- ICH GCP
- US Clinical Trials Registry
- Klinisk utprøving NCT07709182
Airway Occlusion Pressure (P0.1) Guided Pressure Support Ventilation Versus Conventional Management in Weaning Window Patients
Airway Occlusion Pressure (P0.1) Guided Pressure Support Ventilation Versus Conventional Management in Weaning Window Patients: A Randomized Controlled Trial
Studieoversikt
Status
Forhold
Detaljert 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.
Studietype
Registrering (Antatt)
Fase
- Ikke aktuelt
Kontakter og plasseringer
Studiekontakt
- Navn: Muhammad A Kandil, MSc
- Telefonnummer: 00201022644722
- E-post: muhammad.kandil@med.tanta.edu.eg
Studiesteder
-
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Al Gharbia
-
Tanta, Al Gharbia, Egypt, 31527
- Rekruttering
- Tanta University
-
Underetterforsker:
- Aliaa M Belal, MD
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Underetterforsker:
- Taysser M Abdalraheem, MD
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Underetterforsker:
- Sohair M Soliman, MD
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Ta kontakt med:
- Muhammad A Kandil, MSc
- Telefonnummer: 00201022644722
- E-post: muhammad.kandil@med.tanta.edu.eg
-
Underetterforsker:
- Ghada F Elbaradey, MD
-
-
Deltakelseskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
- Voksen
- Eldre voksen
Tar imot friske frivillige
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
Hvordan er studiet utformet?
Designdetaljer
- Primært formål: Behandling
- Tildeling: Randomisert
- Intervensjonsmodell: Parallell tildeling
- Masking: Enkelt
Våpen og intervensjoner
Deltakergruppe / Arm |
Intervensjon / Behandling |
|---|---|
|
Aktiv komparator: Group I (Control Group)
Patients will receive a conventional pressure support ventilation protocol.
|
Patients will receive a conventional pressure support ventilation protocol.
|
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Eksperimentell: Group II (Study Group)
Patients will receive airway occlusion pressure (P0.1)-guided pressure support ventilation (PSV).
|
Patients will receive airway occlusion pressure (P0.1)-guided pressure support ventilation (PSV).
|
Hva måler studien?
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
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 |
Tiltaksbeskrivelse |
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)
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The length of stay in the intensive care unit (ICU) will be recorded from ICU admission to ICU discharge.
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Till the discharge from intensive care unit (Up to 28 days)
|
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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
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Day 28 after the procedure
|
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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
|
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Failed weaning
Tidsramme: 48 hours after extubation
|
"Failed weaning" is defined as reintubation within 48 hours after extubation.
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48 hours after extubation
|
Samarbeidspartnere og etterforskere
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Primær fullføring (Antatt)
Studiet fullført (Antatt)
Datoer for studieregistrering
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
- 36265MD41027/1/6
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
IPD-planbeskrivelse
IPD-delingstidsramme
Tilgangskriterier for IPD-deling
IPD-deling Støtteinformasjonstype
- STUDY_PROTOCOL
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