Adherence to Low Tidal Volume in the Transition to Spontaneous Ventilation in Patients With Acute Respiratory Failure

Launched by UNIVERSITY OF SAO PAULO GENERAL HOSPITAL · Sep 11, 2023

Keywords

ClinConnect Summary

This clinical trial is studying how well patients with acute respiratory failure adapt to a type of breathing support called low tidal volume ventilation. This method uses lower amounts of air per breath, which can help protect the lungs during recovery. The researchers want to find out how often this method is used in the first 24 hours after patients start breathing on their own, and whether using it helps patients recover better and stay off the ventilator longer.

To participate in this study, patients need to be over 18 years old and must be experiencing a specific type of breathing problem called hypoxemic acute respiratory failure, which means they have a low level of oxygen in their blood. Participants will be monitored for 28 days, during which researchers will gather information about their breathing support and health outcomes, such as how many days they spend without needing the ventilator and whether they survive. It's important to note that certain patients, like those with tracheostomies or severe brain injuries, will not be eligible for this study.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age \> 18 years
• • Patients with hypoxemic ARF, defined as a PaO2/FIO2 ratio \<300 mmHg, under controlled invasive mechanical ventilation, with an expected duration of MV of at least 24h.
• • Patients transitioning to spontaneous ventilation modes (PSV, PAV Plus, NAVA or APRV)
• Exclusion Criteria:
• • Tracheostomized patients.
• • Decision not to maintain or add life support measures on the day of assessment (palliative care).
• • Patient in ECMO.
• • Air fistula or barotrauma that prevents adequate tidal volume monitoring.
• • Severe injuries to the central nervous system that result in abolished or very high respiratory drive, for whom it is not possible to maintain protective tidal volume.