Dead Space in Mechanical Ventilation With Constant Expiratory Flow

Status: Recruiting
Location: See location...
Intervention Type: Device
Study Type: Interventional
Study Phase: Not Applicable
SUMMARY

Conventional continuous mandatory mechanical ventilation relies on the passive recoil of the chest wall for expiration. This results in an exponentially decreasing expiratory flow. Flow controlled ventilation (FCV), a new ventilation mode with constant, continuous, controlled expiratory flow, has recently become clinically available and is increasingly being adopted for complex mechanical ventilation during surgery. In both clinical and pre-clinical settings, an improvement in ventilation (CO2 clearance) has been observed during FCV compared to conventional ventilation. Recently, Schranc et al. compared flow-controlled ventilation with pressure-regulated volume control in both double lung ventilation and one-lung ventilation in pigs. They report differences in dead space ventilation that may explain the improved CO2 clearance, although their study was not designed to compare dead space ventilation within the group of double lung ventilation. Dead space ventilation, or wasted ventilation, is the ventilation of hypoperfused lung zones, and is clinically relevant, as it is a strong predictor of mortality in patients with the acute respiratory distress syndrome (ARDS) and is correlated with higher airway driving pressures which are thought to be injurious to the lung (lung stress). This trial aims to study the difference in dead space ventilation between conventional mechanical ventilation in volume-controlled mode and flow controlled-ventilation.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 70
Healthy Volunteers: f
View:

• Adults \[18-70\] yrs

• General anaesthesia for elective surgery

• Arterial line, central venous line and endotracheal tube as part of standard of care

• Expected duration of controlled mechanical ventilation ≥ 60 minutes

• Supine position (0±10°)

Locations
Other Locations
Belgium
Antwerp University Hospital (UZA)
RECRUITING
Edegem
Contact Information
Primary
Carine Smitz
carine.smitz@uza.be
+32 3 821 49 30
Backup
Joke De Wachter
joke.dewachter@uza.be
+32 3 821 30 42
Time Frame
Start Date: 2024-07-22
Estimated Completion Date: 2026-04-30
Participants
Target number of participants: 13
Treatments
Experimental: FCV-VCV
After titration of ventilation in baseline VCV (all arms), participants will first receive 20 min of baseline-matched FCV and subsequently 20 min of baseline-matched VCV.
Experimental: VCV-FCV
After titration of ventilation in baseline VCV (all arms), participants will first receive 20 min of baseline-matched VCV and subsequently 20 min of baseline-matched FCV.
Sponsors
Leads: University Hospital, Antwerp
Collaborators: Universiteit Antwerpen

This content was sourced from clinicaltrials.gov