Automated Analysis of EIT Data for PEEP Setting

NCT ID: NCT03653806

Last Updated: 2020-11-05

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

40 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-11-21

Study Completion Date

2020-05-31

Brief Summary

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First: to develop a computerized algorithm for automated analysis of the electrical impedance tomography (EIT) data. The algorithm calculates the "optimal" positive end-expiratory pressure (PEEP) and inspiratory pressure defined as the "optimal" balance between stretch, ventilation distribution and collapse.

Second: to compare the results of the algorithm with the current standard of care clinical judgement of an experienced ventilation practitioner.

Detailed Description

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The study will be performed at the Intensive Care Unit, Maastricht University Medical Centre. The investigators routinely apply EIT (Pulmovista, Dräger, Lübeck. Germany) in mechanically ventilated patients to optimize the ventilator settings .

An algorithm will be developed by the Institute of Technical Medicine, Furtwangen University, Germany. The algorithm will automatically detect changes in both PEEP and inspiratory pressures. For each PEEP step and/or changes in inspiratory pressure the difference in regional alveolar overdistension and alveolar collapse will be calculated. This makes it possible to select the optimal ventilator setting depending on the best compromise between alveolar overdistension and alveolar collapse.

The algorithm will be tested in 40 EIT guided mechanically ventilated patients. EIT measurements will be performed during an incremental and decremental PEEP trial. The EIT measurement will be performed in the same way as during standard clinical care. EIT data will be analysed offline by a ventilation practitioner with experience in EIT and with the newly developed algorithm. The resulting advice on optimal ventilator settings will be compared for inter-observer variability.

Conditions

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Acute Hypoxemic Respiratory Failure Post-cardiac Surgery

Study Design

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Observational Model Type

OTHER

Study Time Perspective

PROSPECTIVE

Interventions

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computerized algorithm for automated analysis

First: to develop a computerized algorithm for automated analysis of the electrical impedance tomography (EIT) data. The algorithm calculates the "optimal" positive end-expiratory pressure (PEEP) and inspiratory pressure defined as the "optimal" balance between stretch, ventilation distribution and collapse.

Second: to compare the results of the algorithm with the current standard of care clinical judgement of experienced EIT users

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Mechanically ventilated in a volume or pressure controlled mode
* ventilator settings guided by EIT

Exclusion Criteria

* Participants who specifically opt-out regarding the use of the data for research purpose
* Internal pacemaker, Implantable Cardioverter Defibrillator
* Skin lesions, dressings at the thorax, hindering belt placement
* Thoracic circumference \< 70 cm
* Thoracic circumference \> 150 cm
* BMI \> 50
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital Schleswig-Holstein

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

Maastricht University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Dennis Bergmans

Role: STUDY_CHAIR

Maastricht University Medical Center

Locations

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Serge Heines

Maastricht, , Netherlands

Site Status

Countries

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Netherlands

References

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Bodenstein M, David M, Markstaller K. Principles of electrical impedance tomography and its clinical application. Crit Care Med. 2009 Feb;37(2):713-24. doi: 10.1097/CCM.0b013e3181958d2f.

Reference Type BACKGROUND
PMID: 19114889 (View on PubMed)

Costa EL, Borges JB, Melo A, Suarez-Sipmann F, Toufen C Jr, Bohm SH, Amato MB. Bedside estimation of recruitable alveolar collapse and hyperdistension by electrical impedance tomography. Intensive Care Med. 2009 Jun;35(6):1132-7. doi: 10.1007/s00134-009-1447-y. Epub 2009 Mar 3.

Reference Type BACKGROUND
PMID: 19255741 (View on PubMed)

Long Y, Liu DW, He HW, Zhao ZQ. Positive End-expiratory Pressure Titration after Alveolar Recruitment Directed by Electrical Impedance Tomography. Chin Med J (Engl). 2015 Jun 5;128(11):1421-7. doi: 10.4103/0366-6999.157626.

Reference Type BACKGROUND
PMID: 26021494 (View on PubMed)

Other Identifiers

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17-4-053

Identifier Type: -

Identifier Source: org_study_id