Transpulmonary Pressure Gradients in High Frequency Oscillation (TPG in HFO)

This study is currently recruiting participants.
Verified December 2011 by University of British Columbia
Sponsor:
Information provided by (Responsible Party):
University of British Columbia
ClinicalTrials.gov Identifier:
NCT01321398
First received: March 21, 2011
Last updated: December 9, 2011
Last verified: December 2011

March 21, 2011
December 9, 2011
October 2010
March 2012   (final data collection date for primary outcome measure)
To demonstrate the proof of concept that esophageal pressures can easily be obtained in patients undergoing HFO. [ Time Frame: 60 minutes ] [ Designated as safety issue: No ]
Same as current
Complete list of historical versions of study NCT01321398 on ClinicalTrials.gov Archive Site
To determine the transpulmonary pressure gradient in critically ill patients receiving HFO [ Time Frame: 60 minutes ] [ Designated as safety issue: No ]
Same as current
Not Provided
Not Provided
 
Transpulmonary Pressure Gradients in High Frequency Oscillation
Transpulmonary Pressure Gradients in High Frequency Oscillation Study

Patients with severe lung conditions occasionally require support with a special ventilator (breathing machine) called the High Frequency Oscillator (HFO). Effective ventilation requires that the pressure generated by the ventilator be as high as possible but not too high as this can damage the lungs. In patients on HFO, there is not a well defined way to measure this pressure. We will insert a small probe into the esophagus of patients on HFO to see if this is an accurate way to measure lung pressures for these patients. A better understanding of these pressures could lead to improved patient care.

Trials have found that the use of lower tidal volumes (6 ml/kg) during conventional mechanical ventilation decreases morbidity and mortality. Compared to conventional ventilation, high frequency oscillation (HFO) is able to provide much smaller tidal volumes (1.1 - 2.5 ml/kg) and thus theoretically may provide additional lung protection. At this time, while trials of HFO in adults have been inconclusive, the use of HFO for the management of ALI/ARDS has become widespread

Patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) are critically ill and have a high mortality associated with their illness (approximately 50%). Currently, esophageal pressure monitors are used to optimize inflation pressures and improve oxygenation in conventional mechanical ventilation in patients with ALI/ARDS. With this in mind, the purpose of this study is twofold: (1) demonstrate that esophageal pressure monitors can easily be inserted in patients undergoing HFO and (2) report the transpulmonary pressures in these patients.

Observational
Observational Model: Cohort
Time Perspective: Prospective
Not Provided
Not Provided
Non-Probability Sample

Critically Ill

Acute Lung Injury
Other: Esophageal Pressure Monitoring
An esophageal pressure monitor will be placed through the mouth into the esophagus by a study physician. Placement will be confirmed by a bedside chest X-ray. Once placement has been confirmed all air will be evacuated from the balloon by syringe. One ml of air will then be injected to partially inflate the esophageal balloon. Pleural pressure measurements will be recorded after 1 minute without spontaneous breathing or patient care related movement. This measurement will be repeated at 30 minutes and at 60 minutes after the first measurement. Trans-pulmonary pressure is calculated as the difference between esophageal pressure and mouth pressure. Once the measurements have been recorded, the catheter will be removed.
Critically Ill patients receiving HFO
Intervention: Other: Esophageal Pressure Monitoring
Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruiting
8
July 2012
March 2012   (final data collection date for primary outcome measure)

Inclusion Criteria:

  • 19 years of age or older
  • Receiving HFO
  • Informed Consent Obtained

Exclusion Criteria:

  • Esophageal lesions or esophageal surgery within the last 6 months
  • Morbid obesity - defined as a Body Mass Index (BMI) > 40
  • Unstable cervical spine injury or cervical spinal cord injury
Both
19 Years and older
No
Contact: William R Henderson, FRCPC 604-875-5949 william.henderson@vch.ca
Contact: Denise A Foster, RN, CCRP 604-875-4111 ext 68336 denise.foster@vch.ca
Canada
 
NCT01321398
H10-02087
No
University of British Columbia
University of British Columbia
Not Provided
Principal Investigator: William R Henderson, FRCPC Universtiy of British Columbia
University of British Columbia
December 2011

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP