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Airway Occlusion Pressure (P0.1) Guided Pressure Support Ventilation Versus Conventional Management in Weaning Window Patients

11. juli 2026 opdateret af: Muhammad Ahmed Kandil, Tanta University

Airway Occlusion Pressure (P0.1) Guided Pressure Support Ventilation Versus Conventional Management in Weaning Window Patients: A Randomized Controlled Trial

This study aims to determine whether Airway Occlusion Pressure (P0.1) Guided Pressure Support Ventilation is superior to conventional management for patients in weaning windows.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Mechanical ventilation is an essential modality for critically ill patients with acute respiratory failure. It supports gas exchange and reduces respiratory muscle workload, but prolonged use increases the risk of lung injury, diaphragm dysfunction, and infection. Therefore, the process of ventilator weaning is crucial in optimizing patient outcomes.

Airway occlusion pressure (P0.1), the negative pressure generated 100 ms after the onset of inspiration during an occluded breath, provides a direct measurement of patient respiratory drive independent of lung mechanics. It is a strong indicator of ventilatory demand and drive-load imbalance.

Pressure Support Ventilation (PSV) is commonly used during the weaning window, but conventional titration methods rely on clinical assessment alone. These methods do not reliably identify asynchronous events such as ineffective effort, double triggering, or premature cycling, which prolong ventilation.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

80

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

  • Egypten
    • Al Gharbia
      • Tanta, Al Gharbia, Egypten, 31527
        • Rekruttering
        • Tanta University
        • Underforsker:
          • Aliaa M Belal, MD
        • Underforsker:
          • Taysser M Abdalraheem, MD
        • Underforsker:
          • Sohair M Soliman, MD
        • Kontakt:
        • Underforsker:
          • Ghada F Elbaradey, MD

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Mechanically ventilated adult patients ≥ 21 years.
  • Patients on pressure support ventilation for at least 24 hours and clinically determined to be in the weaning window (transition between assisted ventilation and spontaneous ventilation) with improving respiratory status.
  • Hemodynamically stable [mean arterial pressure (MAP) ≥60 mmHg].
  • All patients will be required to have light sedation with a Richmond Agitation-Sedation Scale (RASS) score between -1 and 0 to allow reliable assessment of respiratory drive.

Exclusion Criteria:

  • Patients with neuromuscular disorders affecting respiratory drive
  • Glasgow Coma Scale (GCS) score below 8
  • Cervical spinal cord injury
  • Receipt of neuromuscular blockers within the previous 24 hours
  • Morbid obesity resulting in unreliable respiratory mechanics
  • Pregnancy
  • Deep sedation defined as RASS ≤ -2
  • Hemodynamic instability requiring escalating vasopressor support.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: Group I (Control Group)
Patients will receive a conventional pressure support ventilation protocol.
Andet: Pressure support ventilation protocol
Patients will receive a conventional pressure support ventilation protocol.
Eksperimentel: Group II (Study Group)
Patients will receive airway occlusion pressure (P0.1)-guided pressure support ventilation (PSV).
Andet: Airway occlusion pressure (P0.1)-guided pressure support ventilation (PSV)
Patients will receive airway occlusion pressure (P0.1)-guided pressure support ventilation (PSV).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Ventilator-Free Days
Tidsramme: Day 28 after the procedure
Ventilator-Free Days (VFD) at Day 28, defined as the number of days a patient is free from mechanical ventilation within the first 28 days after randomization. VFD are calculated as 28 minus the total days on mechanical ventilation from Day 0 until successful extubation.
Day 28 after the procedure

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Duration of Mechanical Ventilation
Tidsramme: Till final successful extubation (Up to 48 hours)
Duration of Mechanical Ventilation (DMV) is defined as the total days on mechanical ventilation (MV) from randomization until final successful extubation.
Till final successful extubation (Up to 48 hours)
Length of stay in the intensive care unit
Tidsramme: Till the discharge from intensive care unit (Up to 28 days)
The length of stay in the intensive care unit (ICU) will be recorded from ICU admission to ICU discharge.
Till the discharge from intensive care unit (Up to 28 days)
Patient-Ventilator Asynchrony Index (PVAI)
Tidsramme: Day 28 after the procedure
Daily analysis of a 10-minute waveform segment. "PVAI"="Asynchronous events" /"Total breaths" ×100
Day 28 after the procedure
Dexmedetomidine requirement
Tidsramme: Day 28 after the procedure
Total dose of dexmedetomidine administered to maintain the target sedation level of Richmond Agitation-Sedation Scale (RASS) -1 to 0 during the weaning period.
Day 28 after the procedure
Failed weaning
Tidsramme: 48 hours after extubation
"Failed weaning" is defined as reintubation within 48 hours after extubation.
48 hours after extubation

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Tanta University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. februar 2026

Primær færdiggørelse (Anslået)

1. januar 2028

Studieafslutning (Anslået)

1. januar 2028

Datoer for studieregistrering

Først indsendt

11. juli 2026

Først indsendt, der opfyldte QC-kriterier

11. juli 2026

Først opslået (Faktiske)

16. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

16. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

11. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 36265MD41027/1/6

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

The data will be available upon a reasonable request from the corresponding author after the end of study for one year.

IPD-delingstidsramme

After the end of study for one year.

IPD-delingsadgangskriterier

The data will be available upon a reasonable request from the corresponding author.

IPD-deling Understøttende informationstype

  • STUDY_PROTOCOL

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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Kliniske forsøg med Lufthæmmelsestryk

Kliniske forsøg med Pressure support ventilation protocol

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Sponsorer og samarbejdspartnere

Medicinske tilstande

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CROs by country

CROs in Papua New Guinea

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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