for 10 minutes. |
|
Experimental: Pressure support 7
Pressure support of 7 cm H2O will be applied for 10 minutes. |
Pressure support of 7 cm H2O will be applied for 10 minutes. |
|
Experimental: Pressure support 5
Pressure support of 5 cm H2O will be applied for 10 minutes. |
Pressure support of 5 cm H2O will be applied for 10 minutes. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Computed inspiratory muscle pressure (cPmus)
Time Frame: 2 hours
|
Computed inspiratory muscle pressure (cPmus) will be measured. |
2 hours
|
|
Inspiratory muscle pressure (Pmus)
Time Frame: 2 hours
|
Inspiratory muscle pressure (Pmus) will be measured. |
2 hours
|
|
Computed inspiratory muscle pressure-time product (cPTPmus)
Time Frame: 2 hours
|
Computed inspiratory muscle pressure-time product (cPTPmus) will be measured. |
2 hours
|
|
Inspiratory muscle pressure-time product (PTPmus)
Time Frame: 2 hours
|
Inspiratory muscle pressure-time product (PTPmus) will be measured. |
2 hours
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Occluded airway pressure at 100ms (P0.1)
Time Frame: 2 hours
|
Occluded airway pressure at 100ms (P0.1) will be measured. |
2 hours
|
|
Maximal decrease of airway pressure during end-expiratory occlusion (∆Pocc)
Time Frame: 2 hours
|
Maximal decrease of airway pressure during end-expiratory occlusion (∆Pocc) will be measured. |
2 hours
|
|
Pressure muscle index (PMI)
Time Frame: 2 hours
|
Pressure muscle index (PMI) will be measured. |
2 hours
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jian-Xin Zhou, Capital Medical University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
- IIT2026-032-002
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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